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Evaluating the Potential Health and Revenue Outcomes of a 100% Healthy Vending Machine Nutrition Policy at a Large Agency in Los Angeles County, 2013-2015

Wickramasekaran, Ranjana, N., MPH; Robles, Brenda, MPH; Dewey, George, MPH; Kuo, Tony, MD, MSHS

Journal of Public Health Management and Practice: May/June 2018 - Volume 24 - Issue 3 - p 215–224
doi: 10.1097/PHH.0000000000000702
Research Reports: Research Full Report

Context: Healthy vending machine policies are viewed as a promising strategy for combating the growing obesity epidemic in the United States. Few studies have evaluated the short- and intermediate-term outcomes of healthy vending policies, especially for interventions that require 100% healthy products to be stocked.

Objective: To evaluate the potential impact of a 100% healthy vending machine nutrition policy.

Design: The vendor's quarterly revenue, product sales records, and nutritional information data from 359 unique vending machines were used to conduct a baseline and follow-up policy analysis.

Setting: County of Los Angeles facilities, 2013-2015.

Participants: Vending machines in facilities located across Los Angeles County.

Intervention: A healthy vending machine policy executed in 2013 that required 100% of all products sold in contracted machines meet specified nutrition standards.

Outcome Measures: Policy adherence; average number of calories, sugar, and sodium in food products sold; revenue change.

Results: Policy adherence increased for snacks and beverages sold by the vending machines by 89% and 98%, respectively. Average snack and beverage revenues decreased by 37% and 34%, respectively, during the sampled period.

Conclusions: Although a 100% healthy vending policy represents a promising strategy for encouraging purchases of healthier foods, steps should be taken to counteract potential revenue changes when planning its implementation.

Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, California (Mss Wickramasekaran and Robles, Mr Dewey, and Dr Kuo); Departments of Community Health Sciences (Ms Robles) and Epidemiology (Mr Dewey and Dr Kuo), UCLA Fielding School of Public Health, Los Angeles, California; and Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California (Dr Kuo).

Correspondence: Brenda Robles, MPH, Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Blvd, 8th Floor, Los Angeles, CA 90010 (

This study was part of a project supported partially by a Centers for Disease Control and Prevention initiative in Los Angeles County (# 1U58DP004927-01, 2013-2016). The authors thank Michelle Wood and Patricia L. Cummings for their support and contributions to the sodium reduction work in Los Angeles County. The authors also thank Katrina Vo and Victor Shiau for their technical assistance on the project.

The findings and conclusions in this article are those of the authors and do not necessarily represent the views or the official positions of the Los Angeles County Department of Public Health, Centers for Disease Control and Prevention, or the University of California, Los Angeles. Sources of data for this study included program data and information from the County of Los Angeles.

The authors declare no conflicts of interest.

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