University of California, Berkeley

Making a Difference: Research Informing Policy

ChangeFarm and Food Policy and Obesity

Symposium

University of California DavisMay 21, 2010

Gail Woodward-Lopez Patricia Crawford

Robert C. and Veronica AtkinsCenter for Weight and Health

University of California, Berkeley

University of California, Berkeley

Linking researchers and the communityto prevent childhood obesity

Research & Evaluation Community Action

University of California, Berkeley

Pupil Nutrition, Health and Achievement Act of 2001

(SB 19) First legislated nutrition standards for

competitive foods in schools

Signed but never went into effect

New bills being considered: main concern financial

LEAF pilot study: evaluate SB 19 in secondary schools

University of California, Berkeley

Middle School 2: Food Service Revenues Per Capita, Per Day

$-

$0.50

$1.00

$1.50

$2.00

$2.50

Sep-0

2

Oct-02

Nov-0

2

Dec-0

2

Jan-0

3

Feb-0

3

Mar-03

Apr-03

May-03

Jun-0

3

Jul-0

3

Aug-0

3

Sep-0

3

Oct-03

Nov-0

3

Dec-0

3

Jan-0

4

Feb-0

4

Mar-04

Apr-04

May-04

Jun-0

4

$ P

er C

apita

, Per

Day

Total Revenue A La Carte Revenue Meal Revenue

Farm field trips SB-19 compliance,

garden/cooking

International Marketplace, a la carte food eliminated, daily salad bar

LEAF Evaluation

University of California, Berkeley

SB 12/965 Signed into law at the Governor’s Summit on obesity in 2005

University of California, Berkeley

Success! Sodas and most candy no longer for sale at

schools

Spread across the country

Was the basis for the IOM standards requested by USDA

Fueled the movement toward healthier school foods

University of California, Berkeley

But…………..

University of California, Berkeley

Few years later……………..Positive but modest impact on student

intake

University of California, Berkeley

Many unhealthy foods still offered

University of California, Berkeley

Top 10 Foods Sold Pre / Post Implementation of SB 12

Pre Implementation Foods Post Implementation FoodsBaked! Cheetos Crunchy Flamin' Hot Nature Valley Crunchy Oats ‘N Honey Granola Bar Baked! Ruffles - Cheddar & Sour CreamRold Gold - Classic Style - Tiny Twists PretzelsLay's Baked! Sour Cream & OnionKellogg's Pop Tarts - Strawberry FrostedSunchips French OnionPepperidge Farm Goldfish CheddarKellogg's Pop Tarts - Brown Sugar Cinnamon FrostedCorn Nuts – Ranch

Baked! Cheetos Crunchy Flamin' Hot Sunshine - Cheez-it Reduced Fat CrackersBaked! Lay's – Sour Cream & OnionBaked! Ruffles – Cheddar & Sour CreamCorn Nuts – BarbequeCorn Nuts – RanchGeneral Mills Chex Mix – TraditionalBaked! Lay's – BarbecueRold Gold - Classic Style - Tiny Twists PretzelsNature Valley Crunchy Oats 'N Honey Granola Bar

*Items in red do not adhere to SB12 standards.

University of California, Berkeley

Top 10 Beverages Sold Pre / Post Implementation of SB 965

Pre Implementation Beverages

Post Implementation Beverages

Aquafina Water Aquafina Water

Dasani Water Gatorade - Fruit Punch

Gatorade - Fruit Punch Dasani Water

Gatorade - Lemon-lime Gatorade - Lemon-lime

Powerade -Mountain Blast Gatorade – Orange

Powerade - Fruit Punch Powerade - Mountain Blast

Gatorade - Cool Blue Powerade - Fruit Punch

Gatorade - Orange Gatorade - Cool Blue

Dole 100% Apple Juice Gatorade Frost - Glacier Freeze

Gatorade Frost - Glacier Freeze Dole 100% Orange Juice

*The top 10 beverages adhered to SB 965 pre and post implementation.

University of California, Berkeley

Almost half of entrees are fast food

Salad Entrees10.1%

Fast Food Classics

46.8%Sandwiches

16.2%

Mexican12.9%

Asian4.5%

Other Hot Entrees

4.5%

Dairy2.0% Other

3.1%

University of California, Berkeley

Good start butneed to look at the bigger picture

University of California, Berkeley

67-82% and 61-44% selected whole wheat during immediately after intervention and at follow-up

Classroom Education Component

Cafeteria Promotions Component

Whole Wheat Poster Displayin the school cafeteria

Four lessons of 20 minutes each

3 Components:Outline and Instructional SheetClassroom Poster/Student HandoutIn-class taste-test of whole wheat products

center foreight &

ealthhDr. Robert C. and Veronica Atkins

University of California, Berkeley

Food dollars spent onfoods outside the home

Ref: Nat’l Rest Assn: Industry at a Glance 2006

26%

48%

0%

20%

40%

60%

19702006 Year

center foreight &

ealthhDr. Robert C. and Veronica Atkins

University of California, Berkeley

Which of the following breakfast items that are served at Denny's restaurant do you think has the fewest calories:

A. Ham and cheddar omelet

B. Country fried steak & eggs

C. Three slices of French toast w/ syrup & margarine

D. Three pancakes w/ syrup & margarine

center foreight &

ealthhDr. Robert C. and Veronica Atkins

University of California, Berkeley

Which of the following breakfast items that are served at Denny's restaurant do you think has the fewest calories:

A. Ham and cheddar omelet 595

B. Country fried steak & eggs 464

C. Three slices of French toast w/ syrup & margarine 1000D. Three pancakes w/ syrup & margarine 650

center foreight &

ealthhDr. Robert C. and Veronica Atkins

University of California, Berkeley

Which of the following items that are served at McDonald's restaurant do you think has the most calories:

A. Two Big Macs

B. Two Egg McMuffins

C. One large chocolate shake

D. Four regular hamburgers

center foreight &

ealthhDr. Robert C. and Veronica Atkins

University of California, Berkeley

Which of the following items that are served at McDonald's restaurant do you think has the most calories:

A. Two Big Macs 1080

B. Two Egg McMuffins 600

C. One large chocolate shake 1160

D. Four regular hamburgers 1000

center foreight &

ealthhDr. Robert C. and Veronica Atkins

University of California, BerkeleyHaagen-Dazs’ Model Menu Board

Restaurant Intervention

center foreight &

ealthhDr. Robert C. and Veronica Atkins

University of California, Berkeley

SB1420 introduced by Senator Padilla in 2007

center foreight &

ealthhDr. Robert C. and Veronica Atkins

University of California, Berkeley

center foreight &

ealthhDr. Robert C. and Veronica Atkins

University of California, Berkeley

40 million pounds annually!

Estimated impact of calorie labeling for all Californians

(based on 80% noticing it and 82% eating at fast food

restaurants)

center foreight &

ealthhDr. Robert C. and Veronica Atkins

University of California, Berkeley

Governor signed bill SB1420-Sept. 30, 2008

center foreight &

ealthhDr. Robert C. and Veronica Atkins

University of California, Berkeley

But………….. Findings have been mixed

Impact on purchases has been modest; but can still have a large impact on annual calorie intake

Consumers may be confused by healthy options that have more calories than less healthy options

center foreight &

ealthhDr. Robert C. and Veronica Atkins

University of California, Berkeley

Net increase of healthy purchases using electronic cash register data

Menu Boards vs. ControlEntrees NSSide dish 9.6 %***Snack items 6.8% **

*** p<.001** p<.01

Could prevent the gain of 4-8 lbs per year

center foreight &

ealthhDr. Robert C. and Veronica Atkins

University of California, Berkeley

The biggest impacts came not from the labels but from

Starbuck’s change in default milk offered

Subway’s $5 footlong

center foreight &

ealthhDr. Robert C. and Veronica Atkins

University of California, Berkeley

Biggest impacts will come from policies that don’t require much consumer decision-making or sacrifice:

Price

Product formulations (virtuous cycle)

Optimal defaults

center foreight &

ealthhDr. Robert C. and Veronica Atkins

University of California, Berkeley

Concerns regarding pre-emption

Health Care reform includes a national menu labeling requirement

center foreight &

ealthhDr. Robert C. and Veronica Atkins

University of California, Berkeley

Visit our websiteat

cwh.berkeley.edu

Dr. Robert C. & Veronica AtkinsCenter for Weight and Health

Research Informing Action Now

University of California, Berkeley

Visit our website at www.cnr.berkeley.edu/cwh