Sale Of Soft Drinks Research Articles

Evaluating the impact of marketing interventions on sugar-free and sugar-sweetened soft drink sales and sugar purchases in a fast-food restaurant setting

BackgroundBeverages high in added sugar, such as sugar-sweetened soft drinks, continue to be associated with various health issues. This study examines the effects of a manufacturer-initiated multicomponent intervention on the sales of sugar-free (SFD) and sugar-sweetened (SSD) soft drinks and the amount of sugar people purchase from soft drinks in a fast-food restaurant setting.MethodsA database of monthly sales data of soft drinks from January 2016 to December 2018 was obtained from three treatment and three control fast-food restaurants. A multicomponent intervention consisting of free coupons, point-of-purchase displays, a menu board, and two sugar-free replacements for sugar-sweetened soft drinks was introduced in August 2018 for five months in Western Sydney, Australia. A retrospective interrupted time series analysis was used to model the data and examine the effects of the interventions on SFD and SSD sales and their consequential impact on sugar purchases from soft drinks. The analyses were carried out for volume sales in litres and sugar in grams per millilitre of soft drinks sales. A comparison of these measures within the treatment site (pre- and post-intervention) and between sites (treatment and control) was conducted.ResultsThe interventions had a statistically significant impact on SFDs but not SSDs. On average, SFD sales in the treatment site were 56.75% higher than in the control site. Although SSD sales were lower in the treatment site, the difference with the control site was not statistically significant. The net reduction of 6.34% in the amount of sugar purchased from soft drinks between sites during the experimental period was attributed to the interventions.ConclusionsThe interventions significantly increased SFD sales and reduced sugar purchases in the short run. Aside from free coupons, the findings support the recommendation for fast food restaurants to nudge customers towards choosing SFDs through point-of-purchase displays and the replacement of popular SSDs with their SFD counterparts.

Evaluation of the Biochemical, Physicochemical and Microbiological Quality of Soft Drinks Sold in Some Elementary School of Williamsville (Abidjan, Côte d’Ivoire)

The sale of soft drinks in and around primary schools is recurrent in Côte d'Ivoire. The objective of this work is to evaluate the rate of some biochemical and physicochemical parameters and the health risks related to the consumption of soft drinks. The biochemical and physicochemical parameters were determined according to the standard SOXHLET technique, that of Kjeldhal and also that described by Dubois et al in1956. Potentially pathogenic and pathogenic germs were enumerated and researched according to reference methods described by AFNOR. The moisture content of the different beverages ranged from 3.9±0.05 to 3.2±0.05, and the sugar content from 26.06±2.05 to 5.96±1.60. For the acidity, the higher value was 0.93± 0.15 (Bissap juice) and the lowest was 0.64± 0.02 (Tamarind juice). For proteins, the high value was 44.15 ± 0.11 (Milk Mint Juice) and the low value was 38.15 ± 0.11 (Ginger Juice). As for dry matter, the highest value was found in ginger juice (44.76 ±0.02) and the lowest in bissap juice (40.96 ±0.01). Soft drinks sold in Williamsville schools contain such potentially pathogenic species as Staphylococcus aureus and Bacillus cereus with a wide range of loadings in the drinks. Escherichia coli was not identified. No Salmonella was observed in the different soft drinks analyzed. The presence of potentially pathogenic germs could pose a danger to school children.

Decision making in inventory control by using artificial neural networks

The purpose of this work is to increase the sales of a store devoted to the purchase and sale of soft drinks, even though the store's inventory is overstocked. This occurs as a result of the business's lack of an effective management system that controls product ordering. Additionally, there is no analysis of future sales owing to the variations that may occur because of unforeseen occurrences. The main criterion was that the proprietors of the business submit monthly records from 2017 to July 2019. To accomplish this objective completely, we used the Monte Carlo simulation method to obtain data from August to December 2019; and neural networks to obtain data for all monthly periods in the years 2020, 2021, and 2022, which enabled us to generate records of demand and stock for each of the products. Finally, it was shown that the application of neural networks enables the solution of vehicle control issues, resulting in a maximization of more than 22% of sales, thus achieving the goal and giving an optimum solution to the company.

Characteristics of the School Food Environment Affect the Consumption of Sugar-Sweetened Beverages Among Adolescents.

Sugar-sweetened beverages are widely available and accessible in school environment, and their presence and characteristics of this environment can influence their consumption. This study examines the association of drinking fountains per 100 students, soft drink sales, soft drink advertising, and the presence of street vendors and sugar-sweetened beverages consumption among adolescents in Brazil. This cross-sectional study was carried out using data from the Study of Cardiovascular Risk in Adolescents that was conducted between March 2013 and December 2014. The sample comprised 71,475 adolescents aged 12–17 years from 1,247 public and private schools in Brazilian cities. Sugar-sweetened beverages consumption was the dependent variable. The main effect was the school food environment, which was evaluated based on drinking fountains per 100 students, soft drink sales, soft drink advertising, and the presence of street vendors. Public and private schools that sold soft drinks were associated with higher average sugar-sweetened beverages consumption among adolescents. Our study highlights the importance of creating healthy school food environments by banning sugar-sweetened beverages in schools accordingly.

Is the development of obesogenic food environments a self-reinforcing process? Evidence from soft drink consumption

BackgroundUnderstanding how the development of obesogenic food environments and the consumption of ultra-processed foods and beverages influence each other can help policymakers to identify effective ways to curb the current obesity epidemic. This paper was designed to investigate whether, and to what extent, the consumption of soft drinks and the prevalence of obesity are linked through feedback effects.MethodsAn ecological study design and a simultaneous equation model were used to investigate the existence of a vicious cycle between the consumption of soft drinks and the prevalence of obesity. The analysis was based on a longitudinal dataset covering per capita sales of soft drinks, the age-standardised prevalence rate of obesity and several demographic and socio-economic control variables in a sample of 98 countries worldwide for the period 2005–2019.ResultsUsing a Two-Stage Least Squares (2SLS) regression model with fixed effects, we documented a self-reinforcing process that links consumption and obesity. Changes in the spread of obesity were associated with changes in soft drink consumption: a one-unit increase in the age-adjusted prevalence rate of obesity increased consumption by about 2.39 l per person per year. Similarly, as the consumption of soft drinks rose, so did the prevalence of obesity: the age-adjusted rate of obesity increased by 0.07% for every additional litre consumed per capita. Computing the impact multipliers, we found that the outcome of a one-unit decrease in the average price of soft drinks was twofold: a) the prevalence of obesity increased by around 0.17%; and b) consumption increased by around 2.40 l per person, the sum of the increase directly caused by the price reduction (2 l) and the increase due to the interplay between consumption and obesity (0.4 l).ConclusionsThis study has identified a feedback loop between unhealthy habits (i.e. the consumption of soft drinks) and health outcomes (i.e. the prevalence of obesity). This interplay amplifies the impact of any exogenous changes in the determinants of consumption and obesity. These feedback effects should be considered and exploited in planning effective strategies to tackle the burden of obesity and the global epidemic of non-​communicable diseases.

The causal impact of sugar taxes on soft drink sales: evidence from France and Hungary

Sugar-sweetened beverages (SSBs) are associated with increased body weight and obesity, which induce a wide array of health impairments such as diabetes or cardiovascular disorders. Excise taxes have been introduced to counteract SSB consumption. We investigated the effect of sugar taxes on SSB sales in Hungary and France using a synthetic control approach. For France, we found a slight decrease in SSB sales after tax implementation while overall soft drink sales increased. For Hungary, there was only a short-term decrease in SSB sales which disappeared after 2 years, leading to an overall increase in SSB sales. However, both effects are characterized by great uncertainty.

Impact of sugar-sweetened beverage taxes on price, import and sale volumes in an island: interrupted time series analysis.

To evaluate the impact of changes in import tariffs on sweetened beverages. Interrupted time series analysis was used to examine sweetened beverage tariff increases of 40-60 % in 2008 and to 75 % in 2012, and an approximately 11 % decrease in 2014 when an excise tax replaced the tariff. Post-tax trends were compared with a counterfactual modelled on the pre-tax trend for: quarterly price of an indicator beverage, monthly beverage import volumes (both 2001-2017) and quarterly sales volumes (2012-2017). In a controlled analysis, taxed beverage imports were compared with a sugary snacks control. Cook Islands. NA. In the first year, after the 2008 tariff increase the price of the selected indicator soft drink increased by 7·3 % (95 % CI 6·3 %, 8·3 %) but after the 2012 tariff increase it decreased by 13·9 % (95 % CI -14·9 %, -12·8 %). At the same time, the import volumes of taxed beverages decreased by 13·2 % (95 % CI -38·1 %, 17·8 %) and 2·9 % (95 % CI -41·6 %, 72·5 %), respectively, and decreased by 24·8 % (95 % CI -36·9, -9·8) and 10·2 % (95 % CI -37·1, 37·5) in the controlled analysis. After the 2014 tax decrease, the price of the indicator soft drink decreased by 23·6 % (95 % CI -26·0 %, -21·1 %), sweetened beverage imports increased by 4·5 % (95 % CI -39·5 %, 156·0 %) and sales of full-sugar soft drinks increased by 31 % (95 % CI -21 %, 243 %). The increased import tariffs on sweetened beverages appeared to be effective for reducing import volumes, but this was partly reversed by the reduced tax/tariff in 2014.

Reductions in sugar sales from soft drinks in the UK from 2015 to 2018

BackgroundThe consumption of free sugars in the UK is more than double the guideline intake for adults and close to triple for children, with soft drinks representing a significant proportion. The aim of this study was to assess how individual soft drink companies and consumers have responded to calls to reduce sugar consumption, including the soft drink industry levy (SDIL), between 2015 and 2018.MethodsThis was an annual cross-sectional study using nutrient composition data of 7377 products collected online, paired with volume sales data for 195 brands offered by 57 companies. The main outcome measures were sales volume, sugar content and volume of sugars sold by company and category, expressed in total and per capita per day terms.ResultsBetween 2015 and 2018, the volume of sugars sold per capita per day from soft drinks declined by 30%, equivalent to a reduction of 4.6 g per capita per day. The sales-weighted mean sugar content of soft drinks fell from 4.4 g/100 ml in 2015 to 2.9 g/100 ml in 2018. The total volume sales of soft drinks that are subject to the SDIL (i.e. contain more than 5 g/100 ml of sugar) fell by 50%, while volume sales of low- and zero-sugar (< 5 g/100 ml) drinks rose by 40%.ConclusionAction by the soft drinks industry to reduce sugar in products and change their product portfolios, coupled with changes in consumer purchasing, has led to a significant reduction in the total volume and per capita sales of sugars sold in soft drinks in the UK. The rate of change accelerated between 2017 and 2018, which also implies that the implementation of the SDIL acted as an extra incentive for companies to reformulate above and beyond what was already being done as part of voluntary commitments to reformulation, or changes in sales driven by consumer preferences.

Impact of soft drinks to health and economy: a critical review

AimsTo provide information regarding the different types of soft drinks and critically reviewing their risk on the dental and general health of children and adolescents, as well as the cost associated with such drinks.MethodsThe literature was reviewed using electronic databases, Medline, Embase, Cochrane library, and was complemented by cross-referencing using published references list from reviewed articles. Search words; soft drinks, juices, carbonated drinks, sports and energy drinks, soft drink and dental diseases, soft drink and health, cost of soft drinks, soft drink advertising, sugar tax on soft drinks were used for this review. In total, 104 papers were reviewed by both authors; of these, 62 papers were found to have relevant information.ResultsThe consumption of soft drinks was found to have increased dramatically over the past several decades. The greatest increase in soft drink consumption has been among children and adolescents. Some commercial soft drinks are high in sugar content and acidity. In addition, they supply energy only and are of little nutritional benefit and lack micro-nutrients, vitamins and minerals. Soft drink consumption can contribute to detrimental oral and general health. Efforts have been made by manufacturers and government agencies to reduce the potential harmful effects of sugar-containing soft drinks on teeth and general health. These include banning the sale of soft drinks in schools, restricting soft drinks advertising, modifying the composition of soft drinks and introducing tax on sugar-containing soft drinks.ConclusionsThe consumption of soft drinks with high sugar content and acidity can contribute to detrimental oral health and may also affect general health. Therefore, it is necessary to educate patients about the harmful effects of different types of soft drinks as it is not always easy for individuals to identify from drink labelling the ingredients which they contain.

Food model in western Andalusia

As is known, the type and amount of food consumption determine the nutritional composition of the diet. A healthy nutritional composition plays an essential role in the prevention of diseases such as cardiovascular, diabetes mellitus type 2 and obesity. Regarding overweight and obesity, its prevalence has increased in recent years in our country and more markedly in Andalusia, reaching quite worrying figures, due to unfavorable changes in lifestyle and nutrition. In Andalusia, food consumption figures are lower than national ones and this contrasts with the higher prevalence of overweight and obesity in this Community. In addition, the sale of soft drinks in Andalusia are higher than the national average and sedentary lifestyle is higher. Among the strengths of the food model in western Andalusia, it is worth mentioning the follow-up of a model more adjusted to the Mediterranean diet by women and the elderly. There is a tendency to abandon the Mediterranean diet among the youngest and low socio-economic levels. On the nutritional profile, the lipids (39.1%) exceed the recommendations at the expense of carbohydrates, the consumption of saturated fatty acids (11.3%) exceeds the recommendations and the intakes of zinc and folic acid do not reach the values recommended. In general terms, there is an abandonment, fundamentally on the part of the youngest people of the typical foods of the Mediterranean diet.

Implementasi Metode CHAID (Chi-Squared Automatic Interaction Detection) pada Segmentasi Trend Penjualan Minuman Ringan di Indonesia

Saat ini beberapa outlet mengevaluasi produknya dengan melihat trend penjualan berbagai jenis minuman ringan selama periode tertentu untuk menyusun strategi pemasaran yang efektif. Metode CHAID (Chi-Squared Automatic Interaction Detection) merupakan salah satu metode statistika non-parametrik yang efisien untuk melakukan pengklasifikasian terhadap aspek-aspek apa saja yang dapat meningkatkan penjualan minuman ringan tersebut. CHAID memilih peubah-peubah yang signifikan berdasarkan uji Khi-Kuadrat antara kategori-kategori peubah penjelas dengan kategori-kategori peubah respon berskala nominal atau ordinal. Penelitian ini bertujuan untuk mengklasifikikasikan karakteristik yang menjadi penciri keragaman dan menentukan target pasar yang mampu memaksimumkan keuntungan pada trend penjualan berbagai jenis minuman ringan dengan menggunakan metode CHAID. Hasil dari CHAID berupa diagram pohon berdasarkan segmen dari peubah penjelas yang berasosiasi terhadap peubah respon menjadi informasi yang lebih mudah dimengerti. Penelitian ini menghasilkan 11 dari 20 segmen yang dijadikan sebagai acuan dalam menentukan target pasar terhadap peningkatan trend penjualan minuman ringan yang tersebar di kota-kota besar di Indonesia. Segmen yang terbentuk berasal dari 4 peubah penjelas yaitu persebaran kota, tipe outlet, sumber pembelian, dan metode pembayaran dengan akurasi segmentasi sebesar 71.4%.

Reexamination of an outbreak after forty-seven years: Key lessons from the Sagmalcılar outbreak, 1970

In October of 1970, approximately 1,500 people were ill and 52 people died of a cholera outbreak in Sagmalcilar, Istanbul. The outbreak spread over a wide area, carried through the old waterways passing under the garbage-laden areas near the Habipler village and the open waterways in the region of Esenler, Sagmalcilar. The spread of the disease was stopped at the end of October. During this outbreak, all patients were followed up, isolated and treated by the local healthcare workers. A wide range of immunization studies were conducted and water resources and open water zones were chlorinated. The sale of unbottled water, soft drinks and ice in the region was forbidden, and the dead, as well as cemetery grounds were limed. The houses where outbreaks had occurred were marked with yellow papers. In this study, periodical newspapers, related works and official reports of the Grand National Assembly of Turkey were used as resources. In this article, valuable lessons from the Sagmalcilar outbreak were presented and discussed through an analysis of the studies conducted during this epidemic.

Soft drink prices, sales, body mass index and diabetes: Evidence from a panel of low-, middle- and high-income countries

We take advantage of four different cross-country datasets containing data on 78 countries for the period 1999–2014, in order to assess the relationship of carbonated soft drinks’ sales, as well as their prices, with body mass index (BMI), overweight, obesity and diabetes. Using an ecological study design and multivariate regression longitudinal estimation approaches, we find that carbonated soft drink sales were significantly positively related to BMI, overweight and obesity – but only in the low and lower-middle income countries. This finding was robust to a number of sensitivity and falsification checks. In this sub-sample, an increase in per capita soft drink sales by 1 litre per year was related to an increase of BMI by about 0.009kg/m2 (p<0.1).. This is a small effect, implying that halving annual consumption per capita in this group of countries would result in a drop of BMI by only about 0.03kg/m2. Although soft drink prices were negatively related to weight-related outcomes in the sample of higher middle income and high income countries, this finding was not robust to falsification checks. The results thus suggest that sales restrictions to steer consumers away from soft drinks could indeed have a beneficial health effects in poorer countries, although the effect magnitude appears to be very small. However, given potential limitations of using ecological research design, results from individual level studies would be required to further ascertain the role of soft drink sales and prices in obesity and diabetes.

Differences in Food and Beverage Marketing Policies and Practices in US School Districts, by Demographic Characteristics of School Districts, 2012.

IntroductionFoods and beverages marketed in schools are typically of poor nutritional value. School districts may adopt policies and practices to restrict marketing of unhealthful foods and to promote healthful choices. Students’ exposure to marketing practices differ by school demographics, but these differences have not yet been examined by district characteristics.MethodsWe analyzed data from the 2012 School Health Policies and Practices Study to examine how food and beverage marketing and promotion policies and practices varied by district characteristics such as metropolitan status, size, and percentage of non-Hispanic white students.ResultsMost practices varied significantly by district size: a higher percentage of large districts than small or medium-sized districts restricted marketing of unhealthful foods and promoted healthful options. Compared with districts whose student populations were majority (>50%) non-Hispanic white, a higher percentage of districts whose student populations were minority non-Hispanic white (≤50% non-Hispanic white) prohibited advertising of soft drinks in school buildings and on school grounds, made school meal menus available to students, and provided families with information on school nutrition programs. Compared with suburban and rural districts, a higher percentage of urban districts prohibited the sale of soft drinks on school grounds and used several practices to promote healthful options. ConclusionPreliminary findings showing significant associations between district demographics and marketing policies and practices can be used to help states direct resources, training, and technical assistance to address food and beverage marketing and promotion to districts most in need of improvement.

Impact of a levy on sales of sugar-sweetened beverages within a national chain of restaurants: interrupted time-series analysis

BackgroundConsumption of sugar-sweetened beverages (SSBs) is associated with type 2 diabetes, weight gain, and dental caries. Taxes and levies on these beverages have been proposed as a way to reduce their consumption. However, only limited evidence exists for the effectiveness of taxes and levies where implemented. We aimed to assess the impact of a levy of £0·10 per drink on sales of SSBs delivered nationally in the UK within a restaurant setting using electronic point of sale data. MethodsPoint of sale data for non-alcoholic drinks were obtained from all eligible restaurants (n=37) in one restaurant chain between June 23, 2014, and Feb 28, 2016. We conducted an interrupted time-series analysis using linear mixed-models with restaurant as a random effect to assess whether there was a step-change in sales per customer of levy-eligible SSBs at 12 weeks and 6 months after implementation. We assessed effects on non-levied drinks (other soft drinks, juices, bottled waters, and diet cola) to explore substitution effects. Analyses also adjusted for seasonality and clustering. We stratified analyses by sales area (London, the North of the UK, the South of the UK) to assess regional effects. FindingsOverall, compared with the preintervention period, sales per customer of levy-eligible SSBs declined by 11·7% (p=0·002) at 12 weeks and 9·8% (p=0·004) at 6 months. For non-levy drinks, sales per customer of fruit juice (main menu) increased at 12 weeks (+3·3%, p=0·051) and 6 months (+19·7%, p<0·0001). At 6 months, there was a decrease in sales per customer of diet cola (−7·6%, p=0·002) and bottled waters (−6·7%, p=0·009), whereas sales of other non-levied soft drinks increased (+14·6%, p<0·001). We found marked regional variations, with declines in sales of levy-eligible SSBs in London (−14·2%, p<0·001) and the South (−13·8%, p<0·001), but no change in the North. InterpretationTo our knowledge, this is the first study to assess the impact on sales of a levy on SSBs delivered at scale in a national chain of restaurants. We found evidence of substantial declines in sales of levy-eligible SSBs, with the greatest effects seen in London and the South. A levy on SSBs within restaurant settings has the potential to reduce sales and therefore consumption of these beverages. FundingNational Institute for Health Research.

Trade and investment liberalization, food systems change and highly processed food consumption: a natural experiment contrasting the soft-drink markets of Peru and Bolivia.

BackgroundFree trade agreements (FTAs) can affect food environments and non-communicable disease risks through altering the availability of highly-processed foods. Few studies have quantified such effects. Using a natural experiment this paper quantifies changes in Peru’s soft-drink market before/after entry into the US-Peru FTA, compared with Bolivia, a county with no such agreement.MethodsDifference-in-difference models were used to test for between country differences in the rate of per capita foreign direct investment (FDI) inflows, soft-drink imports, the volumes of various soft-drinks sold, and the volumes of sugar from soft-drinks before/after FTA ratification (2006) and enforcement (2009).ResultsIn Peru average per capita FDI-inflows rose from US$103.11 in the pre-ratification period to US$269.79 post-ratification, with little change in Bolivia. This corresponded with a 122 % increase in Peruvian soft-drink production. There was a significant between-country difference in FDI-inflows pre-/post-ratification (DID:1.07, 95 % CI:0.19–1.96; p = 0.01). Despite little difference in total per capita soft-drink sales volumes there was a significant between-country difference in per capita sugar from soft-drinks pre-/post enforcement (DID:-0.99, 95 % CI: −1.91–0.06; p = 0.03) with stagnated growth in Peru and continued growth in Bolivia. This resulted from stagnated sugar sweetened carbonates growth and increased bottled water, juice and sports & energy drinks growth in Peru, with continued carbonates growth in Bolivia. There was a significant between-country difference in per capita carbonates (DID: −1.44, 95 % CI: −2.52–0.36, p = 0.01) and bottled water (DID:0.63; 95 % CI: −0.01–1.26; p = 0.04) sales volumes.ConclusionsThe FTA may have resulted in increased FDI-inflows and soft-drink production and also contributed to the diversification of soft drinks produced and sold in Peru with some positive (stagnated carbonates and increased bottled water) and some negative (increased juice and sports & energy drinks) implications for nutrition. These changes were not evident in Bolivia. These results should be interpreted cautiously given the study design limitations.

Cost of inaction on sugar-sweetened beverage consumption: implications for obesity in South Africa.

To estimate the effect of increased sugar-sweetened beverage (SSB) consumption on future adult obesity prevalence in South Africa in the absence of preventive measures. A model was constructed to simulate the effect of a 2·4 % annual increase in SSB consumption on obesity prevalence. The model computed the change in energy intake assuming a compounding increase in SSB consumption. The population distribution of BMI by age and sex was modelled by fitting measured data from the 2012 South African National Income Dynamics Survey to the log-normal distribution and shifting the mean values. Over the past decade the prevalence of obesity and related non-communicable diseases has increased in South Africa, as have the sales and availability of SSB. Soft drink sales in South Africa are projected to grow between 2012 and 2017 at an annual compounded growth rate of 2·4 % in the absence of preventive measures to curb consumption. A 2·4 % annual growth in SSB sales alongside population growth and ageing will result in an additional 1 287 000 obese adults in South Africa by 2017, 22 % of which will be due to increased SSB consumption. In order to meet the South African target of reducing the number of people who are obese and/or overweight by 10 % by 2020, the country cannot afford to delay implementing effective population-wide interventions. In the face of plans to increase growth of SSB, the country will soon face even greater challenges in overcoming obesity and related non-communicable diseases.

The effects of sponsorship activation on the sales of a major soft drink brand

Establishing a link between sponsorship efforts and product sales has been a pressing concern in the sponsorship industry, though achieving this has until now proven to be elusive. This paper examines the relationship between sponsorship activation efforts and soft drink sales. Drawing on an online survey of National Association for Stock Car Auto Racing (NASCAR) fans, the study measures the effects of sponsorship-linked public relations, advertising, and sales promotions on the weekly consumption levels of a major soft drink brand. The results of this study successfully confirm soft drink consumption based on sponsorship activation efforts. The authors conclude that it is possible to link sponsorship programmes directly to product sales; that measurement efforts should include measures of sponsorship-linked marketing communications; and that sponsorship-linked marketing communications work synergistically to predict product sales.

De-Fizzing Schools: The Effect on Student Behavior of Having Vending Machines in Schools

In recent years, many researchers have sought to measure the effects of adolescent soft drink consumption due to a suspected link with childhood obesity and other negative health outcomes. While most studies in the existing literature have focused on physical health outcomes, the current study seeks to analyze how providing soft drinks in vending machines affects adolescent in-school behavior and academics. The data for this analysis comes from a school district in which a subset of schools prohibited the sale of soft drinks in vending machines. Using this subset of schools as a treatment group, students at the treatment schools are compared with students at the schools that did not change their vending machine policies. A difference-in-differences estimation shows that the number of times a student was tardy to class decreased significantly at the treatment schools. Students also were less likely to be referred to the principal's office for behavior problems following the policy change. These results suggest that policies directed toward restrictions on soft drinks in school vending machines might improve behavioral outcomes for students.

Website review: Healthy children

I had the pleasure of attending the ASEAN Paediatric Congress held in Singapore in 2011. Many of the presentations were both interesting and informative. One of the highlights for me was a talk given by Dr Marion Burton, President of the American Academy of Pediatrics (AAP), on the changing trends in global paediatric care. Dr Burton gave a broad overview of many of the issues faced by today's children and young people, such as obesity, dental caries and mental health problems. During the talk, he mentioned the AAP's consumer website, http://www.healthychildren.org (Fig. 1), which will be the subject of this website review. Healthy children website homepage. Designed to be a virtual extension of the paediatrician's office, the Healthy Children website aims to provide trustworthy and up-to-date paediatric health information to parents and health consumers. A wide range of topics is covered, for example, vaccination, developmental milestones, healthy living and home safety. The content is developed and reviewed by experts based on the best current scientific evidence. The website is well designed and beautifully set out, and contains many user-friendly and interactive tools. General information can be accessed according to the age of the child using the ‘Ages & Stages’ tool. Registering with the website allows parents to obtain customised health information based on the age(s) of their child(ren). Parents should find a number of tools/sections particularly helpful: Symptom Checker: This tool allows parents to choose the body part where their child is experiencing symptoms, browse through a list of common symptoms for that region, and find out for each symptom the possible causes, when to call for help, as well as general care advice. Ask the Pediatrician: This tool allows parents to read through a number of questions posed by users of the website, together with the answers provided by a team of paediatricians. Many of these are common questions that paediatricians may be asked by parents in their practices. Hot Topics: This is the news section of the website, and contains short articles summarising key messages from recent research and current paediatric headlines. It may be of use to both parents and paediatricians as it is frequently updated and references are provided in most of the articles. My only criticism of this otherwise excellent website is that the website's homepage displays the logo and slogan of a soft drink company, a major sponsor of the site. In my opinion, this may give parents and other users of the website the wrong message about soft drinks, and is in conflict with the AAP's recommendation ‘to restrict the sale of soft drinks and sweetened fruit drinks to students’, as well as their statements that ‘too many of these empty calories can lead to obesity, currently the most common childhood medical condition’ and that the sales of these drinks result in revenue ‘that is earned at the expense of children's long-term health’ (excerpts from HealthyChildren.org audio article on ‘Soft Drinks in Schools’).