by Marion Nestle

Currently browsing posts about: Soft drinks

Apr 25 2013

Coca-Cola: obesity is your fault, not ours

A reader sent me an e-mail received from Coca-Cola:

As you know, obesity is an issue that affects all of us. At Coca-Cola, we believe we can help solve it by working together. As you heard back in January, we are committed to doing our part – by offering more low- and no-calorie choices, more portion controlled packages, and useful calorie information in more places than ever before.

As part of our ongoing commitment to provide more information about calories, we want to share a new “Calorie Balance”  infographic that we created. This is posted on our Company website here.

Our infographic is a simple, easy tool that informs people about where Americans’ calories are coming from and what we can all do to maintain a healthy, active lifestyle.

It communicates government data and third-party published studies in a compelling way, showing that too many calories consumed as compared to those expended can lead to weight gain.

OK.  I can’t resist.  Here’ just one piece of Coke’s infographic:

Guess what #4 is.   And what food is responsible for more than one-third of calories from sugars in U.S. diets?

The infographic gives no guidance about food choices or amounts best for health, but it is quite specific about physical activity.  Do lots!

Overall, I read the infographic as saying “Hey, it’s not our sugar-water that’s making you put on weight.  It’s up to you to choose what you drink and work it off with physical activity.”

Getting active is always good advice, but doesn’t Coke’s phenomenally comprehensive and astronomically expensive  marketing offensive have anything to do with food choices?  Coke must think all that is irrelevant.

I think it’s quite relevant.  And so does the research.

Mar 13 2013

Daily News editorial: The Judge Drank Corporate Kool-Aid

Politics, they say, makes strange bedfellows.  I can understand why the New York Times would do a front-page investigative report on how soda companies engage minority groups as partners while slamming Mayor Bloomberg for overreaching with his soda cap initiative.

But can someone please explain the Daily News?   Here’s yesterday’s front page:

This was followed by two pages of “Soda plan struck down; our cups runneth over” and other gleeful responses to the judge’s soda cap decision.

But then there’s this astonishing editorial.  Explain, please.

Judge drinks the Kool-Aid

In putting Mayor Bloomberg’s soda ban on ice, Manhattan Supreme Court Justice Milton Tingling did a huge disservice to the health and welfare of hundreds of thousands of New Yorkers.

Tingling concluded that the prohibition against selling sugared beverages in containers larger than 16 ounces was both arbitrary and beyond the authority of the Board of Health, which approved the regulations.

The only thing arbitrary here was Tingling’s ruling. More, the judge was the only party who was guilty of overreaching.

At heart, he simply substituted his judgment as to sound public policy for the board’s — an action that’s beyond a judge’s proper purview.

Most amazingly, Tingling held that the board had acted rationally in voting the portion cap as one method of trying to rein in the city’s epidemic of obesity and obesity-related diseases.

He bought the indisputable premise that the board was right to draw connections among high soda consumption, obesity and diabetes, which are debilitating New Yorkers young and old.

But then the judge threw that over by stating the obvious fact that the board did not have the power to ban supersized sugar drinks everywhere, only in establishments regulated by the Health Department.

Because the public could get a 32-ounce cup at, say, a 7-Eleven, but not at restaurants, he in effect deemed the ban to be an ill-designed contraption destined to fail. But who is Milton Tingling to say that? No one.

His fundamental error was to consider the regulation from the point of view of vendors who were hoping to get out from under it.

Those covered by the ban claimed they were the victims of capriciously unequal treatment and shifted Tingling’s concern away from the pressing rationale for a regulation that would have been broadly applied.

There’s nothing arbitrary about the consequences of drinking large quantities of sodas and other overly sweetened beverages.

The correlation in certain communities among consuming soda, becoming obese and contracting related diseases are certain.

The neighborhoods with the highest obesity rates — Harlem, the South Bronx, central Brooklyn — have the largest percentages of people who are likely to drink more than one sugar-sweetened beverage each day.

All too predictably, people in low-income areas such as Bedford-Stuyvesant and East New York, Brooklyn — places where soda consumption is highest — are four times as likely to die from diabetes as residents of the more affluent upper East Side, where people generally consume far fewer sugary drinks.

No matter.

Tingling attended to the arguments of businesses looking after their own financial interests over the demands of public health — while at the same time declaring that the Board of Health is barred from taking into account the substantial economic costs generated by obesity.

Ultimately, Tingling bought into the all-or-nothing argument — the same line of thinking that killed an earlier Bloomberg proposal that would have barred people from buying sugary sodas with food stamps.

The U.S. Department of Agriculture killed that experiment, asserting that it would be unfair and unproductive to target only a limited population in such a test. So Bloomberg tried to go bigger, and Tingling shot him down.

If bringing down a serious threat is a rational goal, as Tingling wrote, then you do it as best you can, even incrementally.

A halfway measure is better than no measure and is certainly not arbitrary.

Bloomberg vows an appeal.

Here’s hoping that Tingling’s judicial superiors recognize that pursuing public health is not just rational, it’s imperative. 

Afterthought: compare this to the Times’ editorial:

There are better ways for Mr. Bloomberg to use his time and resources to combat obesity.  One is to push Gov. Andrew Cuomo and the State Legislature to impose a penny-per-ounce tax on sugary drinks…the big-drinks ban was ill conceived and poorly constructed from the start.

Mar 12 2013

Corporate health 1, public health 0: Judge nixes Bloomberg soda cap

Late yesterday afternoon, while I was fielding international calls about the soda size cap scheduled to take effect today, state Supreme Court justice Milton A. Tingling “enjoined and permanently restrained” New York City from implementing the portion-size rule.  

First, let’s recall what the soda cap is about.

In the 1950s, a 16-ounce soda was LARGE.

 

Today, a 16-ounce soda is SMALL.

 

Never mind the effect of increasing portion size and calories on body weight.  The court, says the Tingling opinion:

Does not find the necessity to address at this point the appropriateness of the Board’s attempts to classify obesity as an epidemic or a contributing factor to chronic disease…the issue before this court is whether the Board has the authority to mandate which issues come under its jurisdiction…in this case it the Portion Cap Rule and whether the Board has the authority to promulgate same (page 10). 

He concludes that the proposed rule is: 

Fraught with arbitrary and capricious consequences… uneven enforcement even within a particular City block, much less the City as a whole…It is arbitrary and capricious because it applies to some but not all food establishments in the City, it excludes other beverages that have significantly higher concentrations of sugar sweeteners and/or calories on suspect grounds, and …no limitations on re-fills…the Portion Cap Rule is found to be arbitrary and capricious (page 34). 

And this:

The Portion Cap Rule, if upheld, would create an administrative Leviathan…The Rule would not only violate the separation of powers doctrine, it would eviscerate it. Such an evisceration has the potential to be more troubling than sugar sweetened beverages (page 35). 

OK, so the soda industry won this round.  How come? 

The New York Times points out that the portion size cap aroused:

the ire of the American soft-drink industry, which undertook a multimillion-dollar campaign to block it, flying banners from airplanes over Coney Island, plastering subway stations with advertisements and filing the lawsuit that led to the ruling.

The American Beverage Association issued this statement:     

The court ruling provides a sigh of relief to New Yorkers and thousands of small businesses in New York City that would have been harmed by this arbitrary and unpopular ban.  With this ruling behind us, we look forward to collaborating with city leaders on solutions that will have a meaningful and lasting impact on the people of New York City.

The Mayor says the city will appeal.

CSPI’s Michael Jacobson notes that this is what happened with calorie labels.  Eventually, he reminds us, the city prevailed:

Many years hence, people will look back and think it was crazy for sugar drinks to ever be served in 32- and 64-ounce pails. 

Mar 10 2013

Daily News Op-Ed: Bloomberg’s soda ‘ban’ should be only the beginning

My double-page op-ed in today’s New York Daily News:

Liberty from big soda: Why Bloomberg’s ‘ban’ should be only the beginning of a public health revolution

 

 

 

Barring any late legal surprises, Mayor Bloomberg’s 16-ounce cap on sugary sodas goes into effect on Tuesday, March 12. After that, restaurants, movie theaters, sports venues and food carts will not be permitted to sell extra-large portions of sugar-packed drinks.

Stay calm. This does not signal the end of democracy in America. This is not the nanny state gone out of control.

If we want Americans to be healthy, we are going to have to take actions like this – and many more – and do so soon. It’s long past time to tax sugar soda, crack down further on what gets sold in our schools, tackle abusive marketing practices, demand a redesign of labels – and extend the soda cap, no matter how controversial it may seem. This must be the beginning, not the end, of efforts toward a healthier America.

In short, we need a series of serious changes to make the healthy choice the easy choice. The soda size cap is a nudge in that direction. You will still be able to drink all the soda, and down all the sugar, that you want. The cap on soda size makes it just a tiny bit harder for you to do so.

That “tiny bit harder” is its point. If you have to order two sodas instead of one, maybe you won’t. If you have to add sugar to your coffee drink yourself, maybe you will only add one or two teaspoons instead of the 10 or more someone else put in there for you.

For a public health nutritionist like me, the soda size cap is a terrific idea. Unlike other foods, sodas are a unique target for intervention. They contain sugars – and sugar calories – but nothing else of nutritional value. They are candy in liquid form. Candy has a place in healthy diets, but a small one. So it should be for sodas.

It’s no surprise that people who drink large amounts of liquid candy have worse diets, are heavier, and have more health problems than those who do not. And it looks like the body doesn’t compute the calories from liquid sugars as accurately as it does for sugars in foods.

On top of that, big sizes make the problems worse. To state the obvious, larger portions have more calories. If an 8-ounce soft drink provides 100 calories, then a 16-ounce drink provides 200, a 32-ounce drink provides 400 and a 64-ounce drink provides 800.

But big sizes also have other effects. They induce people to eat and drink more than they would if given smaller portions. Big sizes confuse people into underestimating the number of calories consumed.

Most people eat whatever size is in front of them – the “default,” in public health-speak – and are content with that amount. So a reasonable goal of public health intervention is to change the default drink to a smaller size. Hence: Bloomberg’s 16-ounce size cap.

From my nutritionist’s perspective, a 16-ounce soda is still generous. Just one contains the equivalent of 12 packets of sugar. Just one provides 10% of the daily calorie needs of someone who typically eats 2,000 calories a day. Just one contains the upper limit of sugar intake that health officials recommend for an entire day. Once you down a 16-ounce soda, it’s best to stop right there.

You may find this hard to believe, but the original Coca-Cola was 6.5 ounces, smaller than any size available today. In the 1950s, Coke advertised its 16-ounce bottle as large enough to serve three.

Times have changed. The sizes of foods and drinks have expanded, and so have waistlines. This is no coincidence. On the basis of calories alone, larger portions are all you need to explain why Americans are putting on pounds.

City officials concerned about the health of their citizens, as those in New York most definitely are, want to do everything they can to prevent obesity and the illnesses that go with it. Their rationale is humanitarian, but also fiscal. Poor health is expensive for both individuals and society. You don’t believe that excessive weight is an issue? Just ask the military.

We can thank Big Soda – Coca-Cola, Pepsi and their trade association, the American Beverage Association – for the contribution of big sodas to weight gain. Soda companies have spent fortunes to create demand, to make drinking large amounts seem normal, to market sodas as essential for health and happiness and, these days, to fight Bloomberg’s soda cap and take the city to court over it.

Soda companies may make things you like to drink, but they are not social service agencies. Their job is to get you to buy more soda to satisfy the financial demands of investors. They are about business. They are not about fun or happiness or personal choice – and they certainly are not about health.

The soda industry may profess to care more about your well-being these days, but it ultimately will not do anything to promote health if doing so harms sales.

So-called “nanny-state” measures – like bans on driving while drunk, smoking in public places and, now, selling absurdly large sugary drinks – help to level the playing field. Such measures are about giving everyone an equal opportunity to live a safer and healthier life.

At the moment, it is up to you to make healthier choices, but that’s not easy in the face of relentless soda marketing. Governments have a responsibility to provide healthier environments for their citizens.

Here are some additional actions New York City should take, if only it were allowed to.

Close the loopholes. The city does not have jurisdiction over sales of sodas in convenience stores and supermarkets. The state does. Gov. Cuomo denied Mayor Bloomberg’s request to extend the size cap to those stores, not on principle but because he hadn’t thought about it. He should, right now. Let’s keep all sugary drinks to 16 ounces or less.

Fix the price differential. A 7.5-ounce can of soda costs twice as much per ounce as a two-liter bottle, and you can’t buy just one; it comes in an 8-pack. Price determines sales. If a 16-ounce soda costs a dollar, a 32-ounce soda should cost two dollars.

Tax sodas. Most people wouldn’t dream of eating candy all day, but soda companies have made it seem normal to drink sodas from morning to night. Raising the price of sodas would discourage sales, especially among young people most susceptible to marketing efforts and most vulnerable to weight gain. A one-cent tax per ounce should do the trick and raise plenty of needed revenue besides.

Remove vending machines from schools. Yes, the Beverage Association only puts “better-for-you” drinks in school vending machines, but sugar-filled sports drinks are still liquid candy. And kids should not have to pay for water in schools.

Restrict marketing of sodas to children. Soda companies market extensively to children and adolescents, especially those in low-income neighborhoods. Just look at billboards, celebrity photos on soda cans and Pepsi’s $50 million dollar deal with Beyoncé. They should not be permitted to market to kids this way. We already have restrictions on cigarette and alcohol marketing to kids. It breaks no new ground to add sodas to the list.

Don’t let SNAP (food stamp) benefits be used for sodas. Bloomberg tried this, but the federal Department of Agriculture said no. There is absolutely no reason that taxpayer-subsidized food assistance for low-income people should go toward junk with no nutritional value. He should try again.

Show full calories on the front of containers. The current way calories are tallied, in a measure called “calories-per-serving,” is confusing because the servings are unrealistically small and people don’t do the math. Soda cans already give the full calories in tiny type on the Nutrition Facts label, but I want to see the full calories in big type on the front.

Actions like these will evoke ferocious opposition from the soda industry, and it will spare no expense to make sure such things never happen. We would surely hear more and more howls of “nanny-state” from those who insist Bloomberg has led us to the brink of a public health police state. Polls say that many New Yorkers oppose the 16-ounce cap and would oppose measures like this, too.

But I can’t tell whether the opposition comes from genuine concern about limits on personal choice or because soda companies have spent millions of dollars to protect their interests and gin up histrionic, misinformed opposition.

Come Tuesday, the 16-ounce soda is the new default size in New York City. While waiting for the court decision and for politics to play out, why not give it a chance? Maybe it will help you live a healthier and longer life.

 

Feb 3 2013

Soda-size cap is a public health issue

Here’s my monthly (first Sunday) Food Matters column from the San Francisco Chronicle. The question (edited) came from a reader of this blog.

Q: You view New York City’s cap on any soda larger than 16 ounces as good for public health. I don’t care if sodas are bad for us. The question is “Whose choice is it?” And what role should the nanny state play in this issue?

A: Your question comes up at a time when the New York State Supreme Court is hearing arguments about whether New York City’s health department has the right to establish a limit on soda sizes.

As an advocate for public health, I think a soda cap makes sense. Sixteen ounces provides two full servings, about 50 grams of sugars, and 200 calories – 10 percent of daily calories for someone who consumes 2,000 calories a day.

That’s a generous amount. In the 1950s, Coca-Cola advertised this size as large enough to serve three people.

You may not care whether sodas are bad for health, but plenty of other people do. These include, among others, officials who must spend taxpayer dollars to care for the health of people with obesity-related chronic illnesses, employers dealing with a chronically ill workforce, the parents and teachers of overweight children, dentists who treat tooth decay, and a military desperate for recruits who can meet fitness standards.

Poor health is much more than an individual, personal problem. If you are ill, your illness has consequences for others.

That is where public health measures come in. The closest analogy is food fortification. You have to eat vitamins and iron with your bread and cereals whether you want to or not. You have to wear seat belts in a car and a helmet on a motorcycle. You can’t drive much over the speed limit or under the influence. You can’t smoke in public places.

Would you leave it up to individuals to do as they please in these instances regardless of the effects of their choices on themselves, other people and society? Haven’t these “nanny state” measures, as you call them, made life healthier and safer for everyone?

All the soda cap is designed to do is to make the default food choice the healthier choice. This isn’t about denial of choice. If you want more than 16 ounces, no government official is stopping you from ordering as many of those sizes as you like.

What troubles me about the freedom-to-choose, nanny-state argument is that it deflects attention from the real issue: the ferocious efforts of the soda industry to protect sales of its products at any monetary or social cost.

The lawsuit against the soda cap is a perfect example. It is funded by the American Beverage Association, the trade association for Coca-Cola, PepsiCo and other soft-drink companies, at what must be astronomical expense.

To confuse the public about corporate profits as a motive, the beverage association enlisted two distinguished civil rights groups – the NAACP and the Hispanic Federation – to file an amicus brief on behalf of its lawsuit.

Never mind that the obesity rate for the communities these groups represent is considerably higher than average in New York City, and that these neighborhoods would benefit most from the soda cap. The amicus brief argues that the soda cap discriminates against them.

The brief, however, neglects to mention that both amicus groups received large donations from soda companies and that the NAACP in particular has a long history of partnership with Coca-Cola.

Financial arrangements between soda companies and ostensibly independent groups demand scrutiny. National and local reporters – bless them – have done just that.

They report, among other connections, that one of the law firms working for Coca-Cola wrote the amicus brief, and that a former president of the Hispanic Federation just took a job with that company.

Last fall, the East Bay Express exposed how the soda industry exploited race issues to divide the electorate and defeat the Measure N soda tax initiative in Richmond. It revealed

that the beverage association not only paid for the successful “grassroots” campaign against Measure N but also encouraged views of the soda tax as racist.

Driven by this experience, the soda industry is repeating this tactic in New York City.

Is a cap on soda sizes discriminatory against groups working for civil rights? Not a chance.

Public health measures are about alleviating health disparities and giving everyone equal access to healthy diets and lifestyles. This makes public health – and initiatives like the soda cap – broadly inclusive and democratic.

If anything is undemocratic and elitist, it is suing New York City over the soda cap.

In funding this lawsuit, the soda industry has made it clear that it will go to any length to protect its profits, even if it means discrediting the groups that would most benefit from this rather benign public health initiative.

Jan 25 2013

Soda industry exploits NAACP and Hispanic Federation in soda cap lawsuit

Who knew that Wednesday’s New York State Supreme Court hearing on the lawsuit filed against New York City’s cap on sodas larger than 16 ounces would turn out to be a debate about race relations?

Let’s be clear.  This lawsuit is about only one thing and one thing only: to protect the profits of Big Soda—mainly, Coca-Cola and PepsiCo.  The lawsuit is funded by their trade association, the American Beverage Association (ABA), at what must be astronomical expense.

But to shift attention away from profit as a motive, the ABA enlisted two organizations of underrepresented groups—the NAACP and Hispanic Federation—to file an amicus brief on behalf of the soda companies.  The brief argues that the soda cap discriminates against citizens and small-business owners in African-American and Hispanic communities.  But it neglects to mention  that both “friends of the court” received funding from soda companies.

The financial arrangements between Big Soda and such groups demand further examination. Fortunately, we have Michael Grynbaum at the New York Times, who explains that:

The obesity rate for African-Americans in New York City is higher than the city average, and city health department officials say minority neighborhoods would be among the key beneficiaries of a rule that would limit the sale of super-size, calorie-laden beverages.

But the N.A.A.C.P. has close ties to big soft-drink companies, particularly Coca-Cola, whose longtime Atlanta law firm, King & Spalding, wrote the amicus brief filed by the civil rights group in support of a lawsuit aimed at blocking Mr. Bloomberg’s soda rules…Coca-Cola has also donated tens of thousands of dollars to a health education program, Project HELP, developed by the National Association for the Advancement of Colored People. The brief describes that program, but not the financial contributions of the beverage company. The brief was filed jointly with another organization, the Hispanic Federation, whose former president, Lillian Rodríguez López, recently took a job at Coca-Cola.

Soda companies have a long history of targeting their marketing efforts to Blacks and Hispanics, as shown in at least one book (and described in one of its reviews).

Last fall, the East Bay Express exposed how the soda industry exploited race issues and used them to divide and conquer in defeating the Measure N soda tax initiative in Richmond, California.

The No on Measure N workers’ paychecks were signed by political consultant Barnes Mosher Whitehurst Lauter & Partners (BMWL), which had been hired by the American Beverage Association….By the time that Big Soda had arrived, the issue of race was already a factor in the campaign. Some opponents of the tax had alleged that it was racist, arguing that it would unfairly harm low-income residents in the city. And the No on Measure N campaign…nurtured that sentiment. Indeed, there is evidence that the beverage association helped keep race at the forefront of the campaign as part of a strategy that exploited Richmond’s existing tensions.

…the beverage industry discovered a winning formula in Richmond last year that it might be able to replicate elsewhere…And if that were to happen, it could drive a wedge through traditional Democratic constituencies in many communities, with blacks and Latinos opposing their longtime political allies — progressives and environmentalists — just like they did in Richmond.

Is a cap on soda sizes discriminatory?  Quite the contrary.

Public health measures like this are about removing health disparities and giving everyone equal access to good nutrition and health.  This makes public health—and initiatives like the soda cap—democratic, inclusive, and anything but elitist.

But I can’t think of anything more elitist, less inclusive, and more undemocratic than suing New York City over the soda cap.

In funding this suit, the soda industry has made it clear that it will go to any lengths at any cost to protect its profitability—even to the point of dragging along with it the very groups that would most benefit from the initiative.

If the American Beverage Association and its corporate members really cared about Black and Hispanic groups, it would stop target marketing,  stop marketing to children, and stop pretending that sugar-sweetened beverages are an important part of active, healthy lifestyles.  It certainly would stop wasting these groups’ time and credibility on anti-public health lawsuits.

Jan 21 2013

Energy drinks: the new frontier for food advocacy?

I am an avid follower of NutraIngredients-USA.com, a daily newsletter for the food industry.  Today, it collects its recent articles on energy drinks in one place.

The makers of energy drinks have managed to get away with positioning these products as healthier alternatives to regular soft drinks.

They also have gotten away with being able to add vitamins and minerals to them that the FDA would not permit in regular Coke or Pepsi.

Unfortunately for them, some manufacturers upped the caffeine to the point where it might be making people sick.  Illnesses among energy drink users have focused attention on these products.

Are energy drinks the new frontier for food advocacy?  I think so, and I’m guessing NutraIngredients-USA does too.

Jan 18 2013

Should sugar-sweetened beverages be regulated? NEJM readers vote yes.

As part of an interactive case study and point-counterpoint on regulation of sugar-sweetened beverages, the New England Journal of Medicine (NEJM) conducted a poll of its U.S. and international readers.  The poll elicited responses from 1290 readers from 75 countries.

Overall, 68% of respondents favored government regulation.

High as this percentage is, the average is much lower than percentages from most countries as a result of one outlier—the United States.

Only 58% of U.S. voters in the poll favored regulation.  Everywhere else in the world, the percent in favor averaged 84%.

These results reminded me of change-in-sales figures from a few years ago:

Americans have reduced soft drink consumption, causing soda companies to focus their marketing efforts overseas.  Trends like these explain Coca-Cola’s new obesity ad campaign and Pepsi’s $50 million deal with Beyoncé. 

In America these days, 58% is an impressive majority.  NEJM readers are likely to be physicians, scientists, and health and health policy professionals. I suspect we will be hearing more about this idea.  Stay tuned for this one too.

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