Comparison of Food Availability in School Stores in Seoul, South Korea Before and After Implementation of Two National Food‐ and Nutrient‐Based Policies

Abstract

Public health interest in preventing childhood obesity and chronic diseases by improving school food environments has been growing around the world. As part of this movement, the South Korean government implemented two policies restricting unhealthy food sales in school stores: 1) a food‐based policy enacted in 2007 restricts specific food sales (e.g., soft drinks), and 2) a nutrient‐based policy enacted in 2009 restricts energy‐dense, nutrient‐poor (EDNP) food sales in school stores. The purpose of the study was to assess the effects of the two policies on the school store food environment.Foods sold in stores located in middle and high schools in Seoul, South Korea were observed before (2006, 15 stores) and after (2013, 12 stores) implementation of the two school store policies. After controlling for the total number of food types offered in school stores and school characteristics (school level, private/public, students’ sex, and income level), numbers and percentages of food types in each category were compared between 2006 and 2013. Also, number and percentage of EDNP foods in 2013 were examined using mixed models with school districts as random effects. All statistical analyses were conducted using SAS 9.4 (SAS Institute, Inc., Cary, NC).The mean number of food types offered in school stores was significantly higher in 2013 (102.3 items) than in 2006 (41.1 items; p<0.001), even after adjusting for school characteristics (p=0.022). When controlling for the total number of food types and school characteristics, the mean number of soft drinks offered in a school store in 2013 (0.3 items) was significantly lower than in 2006 (1.9 items, p=0.032). Soft drinks, the target of the 2007 policy, were still available in 50% of school stores observed in 2013, while 60% of school stores observed in 2006 offered soft drinks. In contrast, EDNP foods, the target of the 2009 policy, were available in all school stores observed in 2013, and represented about 7.6% of food types offered.In school stores in South Korea, a food‐based policy that prohibits soft drinks appears to have been more effective for decreasing availability of restricted items than a nutrient‐based policy. Neither of the two policies, however, eliminated access to unhealthy foods in school stores. To improve school store food environments, alternative strategies such as requiring healthy food sales are likely needed.Support or Funding InformationThis study was supported by the Walker Institute of International and Area Studies, University of South Carolina.