Baseline Assessment of Children’s Meals and Healthy Beverage Options Prior to a State-Level Healthy Default Beverage (HDB) Law
Black Girls Move


Healthy Default
Children’s Meals
Childhood Obesity

How to Cite

McGurk, M., Cacal, S., Vu, U., Sentell, T., Beckelman, T., Lee, J., Yang, A., & Pirkle, C. (2021). Baseline Assessment of Children’s Meals and Healthy Beverage Options Prior to a State-Level Healthy Default Beverage (HDB) Law. Journal of Healthy Eating and Active Living, 1(2), 63–73.


In January 2020, Hawai‘i became the second state with a healthy default beverage (HDB) law, requiring restaurants to offer HDBs with their children’s meals. This observational study presents baseline characteristics of restaurants with a children’s menu and meal, and describes pre-law beverage options to inform future HDB policy language, implementation, and evaluation. Between November and December 2019, data were collected from a statewide sample of unique restaurants (n=383) with health inspection permits. Restaurants were assessed separately for a children’s menu and meal using website reviews, telephone calls, and in-person visits. Meals were evaluated in February 2020 for pre-law beverage type and compliance. Logistic regression was used to estimate the likelihood of having a children’s menu and meal. Most of the restaurants were full-service (70.2%) and non-chains (67.9%). While 49.3% of restaurants had a children’s menu, only 16.7% had a meal. Significant predictors of having a children’s menu were being full-service (OR=2.09; p=0.004), national/international (OR=5.32; p<0.001) or local chains (OR=1.99; p=0.03), neighbor island (non-Honolulu) locations (OR=2.49; p<0.001), and hotel locations (OR=3.77; p<0.001). Only being a national/international chain significantly predicted having a children’s meal (OR=7.57; p<0.001). Although 35.9% of children’s meals offered a non-sugar-sweetened beverage (SSB) option, only 3.1% offered law-compliant beverages. Inclusion of an SSB default option (60.9%) and not specifying the type of default beverage were the predominant factors for pre-law non-compliance. Results support the need for HDB regulations, especially for national/international chains, which were most likely to have children’s meals, and provide data to inform policies in other jurisdictions.


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Copyright (c) 2021 Meghan D. McGurk, Stephanie L. Cacal, Uyen Vu, Tetine Sentell, Toby Beckelman, Jessica Lee, Alyssa Yang, Catherine M. Pirkle