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Improving Food Options

In 2012, Massachusetts adopted comprehensive standards to improve the healthy food options available in middle schools and high schools. One year after implementation, a research team that includes Northeastern associate professor Jessica Hoffman examined compliance with the standards in 74 schools across the commonwealth.

Their findings—that the legislative action led to significant improvements in the competitive foods and beverages available in schools—is encouraging.

Among the most impressive findings, the team found that before imple­men­ta­tion, at the middle school level, just 13 per­cent of com­pet­i­tive foods would have met the stan­dards. One year after imple­men­ta­tion that number rose to 69 per­cent. At the high school level, com­pet­i­tive bev­er­ages that met the stan­dards pre-​​implementation were 28 per­cent, but sky­rock­eted to 80 per­cent.

The study, the researchers say, can serve as an example for states nationwide and is the first to shed light on how schools can successfully implement food standards similar to the recommendations from the Institutes of Medicine and the federal Smart Snacks in Schools standards.

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Associate professor Jessica Hoffman

“For decades competitive foods have not been regulated at the national level, so states have taken it upon themselves to do something,” Hoffman said. “These standards that were put in place in Massachusetts were really exciting because at the time they were some of strictest standards in the whole country.”

Hoffman, an associate professor in the Department of Applied Psychology, is the lead author on the study, which was published Wednesday in the Journal of the Academy of Nutrition and Dietetics.

At the start of the 2012-13 school year, Massachusetts enacted new regulations focused specifically on competitive foods sold in schools. Competitive foods and beverages are those sold in vending machines, school stores, and for fundraisers. Hoffman defined them as the foods that “compete” with the sale of school meals.

Researchers made three site visits to 74 middle schools and high schools in 37 Massachusetts school districts over an 18-month period and cataloged information on thousands of competitive foods, including brand names, packaging, and serving size.

Just one year after imple­men­ta­tion, Hoffman’s team found that a majority of com­pet­i­tive foods sold at schools par­tic­i­pating in the study met the state’s new standards, noting the improvement in middles schools from 13 percent to 69 percent, and in high schools from 28 to 80 percent.

“It’s easier to make the changes in beverages because categorically things are compliant or not compliant,” Hoffman said. “For example,” she added, “the sugar-sweetened beverages are easy to recognize and eliminate.”

The new Massachusetts regulations include allowing the sale of only nonfat or low-fat milk as well as foods or beverages that do not contain artificial sweeteners, and offering fruits and vegetables wherever food is sold in schools.

Hoffman noted that schools received no incentive from the state to make these changes, adding that there is no financial consequence for noncompliance. “People in food services really did want to make improvements,” Hoffman said.

Researchers from Harvard University’s T. H. Chan School of Public Health and Brandeis University’s Heller School of Social Policy and Management also worked on this study.

The paper is the first in the team’s NOURISH study. NOURISH stands for Nutrition Opportunities to Understand Reforms Involving Student Health. In forthcoming papers the research team will focus on the impact these changes are making on students’ diets in and outside of school, and what, if any, financial implications are felt by schools. The study was funded by the Robert Wood Johnson Foundation.