An Analysis of Laws Encouraging Children and Families to Choose Healthy Beverages

child drinking a soda in a restaurant

New laws enacted in recent months in the state of California and city of Baltimore signal that making healthier beverages the default option on children’s menus is gaining strength, according to a paper published in Preventive Medicine.

“Research shows that consuming sugar-sweetened beverages, such as soda, fruit drinks, sports drinks and punches, puts children at risk of obesity and related diseases such as type 2 diabetes and heart disease later in life,” said Y. Tony Yang, a professor of health policy at the George Washington University Milken Institute School of Public Health (Milken Institute SPH) and the new paper’s first author.

In July 2018, Baltimore became the largest U.S. city to prohibit restaurants from including sugar-sweetened beverages on children’s menus. In September 2018, California made history by becoming the first state to require either water or milk as the default choice with children’s meals at all restaurants.

“Studies show that children consume roughly 25 percent of their daily calories dining out, and that they consume nearly twice as many calories in restaurants as they do at home,” Yang said. “Sugar-sweetened beverages make a substantial contribution to children’s calorie intake in restaurants.”

The new laws follow voluntary commitments by businesses including McDonalds and Walt Disney Company to enhance the nutritional qualities offered in their restaurants and theme parks. The cities of Louisville, Ky. and Lafayette, Colo., among others, also passed healthy beverage laws.

Using subtle methods of influencing children’s beverage choices at restaurants, or nudges (a concept in behavioral science, political theory and behavioral economics), will not on its own eradicate childhood obesity, Yang stressed.  However, the law aims to make healthier choices easier options and to influence people's choices in predictable ways without restricting their options.  Evidence from a wide range of fields shows that people tend to stick with defaults and that setting beneficial defaults has high rates of acceptability. 

“The laws reflect a growing understanding among restaurant owners, community members and policymakers alike of the importance in feeding children healthy meals,” Yang said.

“Recent progress in children’s meals law in restaurants in Baltimore City and California State: Make a healthy beverage option the default choice” is published in Preventive Medicine. Yang’s coauthor is Sara E. Benjamin-Neelon of the Johns Hopkins University Bloomberg School of Public Health.