Measure requires restaurants to offer healthy drink options as default choice for keiki meals


Hayli Kealoha, 7, left, and Brieh Kealoha-Wong, 6, eat Happy Meals with their grandparents, Lenora Fabrao-Wong and Guy Wong Sr. (not pictured) and dad, Guy Wong Jr., on Wednesday at McDonalds in downtown Hilo.

All Hawaii restaurants will now be required to offer healthier default drink options with keiki meals.

Among three health-related bills Gov. David Ige signed Tuesday was Senate Bill 549, which requires restaurants to offer healthy beverages as a default choice for drinks automatically included as part of a children’s meal.


Those beverages can include water; sparkling water or flavored water with no added sugar, corn syrup or other natural or artificial sweeteners; 8 ounces or less of unflavored nonfat or 1% dairy milk or a nutritionally equivalent nondairy beverage; and 8 ounces or less of 100% fruit or vegetable juice, or juice diluted with water or carbonated water, with no added sweeteners.

“This afternoon, we’ll be signing three bills that I think allows us to continue to be the healthiest state in the nation,” Ige said during a bill signing ceremony Tuesday. “… And it is measures like the three bills we’ll be signing today that really puts us front and center and … allows us to continue to be leading the charge in terms of keeping our community healthy and active and, most importantly, living long and contributing lives.”

Ige said later, “… I think we do know that many, many, many bad calories are in the drinks that our children consume, and certainly Senate Bill 549 is an effort to reduce that bad habit that some in our community have.”

According to the legislation, Hawaii has experienced an unprecedented increase in obesity and chronic conditions such as type 2 diabetes, heart and liver disease and tooth decay throughout the past 30 years, and in 2013 Hawaii spent an estimated $470 million on obesity-related medical costs.

Soda and other sugary drinks are the largest source of excess sugar in the American diet.

Much of the testimony submitted before committee hearings during the legislative process supported the measure.

“Requiring retail food establishments to provide a healthy default beverage as a part of a children’s meal would encourage families to choose a healthy option when eating outside the home,” the state Department of Health wrote in testimony. “On average, children consume nearly twice as many calories from a restaurant meal (770) as they do from a home cooked meal (420). Adding (sugar-sweetened beverages) to these meals adds calories and sugar that may contribute to obesity and health problems. Ensuring healthy default options in children’s meals is part of a comprehensive public health prevention strategy to reduce the risk for obesity and type 2 diabetes in Hawaii’s children.”

However, Victor Lim, legislative lead for the Hawaii Restaurant Association, wrote in submitted testimony that the organization, which represents more than 3,600 restaurants, thought the legislation might not be necessary.

“Most of the major quick service restaurants have been doing this practice since 2015, and the intent of the Legislature is for this practice to cover all restaurants as one of the possible ways to combat childhood obesity and diabetes in children,” he said Wednesday in an email to the Tribune-Herald.

The legislation does not prohibit restaurants from selling, or a customer from purchasing, an alternative beverage if requested by the customer.

“This policy provides a subtle way of offering the healthy option as the easier choice, to nudge people towards healthy behaviors,” said Lola Irvin, administrator of the DOH Chronic Disease Prevention and Health Promotion Division.

According to Irvin, the DOH will be responsible for creating administrative rules that describe the implementation of the new law.

“Rather than a punitive approach, the legislation creates an equal field for all restaurants that advertise and offer set children’s menus, since all will be offering healthy beverages as the default option,” she said.

The DOH will develop educational materials for restaurants with quick service counters and table service, Irvin said. The department also will follow up with complaints and reach out to businesses not providing the required healthy beverage choices.

The bill was co-introduced by Big Island Sen. Lorraine Inouye, who said she supported the measure because of the concern regarding obesity.

“It’s so important because obesity leads to all sorts of health issues, and it starts at a young age,” she said.

Inouye said she did not receive any comments about the measure.

“So this is a step on the right direction,” she said. “We’ve made changes to the school lunches years ago, to make sure these are healthy meals … This is another good step.”

Email Stephanie Salmons at

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