With each issue, Trib+Edu brings you an interview with experts on issues related to public education. Here is this week's subject:
Daniel R. Taber is an assistant professor of health promotion and behavioral sciences at the University of Texas School of Public Health-Austin Regional Campus. His research focuses on the effects that school's policies have on students' nutrition, weight and physical activity, as well as how those effects may change due to outside factors in students' lives. Taber received a master's of public health degree from the University of Washington and a Ph.D. in epidemiology from the University of North Carolina at Chapel Hill. This summer, he was a visiting scholar at the Global Obesity Prevention Center in the John Hopkins Bloomberg School of Public Health.
Editor's note: This interview has been edited for length and clarity.
Trib+Edu: What are your thoughts on the agriculture commissioner’s recent moves on nutrition policy?
Daniel R. Taber: I've written about this on my personal blog. It’s very frustrating to see because so much progress has been made, and Texas once was a leader. Texas used to be a leader in school nutrition policies. It was one of the first states to make major changes in schools, to set healthier nutrition standards — this was back a little over 10 years ago — and some of the earliest research that came out showing school nutrition policies can have a positive impact came out of Texas. So to see Texas regressing now, going backwards, is very frustrating.
I know there’s this perception that it’s a very political issue, and historically, that’s really not the case. A lot of the Southern conservative states were actually the early leaders in making these changes in schools, but I feel like it’s become a very partisan issue now, only within the last two or three years. It seemed like a few years ago we were all on the same page about the fact that changes need to happen in schools because kids are surrounded by unhealthy options in schools. Now, we’re talking about the right to cupcakes and how that’s more important than making sure kids have healthy options.
Trib+Edu: You recently studied bans on sodas and other sweetened drinks in different states. What are the different kinds of bans that states have, and how widespread are each of them across the country?
Taber: It all depends on what grade level you’re talking about, first of all, and historically, they can vary state to state. Of course, now that the USDA has implemented their Smart Snacks rules, as it’s known, there are some healthier standards nationwide. But previously, at the time the study was done, it was more on a state-by-state basis what the standards were.
Some states banned all sweetened beverages, at least at lower levels. States seem to be more willing to have stricter standards for elementary schools, but as you move on to middle schools and high schools, the standards become looser. So a ban on all sweetened beverages in high school is almost unheard of. That’s extremely rare. Sometimes, at lower grade levels, they will do that. Actually in Texas in 2013, they tried to do that with elementary schools and middle schools, but not high schools. The state Legislature approved it, but [former Gov.] Rick Perry vetoed the bill.
And sometimes states say you can’t drink soda but allow other sweetened beverages. So that could be fruit juices that have a lot of sugar, it could be diet soda, it could be sports drinks, just any kind of drink that has a lot of sugar in it.
Trib+Edu: So what did this study find?
Taber: We found that when states ban soda, particularly when schools still had vending machines that sold sweetened beverages, that students actually drank more sports drinks, energy drinks, fruit juices, basically every other kind of sweetened beverage other than soda, compared to states that hadn’t even banned soda.
It was a cross-sectional study, so we’re not necessarily saying that the policy change would have directly led to some higher sweetened beverage consumption, but at the very least, it shows that the policy didn't really match what students were drinking, that policies haven’t kept up with the times. The whole sweetened beverage industry has really evolved in the last 15 years or so. It used to be all about soda, but since about 2000, soda consumption in the U.S. has actually declined, but consumption of other sweetened beverages has increased so that they almost cancel each other out. The market has become a lot more diverse.
Trib+Edu: So how might industry marketing explain your results, or at least, part of them?
Taber: That can be a big part of it because they certainly market other sweetened beverages more aggressively now. It’s not just encouraging people to drink them but it’s also how they frame it. Sports drinks, for example, are marketed as being a healthy alternative that’s necessary for athletes, but especially when you factor in the serving sizes that sports drinks typically come in, where you’ve got those monster 32 ounce bottles as well as the amount of sugar that comes in them, it’s really not healthy. And that’s why the American Academy of Pediatrics and other health organizations discourage the consumption of health drinks. A lot of fruit juices, as well, are marketed as being a healthy option, but people don’t realize how much sugar these beverages have in them.
Trib+Edu: When you ban these drinks at any level, to what extent do students compensate for that by drinking it outside of school, and how do you try to fix that?
Taber: I think one big thing is giving them healthy alternatives in school because one thing that I actually had another study that came out right about competitive food laws. Those laws refer to anything sold outside of federal school food programs, and competitive food laws are good at doing what they do which is getting rid of unhealthy options.
That study broke it down into more detail of exactly what students had access to in school. We found that competitive food laws did exactly that. Students had fewer unhealthy options, but they didn't necessarily have healthy alternatives. The competitive food laws were not designed to do that. They said you cannot sell beverages that have x amount of sugar, but they weren't necessarily saying, so you need to provide bottled water or unsweetened fruit juices or healthier alternatives instead.
So part of it is making sure they have healthy alternatives. If they can't get soda in school, then they’re gonna buy whatever they can, most likely, whether that means other sweetened beverages in school or leaving campus, especially if you're talking high school students, to get whatever they want somewhere else. So I think you need to reinforce the message to students. You need to offer them healthy alternatives. You need to emphasize nutrition education more. You need to make sure that beverage companies are not marketing in school. At this point in time, you can't control marketing, and you can't stop companies from marketing these beverages to students, but at least they wouldn't getting that message in school. So you need to constantly reinforce it and make sure that they have healthy alternatives available to them.
Trib+Edu: So what other research areas will you be looking at in the future or hope others will explore?
Taber: Everything you’re asking, pretty much, because I’ve always been curious about this same thing. How are kids actually compensating for these changes? I always joke with people that when I was a kid, I sold candy to my classmates, which is terrible for a nutrition researcher to admit that now. But I made money selling candy as a kid. So if the school banned candy in the cafeteria, they could've just come to me to get junk food. It sounds horrible, but that’s just the reality. Kids are very smart and they know how to work the system. So I’m very interested in other factors outside of school that potentially influence whether school policies work or not. Because if you ban sweetened beverages but McDonald's is right across the street, is that really gonna make a difference?
So I’m pursuing more things, like a study I did last year where we did find that students drink more soda if they didn’t have vending machines in school, but that depended on things like whether the states taxes soda or not. So seeing if you have healthier nutrition standards for school, and you have taxes and have zoning codes that regulate where food establishments like fast food restaurants can be built, is that combination enough to stop kids from compensating and actually have more of an impact?