ArticlePublic health nutrition2018
Product reformulation and nutritional improvements after new competitive food standards in schools.
Article in Public health nutrition, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- A Practical Perspective on Confronting the Obesity Epidemic: Public-Health Strategies.Nutrients · 2026Review
- Food Service Directors' Knowledge and Beliefs About Ultraprocessed Foods in California's San Joaquin Valley Schools.Preventing chronic disease · 2026Article
- The effectiveness of mandatoryThe British journal of nutrition · 2025Review
- Alignment Of US School Lunches With The EAT-Lancet Healthy Reference Diet's Standards For Planetary Health.Health affairs (Project Hope) · 2020Article
- Documented Success and Future Potential of the Healthy, Hunger-Free Kids Act.Journal of the Academy of Nutrition and Dietetics · 2020Article
- Post-Healthy, Hunger-Free Kids Act Adherence to Select School Nutrition Standards by Region and Poverty Level: The Healthy Communities Study.Journal of nutrition education and behavior · 2020Observational
- The Impact of 1 Year of Healthier School Food Policies on Students' Diets During and Outside of the School Day.Journal of the Academy of Nutrition and Dietetics · 2018Observational
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectiveIn 2012, Massachusetts enacted school competitive food and beverage standards similar to national Smart Snacks. These standards aim to improve the nutritional quality of competitive snacks. It was previously demonstrated that a majority of foods and beverages were compliant with the standards, but it was unknown whether food manufacturers reformulated products in response to the standards. The present study assessed whether products were reformulated after standards were implemented; the availability of reformulated products outside schools; and whether compliance with the standards improved the nutrient composition of competitive snacks.
designAn observational cohort study documenting all competitive snacks sold before (2012) and after (2013 and 2014) the standards were implemented.
settingThe sample included thirty-six school districts with both a middle and high school.
resultsAfter 2012, energy, saturated fat, Na and sugar decreased and fibre increased among all competitive foods. By 2013, 8 % of foods were reformulated, as were an additional 9 % by 2014. Nearly 15 % of reformulated foods were look-alike products that could not be purchased at supermarkets. Energy and Na in beverages decreased after 2012, in part facilitated by smaller package sizes.
conclusionsMassachusetts' law was effective in improving the nutritional content of snacks and product reformulation helped schools adhere to the law. This suggests fully implementing Smart Snacks standards may similarly improve the foods available in schools nationally. However, only some healthier reformulated foods were available outside schools.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.