How kids meals are getting a makeover in New Orleans

NEW ORLEANS — Known for its decadent menus, New Orleans has become the first city in the South to ban soda and other sugary drinks from kids meals.

The Healthy Kids’ Meal Beverage law went into effect in January and affects the city’s 1,200 restaurants. The default beverage options with kids meals are now limited to water, milk or 100% fruit juice. The new law is part of an effort to give children more healthful food and beverage options, as well as reduce the rate of childhood obesity in the city.

Paulette Briggs Vallery, whose family has a history of diabetes, is grateful for the new law. Drink selections are a struggle each time her family walks into a restaurant. Her 11-year-old son is considered pre-diabetic, and her husband is already living with diabetes.

“When we go to restaurants, the milk and juice and water options aren’t as clearly visible as the sodas are,” said Vallery, a mother of two kids.

Vallery said she and her family instead ask for water with lemon and Sweet’N Low for the table.

“Sometimes, we avoid certain places because we know that they don’t have what we’re looking for,” she said.

While Vallery has substituted fresh carrot and apple juice for sugary drinks at home, she hopes the new law will help her keep sugar from harming her kids’ health when they go out.

“It’s better for all of us in the long run,” Vallery said. “My husband just suffered a stroke and diabetes played a big role in it. It underscores for us, as a family, to just be mindful of what we consume and what we are purchasing. Reading the labels, monitoring blood sugars, and just being aware of the sugar that’s in drinks is a big goal for us.”

What does the new law do?

The New Orleans Health Department has been working to educate restaurants since a new law directed at kids meals took effect in January. Eateries are required to display new default beverage options — not including sodas — on their menus. Photo by Roby Chavez/PBS NewsHour

New Orleans joins a growing list of cities and states that have passed similar laws aimed at sugary drinks. The New Orleans City Council unanimously approved the measure, crafted by the city’s health department, last month.

Eateries must now offer unflavored, unsweetened, or noncarbonated water; nonfat or 1 percent milk; or a 100 percent juice drink option if they offer children’s meals.

Louisiana has one of the highest rates of childhood obesity in the nation for kids between ages 10 and 17 — ranking third in the nation at 22 percent — according to a 2022 State of Obesity Report from the Robert Wood Johnson Foundation.

Nutrition experts say sugary drinks are a major contributor to childhood obesity. Excess consumption of beverages sweetened with added sugars, from sodas and lemonades to sports and energy drinks, can lead to an increased risk of diabetes, asthma, and heart disease, among other chronic diseases.

The New Orleans Health Department hopes the law will help kids to take small steps toward more healthful habits.

“There’s definitely a lot of indulgence here, but we think parents are hungry for change like this [new law] so that their kids aren’t staring at that soda on the menu every time they go out to eat,” said Jeanie Donovan, the deputy director of the city’s health department. “It’s our goal to look at some of our youngest residents of the city and determine how can we promote healthy behaviors and lifestyle choices.”

When the ordinance passed last January, the Louisiana Restaurant Association stood against it, citing economic struggles during the pandemic. Spokesperson Wendy Waring declined to comment once the law went into effect last month. The New Orleans City Council delayed the measure one year to accommodate those concerns.

Since then, the health department has been working to educate restaurants. Residents can call an information line or fill out an online complaint if restaurants are not following the new law, which requires all New Orleans establishments to display the default beverage options on printed and digital menus, and menu boards. For non-compliance, eateries will be given two warnings before they face a $200 fine.

“This is not about punishing restaurants or taking away choices from parents or from kids,” Donovan said.

In behavioral science, she said, an ordinance limiting sugary drinks with kids meals is a type of “nudge policy,” one that makes “a small tweak to the environment to provide a gentle nudge to children and families to make a healthier choice.”

Why focus on kids meals?

American Heart Association staffers display a “Rethink Your Drink” booth at the New Orleans Heart Walk event in November. Participants were challenged to try different variations of healthier drinks, like flavored waters with fruit instead of sports drinks. Photo courtesy of AHA

Sugary drinks are a contributor to chronic disease, diabetes, high blood pressure, and heart disease, according to the Centers for Disease Control and Prevention. About two-thirds of youth in the U.S. consume a sugary drink daily.

Sugary drinks are also the single largest source of calories in children’s diets, according to the Robert Wood Johnson Foundation. On average, kids in the U.S. are drinking more than 30 gallons of sugary drinks per year.

The American Academy of Pediatrics said an excess consumption of added sugars, like those found in sugary drinks, “poses a grave health threat to children and adolescents, disproportionately affecting children of minority and low-income communities.”

The 2019 report calls for more public policies that help limit the intake of added sugars among children and adolescents. Some of the recommendations include raising the price of these beverages with an excise tax, decreasing the marketing of sugary drinks to kids as well as changing default drinks on kids menus.

The American Heart Association said it supported Louisiana’s measure because default beverage options like milk and water in kids meals can reduce sugary drink consumption and improve health outcomes.

“Our kids are drinking more than their body weight in sugary drinks every year. And that high consumption increases things like heart disease and Type 2 diabetes. These are both conditions that potentially lower the body’s immunity to fight other diseases,” said Coretta LaGarde, executive director of the association’s New Orleans branch. “This particular policy is really good for all kids, but especially for underserved communities and our communities of color who are less likely to have access to healthier beverages.”

Do policies aimed at kids meals work?

In a city that consistently makes the list of America’s least healthy cities, LaGarde said these kinds ofpolicies “are opportunities to make … life-changing habits for our young people” and create a generational shift “to build a more health-conscious culture.”

According to a 2021 Harvard study, kids meal policies passed from 2010 to 2020 were intended to create healthier options for kids. But none of the 20 laws reviewed, which varied by location, fully aligned with expert nutrition standards, the study found.

Donovan said it can be challenging to isolate the impact of one policy, like Louisiana’s kids meals beverage law, but it’s a first step toward “changing other parts of the food environment in the city, both for kids and adults.”

The American Heart Association collaborated with the France Meat Market in New Orleans to showcase “Good to Go” meal boxes to increase easy access to healthy, fresh, affordable foods in under-resourced neighborhoods and corner stores. Photo courtesy of AHA

In addition to the changes to restaurant menus, Donovan said, there’s an opportunity for the health department to have a conversation with elected officials and residents about what the city’s children are drinking and eating. That also involves focusing on the outcomes related to the overall health of the child and not necessarily their BMI, or body mass index, she said.

“These policies are important,” said Melissa Fuster from the Tulane School of Public Health and Tropical Medicine. “But at the same time, we cannot pretend that a single policy will solve the childhood obesity or sugary beverage consumption issues.”

“Obesity is very complicated. It has to do with our environment,” she said. “We need to keep doing work to chip at the problem little by little.”

Fuster, an associate professor in the Department of Social Behavioral and Population Science, is working with Megan Knapp, public health professor and researcher at Xavier University of Louisiana, to independently track the law’s progress. Fuster said their research will track compliance, menu changes, and any possible unintended consequences.

Fuster said the team’s research will also learn whether restaurants decide the new law is too much hassle and drop beverage options from their kids meals – or kids meals altogether from their menus.

“Hopefully something like this [new law] can help tip the needle a little bit towards healthier drinking behaviors for kids,” she added.

Parents like Paulette Briggs Vallery hope it’s just the start of new policy initiatives. Vallery would like to see healthier options on menus and at the corner store, especially in underserved neighborhoods.

Those types of changes are important, she said, “because healthier children will lead to healthy adults,” Vallery said.