{"doi":"10.1001/jamanetworkopen.2026.17749","title":"The New Orleans Healthy Default Beverage Policy and Beverage Ordering Among Children","abstract":"<jats:sec id=\"ab-zoi260500-4\">\n                    <jats:title>Importance</jats:title>\n                    <jats:p>Sugar-sweetened beverages (SSBs) are the leading source of added sugar in US children’s diets and are linked to increased obesity risk, and restaurants are critical settings for interventions to reduce SSB consumption. Local menu ordinances requiring default healthier beverages (HDB) are gaining in popularity, but to date, there has been no rigorous evaluation of their effectiveness.</jats:p>\n                  </jats:sec>\n                  <jats:sec id=\"ab-zoi260500-5\">\n                    <jats:title>Objective</jats:title>\n                    <jats:p>To evaluate the outcomes of an HDB ordinance on beverage ordering for children in restaurants.</jats:p>\n                  </jats:sec>\n                  <jats:sec id=\"ab-zoi260500-6\">\n                    <jats:title>Design, Setting, and Participants</jats:title>\n                    <jats:p>Difference-in-differences study using caregiver-reported survey data before and after policy implementation (September 2022 and 2024, respectively) in 2 urban parishes in Louisiana: New Orleans (intervention city) and Baton Rouge (comparison city). Parents and caregivers (≥18 years) of children aged 2 to 12 years who had ordered or eaten at a restaurant with their child in the past 30 days were surveyed.</jats:p>\n                  </jats:sec>\n                  <jats:sec id=\"ab-zoi260500-7\">\n                    <jats:title>Exposure</jats:title>\n                    <jats:p>Implementation of the New Orleans Healthy Kids’ Meal Beverage Ordinance, which mandates that only water, unflavored or low-fat milk, or 100% juice be offered as default beverages with children’s meals.</jats:p>\n                  </jats:sec>\n                  <jats:sec id=\"ab-zoi260500-8\">\n                    <jats:title>Main Outcomes and Measures</jats:title>\n                    <jats:p>The primary outcome was ordering of a healthy default beverage with the most recent children’s restaurant meal. Secondary outcomes included beverage volume, sugar and calorie intake, and selection of beverage types. Models were weighted and adjusted for demographics, dining mode, and caregiver attitudes.</jats:p>\n                  </jats:sec>\n                  <jats:sec id=\"ab-zoi260500-9\">\n                    <jats:title>Results</jats:title>\n                    <jats:p>\n                      A total of 1006 caregivers completed the baseline survey (736 [73.2%] female; 506 in New Orleans, 500 in Baton Rouge), and 1131 completed the postpolicy survey (548 [48.5%] female; 556 in New Orleans, 575 in Baton Rouge). Healthy beverage ordering decreased in both cities, but comparison of before-and-after differences between the 2 cities indicates the ordinance was associated with higher odds of ordering a healthy beverage (adjusted odds ratio [aOR], 2.10; 95% CI, 1.16 to 3.83;\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       = .02), attenuating the ordering decline in New Orleans. Sugar intake decreased by 5.6 g (95% CI, −9.6 to −1.5 g;\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       = .007), and calorie intake declined by 34.0 kcal (95% CI, −59.1 to −8.9 kcal;\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       = .008). The odds of ordering water increased (aOR, 2.08; 95% CI, 1.12 to 3.85), while the odds of ordering 100% juice decreased (aOR, 0.59; 95% CI, 0.36 to 0.96). No significant changes were observed for SSBs or beverage volume.\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec id=\"ab-zoi260500-10\">\n                    <jats:title>Conclusions and Relevance</jats:title>\n                    <jats:p>In this survey study, the New Orleans HDB ordinance was associated with modest but meaningful improvements in children’s beverage ordering, supporting default-based policies as a tool for promoting healthier dietary behaviors.</jats:p>\n                  </jats:sec>","journal":"JAMA Network Open","year":2026,"id":640997,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":746175,"name":"Yin Wang","orcid":"0000-0002-6973-856X","position":1,"is_corresponding":false},{"id":711685,"name":"Charles Stoecker","orcid":"0000-0001-5438-9312","position":2,"is_corresponding":false},{"id":1666276,"name":"María M. Muñoz","orcid":null,"position":3,"is_corresponding":false},{"id":921627,"name":"Donald Rose","orcid":"0000-0002-2110-8059","position":4,"is_corresponding":false},{"id":1468579,"name":"Lisa P. Hofmann","orcid":null,"position":5,"is_corresponding":false},{"id":1104948,"name":"Megan Knapp","orcid":"0000-0001-8575-9101","position":6,"is_corresponding":false},{"id":697117,"name":"Melissa Fuster","orcid":"0000-0001-6357-9986","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"The New Orleans Healthy Default Beverage Policy and Beverage Ordering Among Children","abstract":"<jats:sec id=\"ab-zoi260500-4\">\n                    <jats:title>Importance</jats:title>\n                    <jats:p>Sugar-sweetened beverages (SSBs) are the leading source of added sugar in US children’s diets and are linked to increased obesity risk, and restaurants are critical settings for interventions to reduce SSB consumption. Local menu ordinances requiring default healthier beverages (HDB) are gaining in popularity, but to date, there has been no rigorous evaluation of their effectiveness.</jats:p>\n                  </jats:sec>\n                  <jats:sec id=\"ab-zoi260500-5\">\n                    <jats:title>Objective</jats:title>\n                    <jats:p>To evaluate the outcomes of an HDB ordinance on beverage ordering for children in restaurants.</jats:p>\n                  </jats:sec>\n                  <jats:sec id=\"ab-zoi260500-6\">\n                    <jats:title>Design, Setting, and Participants</jats:title>\n                    <jats:p>Difference-in-differences study using caregiver-reported survey data before and after policy implementation (September 2022 and 2024, respectively) in 2 urban parishes in Louisiana: New Orleans (intervention city) and Baton Rouge (comparison city). Parents and caregivers (≥18 years) of children aged 2 to 12 years who had ordered or eaten at a restaurant with their child in the past 30 days were surveyed.</jats:p>\n                  </jats:sec>\n                  <jats:sec id=\"ab-zoi260500-7\">\n                    <jats:title>Exposure</jats:title>\n                    <jats:p>Implementation of the New Orleans Healthy Kids’ Meal Beverage Ordinance, which mandates that only water, unflavored or low-fat milk, or 100% juice be offered as default beverages with children’s meals.</jats:p>\n                  </jats:sec>\n                  <jats:sec id=\"ab-zoi260500-8\">\n                    <jats:title>Main Outcomes and Measures</jats:title>\n                    <jats:p>The primary outcome was ordering of a healthy default beverage with the most recent children’s restaurant meal. Secondary outcomes included beverage volume, sugar and calorie intake, and selection of beverage types. Models were weighted and adjusted for demographics, dining mode, and caregiver attitudes.</jats:p>\n                  </jats:sec>\n                  <jats:sec id=\"ab-zoi260500-9\">\n                    <jats:title>Results</jats:title>\n                    <jats:p>\n                      A total of 1006 caregivers completed the baseline survey (736 [73.2%] female; 506 in New Orleans, 500 in Baton Rouge), and 1131 completed the postpolicy survey (548 [48.5%] female; 556 in New Orleans, 575 in Baton Rouge). Healthy beverage ordering decreased in both cities, but comparison of before-and-after differences between the 2 cities indicates the ordinance was associated with higher odds of ordering a healthy beverage (adjusted odds ratio [aOR], 2.10; 95% CI, 1.16 to 3.83;\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       = .02), attenuating the ordering decline in New Orleans. Sugar intake decreased by 5.6 g (95% CI, −9.6 to −1.5 g;\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       = .007), and calorie intake declined by 34.0 kcal (95% CI, −59.1 to −8.9 kcal;\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       = .008). The odds of ordering water increased (aOR, 2.08; 95% CI, 1.12 to 3.85), while the odds of ordering 100% juice decreased (aOR, 0.59; 95% CI, 0.36 to 0.96). No significant changes were observed for SSBs or beverage volume.\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec id=\"ab-zoi260500-10\">\n                    <jats:title>Conclusions and Relevance</jats:title>\n                    <jats:p>In this survey study, the New Orleans HDB ordinance was associated with modest but meaningful improvements in children’s beverage ordering, supporting default-based policies as a tool for promoting healthier dietary behaviors.</jats:p>\n                  </jats:sec>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"42268608","pmcid":"PMC13254729","openalex_id":"https://openalex.org/W7164194324","authors":[],"funders":[],"total_grants":0,"fwci":0.0,"citation_percentile":0.68906786,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://doi.org/10.1001/jamanetworkopen.2026.17749","host_type":"journal"},{"url":"https://doi.org/10.1001/jamanetworkopen.2026.17749","host_type":"publisher"},{"url":"https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2850134/fuster_2026_oi_260500_1780432334.19706.pdf","host_type":"publisher"},{"url":"https://pubmed.ncbi.nlm.nih.gov/42268608","host_type":"repository"},{"url":"https://pubmed.ncbi.nlm.nih.gov/42268608/","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC13254729","host_type":"Europe_PMC"}],"fields_of_study":["Obesity, Physical Activity, Diet","Consumer Attitudes and Food Labeling","Nutritional Studies and Diet","Humans","Female","Child","Child, Preschool","New Orleans","Male","Beverages","Sugar-Sweetened Beverages","Restaurants","Nutrition Policy"],"mesh_terms":["Sugar-Sweetened Beverages","Beverages","Child","Child, Preschool","Female","Humans","Male","Restaurants","Nutrition Policy","New Orleans"],"keywords":["Baton rouge","Psychological intervention","Obesity","Meal","Beverage industry","Healthy food"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"doi"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-07T15:15:24.120876Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}