Abstract
This study explored the influence of healthy vending contracts (HVC) on the nutritional quality of vending machine products in 46 Canadian publicly funded recreation and sport facilities. A quasi-experimental comparison design was used to examine the difference in nutritional quality of snack and beverage vending machine products at baseline (December 2015–May 2016) and 18-month follow-up. Staff Surveys assessed facility contract type (HVC or conventional) and vending machine audits identified product nutritional quality. Products were categorized by provincial guidelines as Do Not Sell (DNS), Sell Sometimes (SS) or Sell Most (SM). ANOVA compared categories cross-sectionally (HVC vs conventional) and repeated measures ANOVA compared them longitudinally (HVC-HVC, vs conventional-conventional and conventional-HVC).Approximately one quarter of contracts (24% beverage and 28% snack) had health stipulations at baseline or follow-up. Cross-sectionally, facilities with HVC at any time period had significantly lower percentage DNS (beverage: 56% vs 73%, p = 0.001; snack: 55% vs 85%, p < 0.001), higher SS (beverage: 24% vs 14%, p = 0.003; snack: 35% vs 12%, p < 0.001) and higher SM Products (beverage: 21% vs 13%, p = 0.030; snack: 10% vs 3%, p < 0.003). Longitudinally, facilities with consistent HVC or that changed to HVC showed greater decreases in DNS products over time (p < 0.050).Although less healthy products were still highly prevalent, facilities with HVC or that changed to HVC had fewer unhealthy products available in their vending machines over time compared to those without HVCs. Healthy vending contracts appear to be an effective change strategy.
Highlights
A majority of Canadian children are not consuming healthy diets (Rao et al, 2017). This is concerning considering the association between unhealthy food consumption and increasing rates of childhood obesity (World Health Organization, 2016; Public Health Agency of Canada, 2011); the health repercussions of which persist throughout the life course and place a substantial burden on individuals, broader society and economies worldwide (Vallgårda, 2018)
In Canada, unhealthy food environments are commonplace in public facilities (Raine et al, 2018), including recreation and sport centres (Thomas and Irwin, 2010; Naylor et al, 2010; Chaumette et al, 2009; Olstad et al, 2019) which are frequently visited by children (Thomas and Irwin, 2010; Naylor et al, 2010; Olstad et al, 2011a)
The availability of healthy products differed based on contract type for both snack and beverage vending machines, with higher percentages of Sell Most (SM) and SS products and lower Do Not Sell (DNS) products in facilities with healthy vending contracts (HVC) compared to facilities with conventional contracts
Summary
A majority of Canadian children are not consuming healthy diets (Rao et al, 2017). This is concerning considering the association between unhealthy food consumption and increasing rates of childhood obesity (World Health Organization, 2016; Public Health Agency of Canada, 2011); the health repercussions of which persist throughout the life course and place a substantial (and often inequitable) burden on individuals, broader society and economies worldwide (Vallgårda, 2018). In Canada, unhealthy food environments are commonplace in public facilities (Raine et al, 2018), including recreation and sport centres (Thomas and Irwin, 2010; Naylor et al, 2010; Chaumette et al, 2009; Olstad et al, 2019) which are frequently visited by children (Thomas and Irwin, 2010; Naylor et al, 2010; Olstad et al, 2011a) This contributes to the childhood obesity epidemic, and contradicts their responsibility to provide conditions that are conducive to the good health of citizens (Raine et al, 2018), and may undermine efforts to address unhealthy food environments in other settings (Olstad et al, 2011a; Engler-Stringer et al, 2014; Olstad et al, 2013)
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