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To Gulp or Not to Gulp? New York's Sugary Beverage Ban Question

I’m sure by now you have all heard the debate swirling around Mayor Bloomberg’s latest proposal – the banning of all sodas and other sugary drinks greater than 16 ounces at restaurants, fast food joints, movie theaters, and sports arenas in New York.  There are many reasons this makes sense from a public health and obesity prevention perspective, but there are plenty of tweets, radio spots, and other advertisements showing strong opposition.  The public outcry and the dollars being thrown out by the American Beverage Association (ABA) and others to shoot down the proposal continues to increase as we get closer to the public hearing next week.

I clearly remember my own “Big Gulp” days back in high school, when just about everyone had a giant mug  that we proudly toted around everywhere we went – unfortunately, they were never filled with water or 100% juice.  We would joyfully jump in our cars after school and swing by the gas station on our way to softball practice for a refill (yes, this was probably our second stop of the day) of 64 ounces of sugary goodness. 

Most of us public health folks think this new ban is a good one, after all, theoretically less soda=less calories=less weight gain or more weight loss=better health.  I recently came across another interesting angle that supports the ban in Michael Pollan’s book “In Defense of Food.”  In the book, Pollan highlights research that shows, as a culture, Americans tend to eat everything that’s put in front of us regardless of how full we become, which does not bode well for our “supersized” culture.  I thought this was an interesting research finding (it certainly jived with my own personal experience), especially when applied to the current issue at hand.  If we continue to pour people 32-42-64 ounce drinks then they are going to continue to consume every drop.  However, if they have to get up to purchase another bottle or request a refill after the proposed 16 ounces, maybe they’ll actually stop and think about the negative consequences.  Just maybe.*

Bloomberg’s attempt at a state tax on soda (explored in an earlier R2R discussion on taxes and public health) and a proposed restriction on food stamps to buy sodas both fell flat, so it will be interesting to see the outcome when New York’s Board of Health votes on this proposal in September.  

In the meantime, I’m interested to hear what others think.  We’ve been talking a lot about “swimming upstream” on R2R, and the policy, systems, and environmental improvements that lead to long-lasting, sustainable change.  Do you think this “upstream” ban could have a positive public health impact? Or do you think New York is better off without a “nanny,” as some opponents have quipped?

*Views and opinions are my own – please share your thoughts, too!

Thanks for the fascinating post, Alissa! While I’m personally an enormous proponent of upstream solutions to public health problems, in some ways I sympathize with those who find the new beverage bans intrusive to their daily lives. Bloomberg’s law doesn’t really affect me or my drinking habits on a personal level, but other public health policy initiatives have certainly left me feeling frustrated. For example, even though I may partially believe in the practice of restaurants posting calorie counts on their menus, there are times when I just want to go out and have a burger without feeling awful about it (it’s possible I may be vindicated though, as this study from New York University and Yale shows that posting calories may in fact increase consumption). Perhaps the take-away is that when implementing these policy level changes, as with any other public health intervention, it’s incredibly important that the rationale be evidence-based.

Ultimately, I think solutions could be going even more upstream. For example Alissa, why does the American Beverage Association have the lobbying power to so dramatically influence our legal system in such a way that it negatively affects the lives and well-being of Americans? Certainly personal accountability and health education is necessary, but we must also hold large corporations responsible for activities like targeting children with advertisements and egregiously increasing portion sizes. This does not necessarily mean demonizing these corporations. If we can work with them, leveraging their considerable resources for the common good, we may be able to move much farther than by fighting against them. I’m thinking now about McDonalds offering healthier options on their menu, and establishing anti-obesity campaigns. What do you guys think? Is it crazy to think that we or others could stem the lobbying efforts of entities like tobacco and corporate food? How do you feel about restaurants posting calorie counts on menus? Any food policies we haven’t mentioned that you’d like to “weigh” in on?

*Views and opinions are my own

Just my own personal opinions:

Calorie Posting/Soda Ban: I definitely have a love-hate relationship with the posting of calories on menus. It's been eye-opening for me even as someone in public health--and I'm sure for others--to see that the "healthy" salad that I was ordering daily actually has more fat and calories than a hamburger (yikes!). In that way, it has helped me become more aware as a diner. I also think that it has forced some restaurants to offer healthier options and portions. Now I tend to order healthier 9/10 compared to...well, not so healthy majority of the time. So it works....right?

Not necessarily--and Rachael, I think you made a great point. Decisions should definitely be evidence-based. For me and probably others, common sense says posting calories would work....but I've seen some of the same studies that say it actually increases consumption. It'd be interesting to know what evidence is driving the banning of the sodas and other sugary drinks greater than 16 ounces. Does it make sense? Maybe...but will it have the expected effect on most people?

Education: I also like what the article that you linked to mentions putting calories into context. You have to have a baseline of knowledge to even begin to understand calories counts and nutrition facts. Who cares if the burger has 900 calories if you have no idea how many calories you should be consuming? And words like sugar-free, fat-free, low-carb, organic, gluten-free, natural, etc. = healthy in a lot of people's minds.

I think education helps, but is it really enough? 

A little more "food for thought".. once I went to a fast food place (that I won't name) in the airport and wanted a breakfast sandwich and a cup of coffee. It cost LESS to buy a breakfast sandwich, cup of coffee, AND hash browns than the sandwich and coffee alone. The hash browns would've added nearly 300 calories to the meal. There is something wrong there. It's the culture, it's everywhere, and thus it seems unrealistic to think it could change with education alone.

That being said, I feel policies ARE a necessary component... but which ones are most appropriate and why? Based on what evidence? For me, that's really the question. 

Breaking News: Justice Milton A. Tingling Jr. of the State Supreme Court in Manhattan just invalidated NYC's ban on big sugary drinks, just one day before it was scheduled to go into effect.  You can read more on the decision here.

We're having a lively office debate on evidence - was there enough in this case, and just how much is needed to implement public health policy? How can you build the evidence-base if you're blocked form implementing and evaluating new policies? It seems like a vicious circle.  What do you think?

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