Water Access and Consumption


Water is an ideal beverage choice for children and adults.  It hydrates the body, is very low-cost, and is calorie-free.  Limited access to water during school and after-school hours can pose problems for children’s health if it makes high calorie, sugary drinks (such as soda, fruit drinks, sport drinks, fruit-ades and juice) the default choice for hydration throughout the day.

Reforms are already underway at the school district, state, and federal levels to increase access to safe, free drinking water in school and after-school settings.  With the “Act Relative to School Nutrition,” signed into law on July 30, 2010, the Massachusetts State government required that nutrition standards be developed for competitive foods and beverages, and that schools make water available to all students during the day without charge.  In 2011, the California State government passed similar reform, mandating that school districts provide free access to fresh drinking water during meal times in school food service areas. On a national level, The Healthy, Hunger-Free Kids Act of 2010 requires that schools participating in the National School Lunch Program make potable water available to children at no charge in the place where meals are served during meal times.

The Harvard Prevention Research Center is working with community partners in Boston, including the Boston Public Health Commission, to create public spaces that promote water consumption and reduce access to unhealthy beverages. Below you will find:

  • Lessons to use with children and adolescents and in afterschool and out-of-school time programs to teach kids the importance of healthy lifestyles, including water consumption.
  • Tips for making your school and afterschool program water-friendly.
  • Sample materials which can be handed or emailed to families for communicating these messages.
  • Examples of national and state regulations to promote water in schools.
  • Scientific Publications from the HPRC that provide the evidence-base for the impact of water-access and quality on children’s health, including evidence of successful strategies to increase water access and consumption in afterschool programs and a study comparing costs of different water delivery systems.

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The following units are sample lessons and parent communications from the HPRC’s afterschool Out-of-School Nutrition and Physical Activity, and Food & Fun curricula.

Out of School Nutrition and Physical Activity (OSNAP)                          

OSNAP is an initiative designed to develop healthy habits related to healthy foods, drinks, and physical activity through sustainable policy and environmental strategies during out-of-school time hours. This initiative promotes the following nutrition goals during program hours:

  • Do not serve sugar-sweetened drinks.
  • Offer water as the primary drink every day.
  • Offer a fruit or vegetable option every day.
  • Do not serve foods with trans fats.
  • Do not allow sugar-sweetened drinks to be consumed during program time.
  • When serving grains (like bread, cereals and crackers) at snack, serve whole grains. (A snack is whole grains if a whole grain is listed first on an ingredient label).

Tip Sheets for Implementing Increased Access to Water in Out-of-School-Time Settings: Read about OSNAP’s Quick Start Guide to Promoting Water in afterschool settings.

Food & Fun

This curriculum is designed to assist program staff in providing healthier environments to children during out-of-school time. Food & Fun Afterschool includes 11 teaching units that use both lessons and activities to encourage healthy behaviors through active play, literacy and math skills development, creative learning, and hands-on snack time activities.

Unit 10: Information for Leaders

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Cradock AL, Wilking C, Olliges S, Gortmaker SL. Getting Back on Tap: The Policy Context and Cost of Ensuring Access to Low-Cost Drinking Water in Massachusetts Schools. Am J Prev Med. 2012 Sep;43(3 Suppl 2):S95-101.

Giles CM, Kenney EL, Gortmaker SL, Lee RM, Thayer JC, Mont-Ferguson H, Cradock AL. Increasing Water Availability During Afterschool Snack: Evidence, Strategies, and Partnerships from a Group Randomized Trial. Am J Prev Med. 2012 Sep;43(3 Suppl 2):S136-42.

Gortmaker SL, Story M. Nutrition policy research that can lead to reduced childhood obesity in the u.s. Am J Prev Med. 2012 Sep;43(3 Suppl 2):S149-51.

Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. The Lancet 2001;357:505-508.

Wang YC, Bleich SN, Gortmaker SL. Increasing caloric contribution from sugar-sweetened beverages and 100% fruit juices among US children and adolescents, 1988-2004. Pediatrics. 2008 Jun;121(6):e1604-14.

Wang YC, Ludwig DS, Sonneville K, Jiang H, Gortmaker SL. Impact of change in sweetened caloric beverages on energy intake among children and adolescents. Arch Pediatr Adolesc Med. 2009 Apr;163(4):336-43.

Bleich SN, Wang YC, Wang Y, Gortmaker SL. Increasing Consumption of Sugar-Sweetened Beverages among U.S Adults: 1988-94 to 199-2004. Am J Clin Nutr. 2009 Jan;89(1):372-81.

Mozaffarian RS, Wiecha JL, Roth BA, Nelson TF, Lee RM, Gortmaker SL. Impact of an organizational intervention designed to improve snack and beverage quality in YMCA after-school programs. Am J Public Health. 2010 May;100(5):925-32.

Cradock AL, McHugh A, Mont-Ferguson H, Grant L, Barrett JL, Wang YC, Gortmaker SL. Effect of school district policy change on consumption of sugar-sweetened beverages among high school students, Boston, massachusetts, 2004-2006. Prev Chronic Dis. 2011 Jul;8(4):A74.

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Other Resources

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