Promo%ons for Healthy and Unhealthy Foods in Minnesota Schools,

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1 Promo%ons for Healthy and Unhealthy Foods in Minnesota Schools, Nicole Larson PhD, MPH, RDN Division of Epidemiology and Community Health School of Public Health University of Minnesota

2 Acknowledgements Authorship Team Marilyn S. Nanney PhD, MPH, RD 1 Brandon Coombes 2 Caitlin Caspi, ScD 1 Cynthia S. Davey MS 2 Martha Y. Kubik PhD, RN 3 Nicole Larson, PhD, MPH, RDN 4 Toben F. Nelson, ScD 4 Affilia%ons University of Minnesota Dept. of Family Medicine & Community Health 1 Clinical and TranslaPonal Science InsPtute 2 School of Nursing 3 School of Public Health 4 NO CONFLICT OF INTEREST TO REPORT

3 Acknowledgements Funding: NaPonal InsPtute of Child Health and Human Development (5R01HD , PI: M.S. Nanney). Publica%ons: Larson N, Davey CS, Coombes B, Caspi C, Kubik MY, and Nanney MS. Food and beverage promopons in Minnesota secondary schools: secular changes, correlates, and associapons with adolescents dietary behaviors. J Sch Health. In press.

4 Best Prac%ces for Promo%ng Healthy Foods Engagement Strategies Provide calorie and nutripon informapon for foods available at school Conduct taste tests Provide nutripon lessons in school cafeteria IdenPfy preferred healthy foods Environmental Strategies Price healthy foods at a lower cost Label healthy foods with appealing names Display fruits and vegetables accessibly Display fruits and vegetables a\racpvely

5 Adver%sing for Unhealthy Foods Food and beverage marketers spent $149 million on in school markepng in 2009 Students are vulnerable to markepng, parpcularly when it is lent legipmacy by placement in school se_ngs Policies are needed to limit in school exposure to adverpsing for energy dense, nutrient poor foods (e.g., soa drinks)

6 Outline Have there been secular changes in the implementapon of healthy food promopon strategies from ? Overall rates DispariPes by school characterispcs Have there been secular changes in policies that prohibit adverpsing for unhealthy food from ? Overall rates DispariPes by school characterispcs Are school efforts to coordinate health improvements related to implementapon of strategies and policies? Are schools that implement healthy food promopon strategies more likely to implement adverpsing policies? Do food promopon strategies and adverpsing policies support healthy dietary behaviors?

7 Engagement Strategies, % of 40 schools Provide calorie and nutripon informapon Conduct taste tests Provide nutripon lessons in cafeteria IdenPfy preferred healthy foods

8 Environmental Strategies, % of 40 schools Price healthy foods Label healthy foods at lower cost with appealing names 75 Display fruits and vegetables accessibly 68 Display fruits and vegetables a\racpvely

9 Healthy Food Promo%on Strategies: Significant trends over Pme by school locapon and free/reduced price meal eligibility Conduct Taste Tes%ng Price Healthy Foods at Lower Cost

10 Dispari%es in Implementa%on, 2012 School locapon Town/rural: fewer environmental strategies overall School level Middle schools: less use of price incenpves Free/reduced price lunch eligibility >40% eligible: lower accessibility of fruits and vegetables, less likely to provide nutripon lessons

11 Policies Banning Adver%sing, p value Prevalence by school locapon (%) Building Grounds Buses PublicaPons Banned adverpsing score (mean)* *Number of locapons where adverpsing of unhealthy foods and beverages were banned

12 Significant trends over %me by school loca%on Prohibit advertising in school publications

13 Dispari%es in Adver%sing Policies, School locapon Town/rural: less likely to prohibit adverpsing on school grounds School level High schools: less likely to prohibit adverpsing in the school building, on school grounds, on buses, and in publicapons Free/reduced price meal eligibility No disparipes observed

14 Linkages with School Efforts to Coordinate Health Improvement Banned AdverPsing Policies: No associapon with any measure of efforts to coordinate school health improvements Healthy PromoPon Strategies: ImplementaPon linked to greater diversity of stakeholders on school health councils

15 Adver%sing Policies and Environmental Strategies Number of 1.5 implemented strategies Number of loca%ons where adver%sing of unhealthy foods/beverages was banned

16 Linkages with Students Dietary Behaviors Banned AdverPsing Policies: No associapon with student fruit/vegetable or sugarsweetened beverage intake Healthy Food Price IncenPves: ImplementaPon linked to greater fruit/vegetable intake only among 12 th grade students No associapon with student sugar sweetened beverage intake

17 Conclusions Li\le change from in the use of strategies to promote healthy eapng Li\le change in efforts to limit exposure to adverpsing for unhealthy foods Town/rural schools lagged behind city and suburban schools PosiPve influence of school health councils Price incenpves promoted healthy choices