Limited implementation of California's Healthy Default Beverage law for children's meals sold online

Hannah R Thompson; Anna Martin; Ron Strochlic; Sonali Singh; Gail Woodward-Lopez

doi:10.1017/S1368980022000039

Limited implementation of California's Healthy Default Beverage law for children's meals sold online

Public Health Nutr. 2022 Jan 10;25(7):1-10. doi: 10.1017/S1368980022000039. Online ahead of print.

Authors

Hannah R Thompson^{1

2}, Anna Martin², Ron Strochlic², Sonali Singh^{1

2}, Gail Woodward-Lopez²

Affiliations

¹ University of California Berkeley, School of Public Health, 2121 Berkeley Way, 6120, Berkeley, CA94720-7360, USA.
² University of California Agriculture and Natural Resources, Nutrition Policy Institute, 1111 Franklin, Fifth Floor, Oakland, CA94607, USA.

Abstract

Objective: To reduce children's sugar-sweetened beverage intake, California's Healthy-By-Default Beverage law (SB1192) mandates only unflavoured dairy/non-dairy milk or water be the default drinks with restaurant children's meals. The objective of this study is to examine consistency with this law for meals sold through online platforms from restaurants in low-income California neighbourhoods.

Design: This observational, cross-sectional study examines beverage availability, upcharges (additional cost) and presentation of beverage options consistent with SB1192 (using four increasingly restrictive criteria) within a random sample of quick-service restaurants (QSR) in Supplemental Nutrition Assistance Program Education eligible census tracts selling children's meals online from November 2020 to April 2021.

Setting: Low-income California neighbourhoods (n 226 census tracts).

Participants: QSR that sold children's meals online via a restaurant-specific platform, DoorDash, GrubHub and/or UberEats (n 631 observations from 254 QSR).

Results: Seventy percent of observations offered water; 63 % offered unflavoured milk. Among all beverages, water was most likely to have an upcharge; among observations offering water (n 445), 41 % had an upcharge (average $0·51). Among observations offering unflavoured milk (n 396), 11 % had an upcharge (average $0·38). No observations upcharged for soda (regular or diet). Implementation consistency with SB1192 ranged from 40·5 % (using the least restrictive criteria) to 5·6 % (most restrictive) of observations.

Conclusions: Based on observations from restaurant websites and three of the most popular online ordering platforms, most California QSR located in low-income neighbourhoods are not offering children's meal beverages consistent with the state's Healthy-By-Default Beverage law. As the popularity of online ordering increases, further work to ensure restaurants offering healthy default beverages with children's meals sold online is necessary.

Keywords: Children’s meals; Fast food restaurants; Healthy default beverages; Sugar-sweetened beverages.