Table 2.
Beverages included with kids’ meals on menus and offered by cashiers/servers during orders at restaurants before and after policy went into effect in California (n 110 quick-service restaurants; n 190 inside and drive-through menus and orders) and Wilmington, Delaware (n nine quick-service and five full-service restaurants, n 17 inside and drive-through menus and orders)*
| Pre-Policy† | Post-Policy† | Pre-Post Change‡ | |||||
|---|---|---|---|---|---|---|---|
| n | % | n | % | n | Percentage point | P-value | |
| California Menu Boards§ | |||||||
| Water || (n 125 menus) | 65 | 52·0 | 75 | 60·0 | +10 | +8·0 | < 0·0001**** |
| Unflavoured milk ¶ (n 132 menus) | 104 | 78·8 | 103 | 78·0 | −1 | −0·8 | 0·65 |
| Flavoured milk¶ (n 114 menus) | 25 | 21·9 | 3 | 2·6 | −22 | −19·3 | < 0·0001**** |
| Juice** (n 125 menus) | 56 | 44·8 | 13 | 10·4 | −43 | −34·4 | < 0·0001**** |
| SSB†† (n 117 menus) | 41 | 35·0 | 7 | 6·0 | −34 | −29·1 | < 0·0001**** |
| Diet drink (n 116 menus) | 5 | 4·3 | 0 | 0·0 | −5 | −4·3 | n/a |
| “Drink’/’Kids’ drink’‡‡ (n 134 menus) | 18 | 13·4 | 11 | 8·2 | −7 | −5·2 | 0·003*** |
| California Cashier Orders | |||||||
| Beverages initially offered by cashier compared with California standards (n 180 orders) | |||||||
| Only water and/or unflavoured milk | 6 | 3·3 | 1 | 0·6 | −5 | −2·8 | < 0·0001**** |
| Other drinks in addition to above | 18 | 10·0 | 34 | 18·9 | +16 | +8·9 | 0·002*** |
| Only other drinks | 22 | 12·2 | 21 | 11·7 | −1 | −0·6 | 0·77 |
| Asked what drink the customer wanted with kids’ meal | 101 | 56·1 | 96 | 53·3 | −5 | −2·8 | 0·56 |
| Cashier provided a beverage or fountain cup without offering any options (cashier-chosen beverage) | 33 | 18·3 | 25 | 13·0 | −8 | −4·4 | 0·15 |
| Wilmington Menus or Menu Boards | |||||||
| Water || (n 10 menus) | 4 | 40·0 | 3 | 30·0 | −1 | −10·0 | n/a |
| Unflavoured milk ¶ (n 12 menus) | 8 | 66·7 | 7 | 58·3 | −1 | −8·3 | n/a |
| Flavoured milk ¶ (n 11 menus) | 2 | 18·2 | 2 | 18·2 | 0 | 0·0 | n/a |
| Milk combined, unflavoured and flavoured §§ (n 12 menus) | 8 | 66·7 | 8 | 66·7 | 0 | 0·0 | n/a |
| Juice ** (n 11 menus) | 9 | 81·8 | 6 | 54·6 | −3 | −27·3 | n/a |
| SSB†† (n 13 menus) | 6 | 46·2 | 5 | 38·5 | −1 | −7·7 | n/a |
| Diet drink (n 13 menus) | 6 | 46·2 | 3 | 23·1 | −3 | −23·1 | n/a |
| ‘Drink’/’With Drink’/’Kids’ drink’‡‡ (n 10 menus) | 3 | 30·0 | 3 | 30·0 | 0 | 0·0 | n/a |
| Wilmington Cashier/Server Orders|||| | |||||||
| Beverages initially offered by cashier/server compared with Wilmington, Delaware, standards (n 17 orders) | |||||||
| Only plain water, flavoured or unflavoured milk or juice | – | – | 1 | 5·9 | – | – | – |
| Other drinks in addition to above | – | – | 1 | 5·9 | – | – | – |
| Only other drinks | – | – | 1 | 5·9 | – | – | – |
| Asked what drink the customer wanted with kids’ meal | – | – | 8 | 47·1 | – | – | – |
| Cashier provided a beverage or fountain cup without offering any options (cashier-chosen beverage) | – | – | 2 | 11·8 | – | – | – |
| Not offered drink, had to be requested¶¶ | – | – | 4 | 23·5 | – | – | – |
SSB, sugar-sweetened beverages.
Beverages in italics are allowed as default beverages per policy. Inside and drive-through venues each represent one observation; results presented combine both venues.
Pre-policy data were collected within 1 month of the policy going into effect (December 2019–January 2020); post-policy data were collected 9–12 months after the policy went into effect.
Multilevel logistic regression was used to compare pre-post changes, adjusting for clustering by chain and by restaurant and adjusted for presence of drive-through; n/a signifies unable to derive P value. ***P < 0·001, ****P < 0·0001.
In California, sample size varies due to missing responses. Missing responses were excluded from analysis for that category. In California, data from menus were collected from both inside the restaurant and in the drive-through, where available. In Wilmington, data from menus were collected inside the restaurant only.
Water includes tap and/or bottled water that is unsweetened but may include non-energetic flavourings; tap water served from a water pitcher or as an option at the soda fountain was included.
Unflavoured milk includes unsweetened and plain milks or non-dairy equivalents; flavoured milk includes chocolate, vanilla, strawberry or other flavoured milks.
Juice includes 100 % fruit juice and diluted juice. Diluted juice has water added to 100 % juice without added sugars.
Sweetened drinks include soda, sports drinks, energy drinks, fruit-flavoured drinks, fountain drink(s) not further specified, horchata, milk shakes and coffee or teas with added sugars.
‘Drink’ or ‘kids’ drink’ listed on menu without further specification.
Category is displayed for Wilmington only as Wilmington’s ordinance allows any milk (flavoured and unflavoured).
In Wilmington, order data were collected post-policy only.
'Not offered drink, had to be requested’ was a separate response option added for the Wilmington full-service restaurants. The cashier/server did not verbally or physically offer a beverage; the data collector had to request one.