Rudd Center for Food Policy and Obesity
The Rudd Center Health Digest

November 2013

Rudd Center Launches Update on Fast Food FACTS Report

Fast Food FACTS

In 2012 the fast food industry spent $4.6 billion to advertise mostly unhealthy products, and children and teens remained key audiences for that advertising, according to a new report by the Yale Rudd Center for Food Policy & Obesity. The report highlights a few positive developments, such as healthier sides and beverages in most restaurants’ kids’ meals, but also shows that restaurants still have a long way to go to promote only healthier fast food options to kids. 

“There were some improvements, but they have been small, and the pace too slow,” said Marlene Schwartz, PhD, Rudd Center Director. “Without more significant changes, we are unlikely to see meaningful reductions in unhealthy fast food consumption by young people.”

The report, “Fast Food FACTS 2013,” is a follow-up to a report released in 2010. Using the same methods, researchers examined 18 of the top fast-food restaurants in the United States and documented changes in the nutritional quality of menu items along with changes in marketing to children and teens on TV, the Internet, mobile devices and in social media.

“Most fast food restaurants stepped up advertising to children and teens,” said Jennifer Harris, PhD, MBA, the Rudd Center’s Director of Marketing Initiatives and lead author of the report. “Most advertising promotes unhealthy regular menu items and often takes unfair advantage of young people’s vulnerability to marketing, making it even tougher for parents to raise healthy children.”

The authors recommend that restaurants apply nutrition standards to all kids’ meals and automatically provide healthy sides and beverages. They also should stop marketing their least healthy items to children and teens, added the researchers.

The release of the report was covered by major media outlets, including Bloomberg BusinessweekLos Angeles Times, U.S. News & World Report, Time Health & Family, and Advertising Age.

The full report, report summary, and tools for consumers and researchers, including a video about marketing, a video about nutrition and an infographic are available at

The Center for Science in the Public Interest used research from Fast Food FACTS to inform an action alert urging restaurants to remove soda from children’s menus.

Detailed findings of the report were presented at the American Public Health Association’s annual meeting in Boston. The report was supported by a grant from the Robert Wood Johnson Foundation.

Fast Food FACTS 2013 was co-authored by Rudd Center’s Jennifer L. Harris, PhD, MBA, Director of Marketing Initiatives; Marlene B. Schwartz, PhD, Director; Christina R. Munsell, MS, RD, Research Associate; Cathryn Dembek, MBA, Research Associate; Sai Liu, MPH, Biostatistician; Megan LoDolce, MA, Research Associate; Amy Heard, BA, Research Assistant; Frances Fleming-Milici, PhD, Research Associate; and Bridgette Kidd, MS, RD, former Research Assistant.

WellSAT Helps Health and Education Agencies Improve Wellness Policies


The Rudd Center for Food Policy & Obesity’s Wellness School Assessment Tool (WellSAT) is a reliable and user-friendly resource for health and education agencies to use to improve Local Wellness Policies (LWPs) and align them with federal standards, according to a study recently published by the New York State Department of Health in the Journal of School Health.

The Child Nutrition and WIC (Women, Infants and Children program) Reauthorization Act of 2004 mandates that all school districts participating in the National School Lunch Program write LWPs, with the goals of improving school nutrition and increasing quality physical education.  

The WellSAT allows users to assess the quality of their school district’s wellness policy, and provides them with personalized guidance and resources to make improvements. The online, interactive tool is user-friendly and free for anyone to use.

In the current study, researchers from the New York State Department of Health asked five public health practitioners to use the WellSAT to assess 50 LWPs. Researchers also field tested the WellSAT with 18 public health practitioners as part of a statewide public health initiative.

Results from both phases of the study demonstrated that the WellSAT was feasible for users not accustomed to research. In the initial phase, all five public health practitioners used the online application successfully to code their assigned policies, download data files, and submit them through e-mail. Participants in the field study reported a steeper learning curve when completing the WellSAT; however, all eighteen participants were able to use the WellSAT to assess the LWPs of school districts, share the results with local wellness committees and download and submit their data.

“Previous research shows that written school wellness policies have the potential to promote significant improvements in the school environment,” said Kathryn Henderson, PhD, co-author and Rudd Center Director of School and Community Initiatives. “This study shows that the WellSAT is a practical tool for education or health agencies to use in evaluating and strengthening these policies.”

“School wellness policies are an important tool for promoting healthy eating and physical activity through changes in school environments, “said Meghan O’Connell, MPH, co-author and Rudd Center Research Associate. “The WellSAT offers a consistent and reliable means of assessing the comprehensiveness and strength of school wellness policies within or among states.”

The study was funded and conducted by the Chronic Disease and Risk Factor Surveillance Unit at the New York State Department of Health. The development of the WellSAT was funded by the Robert Wood Johnson Foundation. Other authors include Kathleen Wales, BS, from the Bureau of Chronic Disease Evaluation and Research in the New York State Department of Health, and the Rudd Center’s Research Associate, Meghan O’Connell, MPH. 

Sesame Street Characters to Promote Fruits and Vegetables to Children

Sesame Workshop, the Produce Marketing Association (PMA), and the Partnership for a Healthier America (PHA) have teamed up to encourage kids to consume more fruits and vegetables. As part of its commitment to PHA, Sesame Workshop will license its characters to PMA’s community of growers, suppliers, and retailers for free for two years to promote fruits and vegetables to children.

"Sesame Workshop's commitment to donate its characters to market fruits and vegetables shows tremendous dedication to the cause of improving young children's diets,” said Rudd Center Director, Marlene Schwartz, PhD. “Instead of undermining parents, as most child-directed food marketing does, these trusted characters will be parents' allies in the grocery store."

The partnership was announced at the White House and is part of First Lady Michelle Obama’s Let’s Move! initiative. The announcement follows the first-ever White House convening on food marketing to children, during which the First Lady called on stakeholders to leverage the power of marketing to promote healthy products and decrease the marketing of unhealthy products to kids.

Sesame Street characters may be on produce in stores as early as mid-2014.    

Stigma-based Bullying Associated with Negative Mental and Physical Health Outcomes among Adolescents

Rudd Center Image Gallery

Weight-and race-based stigmatization during adolescence may have implications for changes in health outcomes across development, according a study published by Yale researchers in the Journal of Health Psychology.

The study examined the associations between stigma-based bullying and health outcomes using survey and health data from 644 students in 12 New Haven public schools. The majority of the students were Black or Latino, 90% of whom were eligible for free or reduced-price school meals.

Over a two-year span, researchers found that reported stigmatization among Black and Latino, socioeconomically disadvantaged, urban students, was indirectly associated with increased blood pressure and BMI as well as decreased self-reported health due to mental health symptoms. The researchers determined that weight-and race-based bullying were both associated with greater negative emotional symptoms, which in turn were associated with adverse changes in physical health.

Previous research has found that weight, race, and other forms of bias can increase vulnerability to poor body image, low self-esteem, and depression. Evidence from the current study shows that mental health is an important mechanism driving the link between stigma-based bullying and physical health outcomes.

According to the Yale researchers, more research is needed to understand how stigma-based bullying and other forms of discrimination affect health outcomes throughout the course of an individual’s life.

The Rudd Center offers resources and strategies for victims of bias, including young people and families, as well as for professionals who work with them, including teachers, employers, and health care professionals. 

The study was authored by Lisa Rosenthal, Assistant Professor, Pace University; Valerie Earnshaw, Postdoctoral Fellow, CIRA, Yale University; Amy Carroll-Scott, Associate Research Scientist, Yale University School of Public Health; Kathryn Henderson, Director of School and Community Initiatives, Yale Rudd Center; Susan Peters, New Haven, CT Public Schools; Catherine McCaslin, Director of Department of Research, Assessment, and Student Information, New Haven Public Schools; and Jeannette Ickovics, Professor of Epidemiology and Public Health and Psychology, Yale University. 

Mexico Passes Sugary Drink Tax 

In a move to curb spiraling obesity rates and raise much-needed revenue, Mexico’s Senate passed a 1peso-per-liter tax on sugary beverages. Mexico is the world’s largest consumer of soda, and recently surpassed the United States in obesity levels. 

Reuters reported that Mexico is the first large soft-drink consumer market to impose a tax on sugary drinks. Beverage companies are expected to raise their prices in response to the tax, and pass the cost on to consumers. Research indicates that increased costs could reduce consumption.

Upcoming Seminar Speakers 

December 4, 2013 12:30 pm
Amy Dawson Taggart
National Director, Mission: Readiness
Childhood Obesity: A National Security Issue?

Subscribe to our mailing list to receive reminders of upcoming seminars and schedule changes. 

Unless otherwise noted, seminars are held at the Rudd Center. The seminars are free and open to the public. Seating is limited. The full schedule for the Fall Seminar Series is available online and for download.

Just Published by the Rudd Center

Families on Food Assistance Buying Fewer Full-Fat Dairy Products

Efforts to reduce consumption of saturated fat among women and young children receiving food assistance appear to be paying off, according to a study by the Yale Rudd Center for Food Policy & Obesity.

Purchases of whole milk and cheese have decreased among families participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) after the program was revised in 2009 to offer foods that better reflect the Dietary Guidelines for Americans. The study is published in the Journal of the Academy of Nutrition and Dietetics.

The WIC program is designed to help meet the nutritional needs of pregnant and postpartum women, infants, and young children who are at nutritional risk. Prior to the WIC food package revisions, allowances of milk and cheese exceeded dietary recommendations for dairy consumption in very young children, and most milk consumed was whole milk. After the revisions, whole milk was authorized only for children under age 2, while women and older children received milk with no more than 2% milk fat. States could further restrict it to low- or non-fat milk. Cheese allowances were largely reduced too.

The Yale researchers examined milk and cheese purchases made at a New England supermarket chain by Connecticut households participating in WIC, over a two-year period. Milk and cheese volume purchased by these households were compared before and after the WIC revisions.

The most significant change after the WIC revisions was replacement of whole milk with lower-fat varieties, resulting in a reduction in consumption of saturated fat from purchased milk. Prior to the revisions in Connecticut, whole milk accounted for, on average, 57% of total milk purchases and 56% of WIC milk purchases. With the new WIC packages, the whole-milk share declined to 33% in total milk purchases, and 25% in WIC milk purchases. Purchases of cheese using WIC benefits declined after the revisions by 77%.

The WIC revisions did not result in unintended consequences, such as substantial decreases in milk purchases below recommend levels.

The authors assert that similar results have been seen from other food policy changes. A study published in the journal Pediatrics examined juice purchases after the WIC revisions, and found that 100% juice was purchased about 25% less often by WIC participants. A study recently published in the American Journal of Preventive Medicine found that purchases of 100% whole-grain bread and brown rice increased among WIC participants.

“Reducing saturated fat consumption was one of the goals for revising the WIC food packages,” said Tatiana Andreyeva, PhD, lead author and director of economic initiatives at the Rudd Center. “This study shows that the revisions were successful and necessary, given excessive consumption of saturated fat and calories by vulnerable populations.”

Andreyeva’s co-authors include Rudd Center’s Joerg Luedicke, MS, Statistical Consultant; Kathryn Henderson, PhD, Director of School and Community Initiatives; and Marlene Schwartz, PhD, Director. 

The study was funded by a grant from the Economic Research Service at the U.S. Department of Agriculture.  

The Latest Rudd Center Podcasts

Olivier De Schutter, PhD, LLM
Professor, University of Louvain and College of Europe; Visiting Professor, Columbia University; Global Law School Faculty, New York University
Reforming the Food Systems: Making the Transition Succeed

Dianne Ward, EdD
Professor of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
Going to Scale: Strategies for Disseminating the NAP SACC Program

Kathleen L. Keller, PhD and Katharine L. Loeb, PhD
Assistant Professor, Department of Nutritional Sciences and Department of Food Science, Pennsylvania State University
Associate Professor, School of Psychology; Director, PhD Program in Clinical Psychology; Fairleigh Dickinson University
Optimal Defaults and Associative Conditioning: Two Strategies to Change Children's Eating Behavior in the Prevention of Childhood Obesity

The Rudd Center’s extensive library of podcasts is available for download on iTunes.

Front Burner News

Americans Say Obesity is Cause for Significant Concern

The majority of Americans feel obesity is cause for significant concern, but do not think the government should intervene with policies that may result in healthier eating habits, according to the Pew Research Center. Read more.

Weight Bias Bill Proposed in Massachusetts

The Massachusetts state legislature is considering a bill that would include weight in the state’s anti-discrimination laws. The bill will come up for a full vote later this year. Read more.

FDA Bans Trans Fats 

The Food and Drug Administration has declared that partially hydrogenated oils, the source of trans fats, are a threat to public health and will require the food industry to phase them out. Read more.

Guidelines Urge Doctors to Address Obesity  

A group of medical organizations, including the American Heart Association, the American College of Cardiology, and the Obesity Society, have released guidelines urging physicians to be aggressive when it comes to helping patients lose weight. Read more.

Doctors Recommend Limiting Kids’ Screen Time 

A new American Academy of Pediatrics policy recommends that kids’ screen time, including using a computer or smartphone for entertainment, be limited to two hours per day.
Read more.

Devastating Effects of Diabetes

Diabetes kills one person every six seconds and afflicts 382 million people worldwide, according to the International Diabetes Federation. The number of diabetes cases has climbed 4.4% over the past two years, affecting more than 5% of the world’s population. Read more.

McDonald’s Charitable Activities Questioned

McDonalds' fiscal support of the Ronald McDonald House Charities (RMHC) has not increased much over the years, according to a report by Corporate Accountability International, Eat Drink Politics, and the Small Planet Fund. Despite the ongoing publicity McDonald’s receives from the charity’s name, the fast food chain's donations still account for only 20% of the RMHC revenue. Read more.

Calorie Counts on Food Labels Sometimes Misleading 

Calorie counts on food labels can be off by 20% in some cases, and still be in compliance with FDA regulations, according to Market Watch. Read more.

New York City Health Department Launches Nutrition Tool 

The New York City Health Department recently launched MenuStat, a public database of 35,000 restaurant foods and beverages from 66 of the top U.S. restaurant chains. The database allows users to analyze nutrition trends across restaurants and food categories over time. Read more.

Role of Smartphone Apps in Dieting

Smartphone apps allow consumers to track every aspect of their diet, but some researchers question if this is a beneficial tool for health. Read more. 


Putting the Oversized Soda Fight into Perspective

Mayor Bloomberg's initiative to limit the portion size of sugary drinks aims to prevent the next generation of New Yorkers from developing potentially deadly habits, according to Richard Buery, President and CEO of The Children's Aid Society. Read more.

Coca-Cola’s Marketing Reality 

If Coca-Cola really wants to prevent obesity in kids, they should market their healthiest drinks rather than their unhealthiest, according to Nikki Highsmith Vernick, of the Horizon Foundation, Gene M. Ransom III, of MedChi, and Rev. Robert A.F. Turner, of People Acting Together in Howard County. Read more.

A Sugary Drink Tax Would Benefit Children and Families 

A sugary drink tax would dramatically reduce consumption of the beverages and save lives, according to California Senator Bill Monning, sponsor of a recent tax bill. Read more.


Voters Reject Sugary Drink Tax in Colorado

Telluride, Colorado voters rejected a ballot measure that would have instituted a one-cent-per-ounce tax on sugary drinks. The tax was meant to discourage soda consumption and raise an estimated $400,000 in revenue for health and wellness programming in the town. Read more.

Increase the Cost of Sugary Drinks to Decrease Sales

Raising the cost of high-calorie beverages by a few cents decreases the sales of these beverages, according to researchers at Harvard. Read more

Sugary Drink Tax Proposed in San Francisco

San Francisco has introduced a ballot measure that would impose a tax on sugary beverages. The proceeds would fund health, nutrition, and activity programs for city youth. Read more

Sugary Drink Tax Could Cut Obesity 

A 20% sugary drink tax would reduce the number of overweight or obese people in the UK by 285,000, according to experts from Oxford and Reading universities. Read more.  

Soda Companies Address Obesity but not Diabetes


Coke and Pepsi address obesity, but not diabetes, in their pro-health campaigns, according to an article in PR Newser. The reason for this, according to Georgetown University researchers, is that consumers consider diabetes to be a disease which beverage brands contribute to, whereas they consider obesity to be a lifestyle problem. Read more.

Boston Supermarkets Promote Healthy Beverages  

Boston’s Mayor Thomas Menino recently announced a partnership with several large supermarkets to help educate shoppers about healthy beverage options. Read more

Health Advocates Celebrate Mexico’s Sugary Drink Tax  

Mexico's leadership in passing a sugary drink tax may pave the way for other governments to use taxes to stem soda consumption, according to health advocates. Read more.  


Mexico Bans Junk Food Ads during Children's Programming
The Mexican government will mandate the removal of junk food advertisements from television during children's programming hours as part of a public health campaign. Read more.

Obese Youth are More Receptive to Fast Food Ads
Obese youth are more receptive to fast food advertisement tha non-obese youth, according to a new study published in the American Journal of Preventive Medicien. Read More

Online Privacy Bill Proposed 

A group of lawmakers have proposed joint bills that would curb tracking of, and advertising to, children on the internet. Read more.