Can Simply Providing Water to Students Affect Their Weight?

Summary and Comment |
January 26, 2016

Can Simply Providing Water to Students Affect Their Weight?

  1. John D. Cowden, MD, MPH

Providing easily accessible water in school cafeterias was linked to reduced weight.

  1. John D. Cowden, MD, MPH

The removal of sugar-sweetened beverages, such as soda, juice, and energy drinks, from schools has become a popular way to combat the child obesity epidemic in the U.S. A complementary strategy — making water more easily available and attractive as a school lunch drink option — was evaluated in a quasi-experimental study of roughly 1.1 million elementary and middle school students in New York City.

The study involved 483 public schools that installed “water jets” (large, fast-dispensing, electrically-cooled, water jugs costing about $1000 each) in cafeterias from 2008 to 2013 and 744 schools that did not. Standardized body-mass index (zBMI), overweight, and obesity were compared before and after installation of water jets between students at schools with and without water jets.

Water jet availability was associated with small, but significant, reductions in zBMI and rate of overweight in boys (–0.025 and –0.9 percentage points, respectively) and in girls (–0.022 and –0.6 percentage points, respectively), as well as rate of obesity in boys (–0.5 percentage points). In exploring possible mechanisms for this reduction, the authors found that students in schools with water jets bought about 14 fewer half-pints of fat-free chocolate milk per student per year.


Although the childhood obesity epidemic has complex causes, there are simple, school-based solutions that can have a significant effect on children's nutrition. Pairing removal of sweet drinks with addition of easily accessible water holds promise at the public health policy level and can inform conversations with families in the clinical setting, as well.

Editor Disclosures at Time of Publication

  • Disclosures for John D. Cowden, MD, MPH at time of publication Leadership positions in professional societies Co-Chair, Culture, Ethnicity, and Health Care Special Interest Group, Academic Pediatric Association


Reader Comments (2)

Steve Park Physician, Other, Essentia Health Obesity Medicine

Why are schools still serving fat free CHOCOLATE milk with sugar?

THOMAS BEACH Physician, Family Medicine/General Practice, Gaylord MI Veterans Clinic

Interesting. When I was in grade through high school, schools had water fountains in the hall. What happened?

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