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by Stephanie Linakis, MS

The Crime

Cookies, candy, breakfast cereal, and ice cream may be sweet, but they aren't the largest source of daily calories for adults and kids. That honor goes to sugar-sweetened beverages.

Sugar-sweetened beverages, or SSBs, are at the center of much debate in obesity research these days. More and more studies support an association between SSB consumption and heightened caloric intake, weight gain, obesity and a number of other poor health outcomes among people of all ages. And it’s not just soda. Other carbonated soft drinks, juice, sport and energy drinks, sweetened milk, tea, and coffee, and other beverages where any type of sugar has been added stand colorfully side by side in the suspect lineup.

The Punishment

Policymakers and public health advocates have proposed varied strategies for reducing SSB intake. Perhaps most notoriously (or famously?), former New York City Mayor, Michael Bloomberg, attempted in 2012 to limit the sale of sodas and other sugary beverages to no more than 16 ounces nearly everywhere that they are sold, except groceries and convenience stores. As background, McDonald’s has increased drink sizes 457 percent since 1955, from 7 fluid ounces to 32 fluid ounces. Regardless, critics immediately attacked the proposed “ban” as further evidence of the Mayor’s growing nanny state, especially the beverage industry. In June 2014, the N.Y. state Court of Appeals ruled the ban illegal on the grounds that the local health board overstepped its authority.

Taxing SSBs has been perhaps the most common approach to curbing SSB consumption. As of January 1, 34 states and D.C. are applying sales taxes to regular, sugar-sweetened sodas through food stores.  However, a report from Yale’s Rudd Center for Food Policy & Obesity that the sales taxes are not significant or obvious enough to consumers to reduce consumption. 

In response, policymakers are increasingly considering larger excise taxes, where consumers see the increased price at the point of purchase. Congresswoman Rosa DeLauro (D-CT) introduced the federal Sugar-Sweetened Beverages Tax Act of 2014 (SWEET Act), which would amend the I.R.S. code to impose a one-cent excise tax on manufacturers for every teaspoon of added sugar in beverages. The tax would raise approximately $10m in revenue that would be directed towards programs to reduce health conditions related to sugar-sweetened beverage consumption.

If Representative DeLauro’s bill succeeds, while it’s a long shot, the U.S. would join Mexico in having a national SSB tax. Mexico’s policy went into effect this year, and taxes soda at the rate of one peso (roughly US$.08) per liter. Consumption is already down

The Plea

Other strategies have been employed for reducing SSB intake, too, including public education and warning labels, eliminating them from hospitals and schools, etc. I vote for more of all the above – taxes, education, warning labels, etc. alike. Package design (size and shape) can bias perceptions of quantity, and consumers subsequently drink more as a result.  Redesigning packages to help reduce consumption might be effective.  The obesity epidemic is a crisis, calling for all hands (or options) on deck.
 


Comments

Rich P.
10/03/2014 1:29am

Should artificial sweeteners be one of the "all hands" approaches?

Reply
Stephanie Linakis
10/06/2014 5:16pm

Great question, Rich. As for whether consuming artificial sweeteners in the place of sugar-sweetened products leads to weight loss or maintenance, the evidence is mixed. A very recent study in Nature (J. Suez et al. Nature http://dx.doi.org/10.1038/nature13793; 2014) claims that artificial sweeteners can in fact raise blood sugar levels by altering the balance of gut microbes, and has reopened this debate with new vigor. Whether the results from this study (conducted with mice) extend to humans is uncertain, and we probably need more research before conclusions can be drawn. Until then, yes – I personally can see a limited role for artificially sweetened drinks as an alternative to sugar-sweetened ones; artificial sweeteners may not be harmless, but sugar is a known bad actor.

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