Are laws restricting soft drinks sales in Brazilian schools able to lower their availability?

Camila Zancheta Ricardo,Catarina Machado Azeredo,Maria Alvim Leite,Renata Bertazzi Levy,Fernanda Rauber

doi:10.11606/s1518-8787.2020054001227

Camila Zancheta Ricardo, Catarina Machado Azeredo + Show 3 more

Open Access

https://doi.org/10.11606/s1518-8787.2020054001227

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Abstract

ABSTRACTOBJECTIVE To describe students protected by laws and exposed to soft drinks sales and assess whether forbidding laws are associated with lower availability of these beverages.METHODS We identified laws forbidding non-government administered cafeterias or sales of soft drinks in schools in the 27 Brazilian state capitals. Data on soft drinks sales were obtained from Pesquisa Nacional de Saúde do Escolar 2015 (PeNSE – National Survey of School Health 2015), for a representative sample of 9th graders from public and private schools. Students were attributed with the status of their school regarding the law and sale of soft drinks. Co-variables were school status (public or private), school size, geographic regions, mother’s educational level, score of goods and services. We performed multivariate analyses using Poisson regression.RESULTS The total of 23 laws forbidding sales of soft drinks covered 63.0% of capitals, comprising 56.9% of students. Law coverage was higher among students from more developed regions (67.6%) and in public schools (60.6%), compared with those from less developed regions (38.0%) and private schools (45.8%). Soft drinks were available for 33.9% of students. Students attending public schools in less developed regions had the lowest availability of soft drinks, regardless of law coverage (14.8%; 12.0%); while students attending private schools in these regions had a high availability, regardless of law coverage (82.1%; 73.4%). Restrictive laws were associated with lower sales of soft drinks in more developed regions, and restrictions had a greater association with the availability of soft drinks in public schools (PR = 0.25; 95%CI = 0.15-0.41), compared with private schools (PR = 0.48; 95%CI = 0.35-0.66).CONCLUSION Laws restricting soft drinks in schools were associated with fewer sales in more developed regions. Private schools were less compliant with the law than public schools. A broadly enforced national law could reduce the availability of soft drinks in schools.

Highlights

Sugar-sweetened beverages (SSB) are highly consumed worldwide[1,2], and soft drinks are the top source of calories from SSB among adolescents[3]
Law coverage was higher among students from more developed regions (67.6%) and in public schools (60.6%), compared with those from less developed regions (38.0%) and private schools (45.8%)
Students attending public schools in less developed regions had the lowest availability of soft drinks, regardless of law coverage (14.8%; 12.0%); while students attending private schools in these regions had a high availability, regardless of law coverage (82.1%; 73.4%)

Summary

Introduction

Sugar-sweetened beverages (SSB) are highly consumed worldwide[1,2], and soft drinks are the top source of calories from SSB among adolescents[3]. School food environment may increase soft drinks consumption and, health risks. Studies carried out in several countries found an association between the availability of unhealthy foods in schools and a higher consumption of these foods by students[9,10,11,12]. This is a consequence of the easy access and the daily exposure to unhealthy foods[13]. Laws restricting unhealthy foods and beverages in school environments might be an effective strategy to prevent and control childhood obesity and other diet-related non-communicable diseases[14,15]

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