Monday, June 11, 2012

Highlights from the National Soda Summit

Last week, Prevention Services Division (PSD) division director Chris Lindley and PSD law and policy manager Susan Motika attended the first ever national Soda Summit, in Washington D.C.  Sponsored by the Center for Science in the Public Interest, the two day event featured leading policy makers and public health leaders seeking to reduce soda and sugar consumption in America.

Motika summarizes the Summit for Colorado public health and partners in her Soda Summit Summary.

Soda Summit Summary

New York City Public Health Commissioner Thomas Farley

New York City Public Health Commissioner Thomas Farley featured prominently on the agenda, explaining why New York Mayor Michael Bloomberg is pushing to limit the size of a soda serving to 16 ounces at restaurants, delis, sports arenas and movie theaters. New York City’s latest foray into food policy regulation was unsurprising to Chris Lindley:  “New York public health has always blazed a trail for the rest of the nation,” he observed.   Below are highlights from Farley’s address, From Supersized to Human Sized:  Reintroducing Reasonable Portions of Sugary Drunks in New York City. 

Why New York City cares about obesity
  • Farley estimated that in New York, 5,800 deaths per year are attributed to obesity.
  • One in eight residents has Type 2 diabetes
    • There are 2,600 amputations per year related to diabetes
  • Sugar drink consumption in New York is “strongly correlated” with obesity in the neighborhoods.  

Portion size drives consumption
  • Farley said that people given larger portions tend to consume them.
  • He tracked the historical growth of portion sizes:
    • A Coke ad from the 1950’s said that 16 ounces could serve three people.
    • In 1955 McDonald’s had a 7 ounce drink size.
    • Now a McDonald’s child size is 12 ounces.
    • However, in some countries outside the U.S., McDonald’s features smaller soda serving sizes.

Hope is that consumers will think twice
  • The limit on serving sizes does not restrict customers from purchasing additional servings serving.
  • It’s designed to help consumers pause and ask themselves, “Are you sure?  Do you really want that?” 

Philadelphia Mayor Michael Nutter’s Keynote Address

Philadelphia Mayor Michael Nutter, who has twice proposed soda taxes in his city, provided the keynote address at the Soda Summit.   Learning from the Surgeon General’s 1964 Report, Smoking and Health, which was catalytic for the tobacco control movement, Nutter called for the Surgeon General to issue a report about sugary drinks’ impact on the body. 

Nutter’s work to limit access to sugary drinks is driven by Philadelphia’s grim statistics on obesity and chronic disease. In Philadelphia:

  • Two-thirds of adults and 40% of children are overweight or obese.
  • In some neighborhoods, more than half the children are overweight or obese.
  • African American children have a 15% higher prevalence of obesity than white children. 
  • Hispanic children are 25% more likely than white children to be overweight or obese.
  • Nearly half of all African American adults have hypertension and 20% have diabetes.
  • Obesity leads to the loss of $1 billion annually in productivity for Philadelphia businesses.
  • Children drink one to two sugary drinks per day with African American children consuming significantly more than white children 

Two tax measures proposed

Mayor Nutter sees taxes and regulations on sugar sweetened beverages (SSB) as part of a “multi-pronged approach” to decrease sugary drink consumption.  “Education, taxation, and increased access to healthier options have to all be part of the discussion,” he explained. 

During 2010, he proposed a sugar sweetened beverage tax of two-cents per ounce.  “My hope was to impose a tax on retailers based on annual sales volume,”  Nutter said, which could have generated $77 million annually to combat obesity.  The measure came close to passage that year.

In 2011, with Philadelphia’s public school system facing a steep budget shortfall, he reintroduced the SSB tax – this time aimed at distributors.  Again, the tax faced “determined opposition” from the beverage and the proposal was not put to a vote of the city council.

The two tax campaigns were not without benefits, Nutter said. “We created a dialogue about the tough decisions that have to be made to protect the health of our children and the productivity of our workforce. We also saw that powerful interests would not sit back when the status quo is threatened.”  

Arguments against taxation:  a point-counterpoint

Nutter countered the industry’s main objections to an SSB tax:

Soda has not been conclusively connected to a rise in obesity rates
Soda has no nutritional benefits; the extra calories sugary beverages inject into the American diet turn into extra pounds over time. 

A sugar sweetened beverage tax or large serving soda ban negatively affects the personal liberties of low income individuals.
Governments want to create and promote policies that encourage citizens to make conscious and well informed decisions about the health impact of what they are buying for themselves, their families and children.

By putting a soda tax into effect, people will consume less product resulting in layoffs by the soda industry and increasing unemployment.
Delivery trucks will still need drivers and packaging plans will still need workers, whether it is for 5,000 cases of soda or 5,000 cases of water or 5,000 cases of low-sugar or no-sugar products.  People will still be thirsty and drinks will still need to be delivered and will still be sold and bought.  

“Get Healthy Philly”

With no soda tax, Philadelphia was still left with burgeoning obesity rates and no comprehensive response to this serious public health problem.  “Get Healthy Philly,” funded through federal stimulus dollars, is a multi-sector initiative to address obesity through policy and systems change.  Nutter cited the following outcomes:

  • More than 90 schools have replaced candy bars with healthy foods.
  • Food and fitness standards have been developed for 300 after school programs affecting more than 20,000 low income students.
  • The Menu Labeling Law provides Philadelphians critical information about calories, sodium, fat and carbs.  Nutter said that nearly 40% of customers have said this information leads them to make healthier decisions.
  • Philly Food Bucks allows low income Philadelphians who use food stamps to receive a $2 Philly Food Buck coupon for every $5 they spend at a farmers market.  
  • 260 vending machines in municipal buildings offer healthier options.  Philadelphia vending machines offer more water and non-caloric drinks, put healthy options at eye level, limit portion sizes of sugary drinks, and provide calorie labeling on each machine.   

The crucible of leadership

Nutter said that of all the things he’s done, making Philadelphia smoke free was “far and away the best thing I’ve ever done.”   

On the leadership challenges of public service, he observed that many elected officials get “caught up in the trappings” and focus on how they keep the job rather than on doing the job.  “I love my job but I am going to do my job. . . If you have a deep seated need to be loved and admired this is not the job for you – go work in a pet shop.” 

He said that he had only been worried about his career, he may not have taken on the tobacco issue as a city councilor. 

For the text of Mayor Nutter’s published remarks, click HERE.

Kelly Brownell, Director, Yale Rudd Center for Food Policy and Obesity

Cited by Time magazine as a leading “warrior” in the area of nutrition and public policy, Kelly Brownell began by referencing the beverage industry’s recent full page ads in the Washington Post in response to New York City’s proposal to limit the size of soda servings.  “We’re at an interesting point in history,” Brownell observed. 

In terms of restricting or removing “bad foods” – Brownell asked “why begin with SSBs?”  He answered: 

  • SSBs are the single greatest source of added sugar in the diet.
  • SSBs are completely empty calories.
  • People don’t lessen their food intake as a result of consuming SSBs and thus consume more calories than they need.
  • Sugar may be addictive.
  • SSB marketing targets vulnerable populations.
  • There’s “rock solid” proof of harm from SSB consumption.

Can food be addictive?

Brownell said that a new study, about to be released, addresses this topic. In general: 
  • “Hyper palatable” foods activate the same brain reward system as heroin, causing withdrawal and cravings.
  • People may need more of the substance to get the reward.
  • Brownell’s prediction of industry responses to the linkage of food and addiction
·         Plant doubt.
·         Call studies “junk science.”
·         Attack scientists as biased.
·         Buy scientists to do negative studies.
·         Pass “shield laws” to reduce exposure.

Looking ahead

Looking ahead five to 10 years, Brownell predicted that the food addiction discussion would become prominent; local, state and federal taxes on SSBs would be implemented; litigation, including multi-state litigation by state attorneys general would be commenced; SSBs would be eliminated in schools, preschools and governments; and that SSB consumption would decline. 

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