The following is a guest post from Megan Yarbrough, Public Health Policy Campaign Manager at Rescue Social Change Group in Alexandria, VA. These views are her own.
Last week, Mayor Bloomberg announced a plan to limit the sale of sugary drinks in New York City’s restaurants, delis, movie theaters, and street carts – basically any food-serving venue that receives a letter grade from the health department. The new policy would ban the sale of sugary drinks larger than 16 ounces – and would only apply to drinks with 25 calories or more per eight ounces, specifically exempting diet sodas, fruit juices, and dairy-based drinks.
Strategically speaking, it’s a smart move. Unlike a sugary beverage tax, which would require the approval of the Council, the ban on sugary drinks larger than 16 ounces only requires approval from the city’s Board of Health, whose 11 members were all appointed by Mayor Bloomberg.
Naturally, Mayor Bloomberg’s announcement has caused some uproar. Will it work? I don’t have a crystal ball, but here’s what I think – and what the experts are saying.
First, it’s important to understand why Mayor Bloomberg chose sugary drinks. Contrary to what some seem to believe, he didn’t just put the names of all the food and beverages in America into a hat and pull one out.
Today, more than two-thirds of Americans are overweight or obese – and soft drinks are known to increase the risk of becoming overweight or obese.
Unfortunately, we’re buying more sugary drinks, historically speaking, than ever before. Portion sizes have ballooned in recent years. The average soda is now 6 times larger than it was in the 1950s. And if I were to stop off at a fast food restaurant and order a small-sized drink today, the beverage I would receive would be the same or larger than what I received when ordering a medium as a child.
What’s even crazier is that companies sold over 14 billion gallons of sugary drinks in 2008. To put that into perspective, that is the same as serving 506 12-oz servings per year to every single adult and child in America.
Then there’s the issue of actual consumption. Today, sugary drinks account for half of all added sugars in the average American diet. In teenage diets, sugary drinks are currently the biggest single source of calories and added sugars – and youth who drink more sugary beverages consume more calories per day than kids who drink fewer. In fact, one study by the Harvard School of Public Health found that each sugary drink serving consumed by a child per day increased that child’s chance of becoming overweight by 60%. Unfortunately, the average 12- to- 19-year-old boy consumes two 12-ounce sodas every day, with girls consuming just slightly (about 1/4) less.
Lastly, although the effectiveness of some measures meant to curb obesity may be less clear, the evidence that decreasing portion sizes leads to a decrease in calories consumed is strong. Larger containers mean people will consume more, often without regard to whether they are actually hungry or even enjoying the product they are eating. Take the well-known popcorn study from Cornell University, for example. It found that portion size matters just as much, if not more, than taste. According to the study, moviegoers given 2-week-old stale popcorn in big buckets ate 34% more than those given the same (gross!) stale popcorn in medium-sized containers.
All of that just scratches the surface as to why Bloomberg chose sugary drinks and not French fries, pizza, milkshakes or popcorn.
Understandably, people have some concerns. The first of which is what I just mentioned above – what about milkshakes, ice cream, French fries, and other fatty foods? But Americans are not consuming milkshakes or ice cream in the same quantities as they are sugary drinks – and while it’s true that sugary drinks aren’t the only unhealthy item out there, studies show that beverages are more likely to promote obesity than solid foods. Why? Because when people consume a solid food, like pizza, they are more likely to compensate to some degree by reducing calories consumed elsewhere in their diet. Unfortunately, the same cannot be said of beverages – meaning most people do not view their Big Gulp or that large drink they got with their combo meal as part of their overall diet and fail to factor the calories consumed into their overall intake. As a result, they are just extra calories on top of everything else.
A second common concern seems to be the “personal freedom” argument, coupled with the fear-mongering question, “What’s next? Why stop at banning soft drinks?” To address that concern, I’d first re-emphasize that this is a limit applied only to beverages over 16 ounces in specific venues, not an outright ban. You can still go to your local grocery store and pick up a 2-liter. Then I’d direct you to Michele Simon, author of Appetite for Profit, who correctly points out:
“…government places reasonable limits on all sorts of behaviors and business practices, every single day. Such as speed limits, which are meant to protect you as well as others. Society has also decided (instead of prohibition) to place various rules on how alcohol is produced, sold, and marketed. For example, many states place upper limits on how much alcohol can be in beer–a regulation designed to protect the health and safety of the public. The sky has not fallen, beer sales are doing well, and beer drinkers are happy (mostly).”
Another commonly used argument against Bloomberg’s proposed policy is exercise – that is, we should be focusing on getting people to move more, not eat less. Naturally, the soda companies are big proponents of this one. In an interview with CNN, Coca-Cola’s VP of Science and Regulatory Affairs, Rhona Applebaum, says the tragedy “is that we’ve taken physical education out of schools” and that the government should be focusing on increasing physical activity, not soda bans. (Ironically, before you can watch this video clip on CNN – you watch an ad by the American Beverage Association touting their public health contributions).
The problem with the exercise argument is that science disagrees. While it is certainly true that we’re moving less and that physical activity is crucial to a person’s wellbeing (regardless of their weight), we’re eating far, far more – and it is way more difficult to burn off calories than it is to just not consume them in the first place. The average adult needs to walk or jog at a moderate pace for 45-60 minutes to bun off 250 calories, the typical amount of calories found in a 20-ounce bottle of soda. Essentially, to fix this crisis, we need to consume way less and move more.
Related, of course, is the industry’s other favorite argument – that obesity is caused by a multitude of complex factors, not just sugary drinks. McDonald’s certainly agrees, telling Reuters that, “Public health issues cannot be effectively addressed through a narrowly focused and misguided ban. … This is a complex topic, and one that requires a more collaborative and comprehensive approach.”
So yes, it is. Does that mean we should do nothing to address obesity unless we can implement a policy that simultaneously addresses every last factor? I think not.
Popular industry arguments aside, I’ve seen a lot of comments on the Internet using the refill argument, or the argument that folks will just buy two drinks instead of one. When it comes to purchasing multiple beverages — history, and economics, suggests otherwise. Those who suggest that people will purchase two 16-ounce drinks in place of a 32-ounce forget the very reason that movie theaters and McDonald’s introduced larger portion sizes in the first place. People weren’t buying two, but they would purchase bigger portions. They were concerned with how it made them appear. Plus, there’s the added cost. If a small tax on soda would decrease consumption, I imagine so will paying twice as much for the same amount of soda. As for refills, I’m skeptical that folks will get up and go to the soda machine that many times. And, of course, some places don’t offer refills (like stadiums and often times movie theaters) – and other situations aren’t conducive to them (like the drive-through or street carts, where you leave after making your purchase).
Lastly, there’s my favorite criticism, also offered by the food and beverage industry. In a statement released last Thursday, Coca-Cola claimed, “New Yorkers expect and deserve better than this. They can make their own choices about the beverages they purchase.” McDonald’s offered a similar statement via Twitter, telling Bloomberg “We trust our customers to make the choices that are best for them.” It’s a nice sentiment, but if they actually believed that – they would stop spending billions of dollars per year to convince us to buy their products and just trust consumers to pick their product at the store.
So will it work? My hunch is yes, but time will tell. At the very least, science – coupled with the seriousness of the issue – warrants that we give it a try. I only hope that it is allowed to remain in effect long enough to truly measure its impact and that Bloomberg’s successor does not reverse it.