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- 1. Soda, Public Health, and Politics Jenna Goldstein
- 2. Why is soda being talked about in the media? • There currently is an obesity epidemic • According to the Center for Disease Control the percentage of children and adolescents that are obese has increased more than 3x since the 1970s (12) • In adults, 40% are affected by obesity (Szabo, 2018) • Sugary beverages are a major contributor to the obesity epidemic (Sugary Drinks, 2019) • They are also the largest source of calories and added sugar in the US diet (Sugary Drinks, 2019)
- 3. Evolution of Soda Sizes Before the 1950s 6.5 ounces was the average soda size After the 1950s The 12 ounce can, widely available by 1960 early 1990s By the early 1990s- 20-ounce plastic bottles became the most popular Currently we even have 1 Liter bottles (3) (Sugary Drinks, 2019)
- 4. Why is soda so unhealthy? There are many health issues that can develop from drinking soda that have been found through many studies from a wide range of researchers including increased risk of: Dying from digestive disorders Premature death Type 2 Diabetes Mellitus Cancer Cardiac and circulatory issues In 1 teaspoon there are 4.2 grams of sugar, in one average can of soda there are 7-10 teaspoons of sugar (Sugary Drinks, 2019) (Sugary Drinks, 2019), (LaMotte, 2019b)
- 5. What have we tried? Taxes on sugary drinks/sodas • This is supported by the American Heart Association, the American Cancer Society, and American Diabetes Association (Szabo, 2018) • Critics say the government should not influence what people chose to drink This is being done in more than 30 countries and 9 US cities/localities (Szabo, 2018) • Berkeley California • San Francisco California • Oakland California • Albany California • Philadelphia Pennsylvania • Boulder Colorado • Portland Oregon • Cook County Illinois • Seattle Washington
- 6. What should we try? Making soda only able to be purchased by those 18 years or older • But no age limit to consume soda Making soda unable to be included in kids' meals • The choices would be milk, water, or low sugar apple juice • If you wanted to have soda, there would be an upcharge, or you would have to purchase separately Taxing soda nation wide and using the profits to subsidize bottled water in order to make water more affordable than soda Limit advertisements for soda At the end of every soda advertisement an ad about the dangers of soda and their links to obesity and health issues could play
- 7. Why Is This So Hard? • The soda industry does not appreciate anything that could decrease their sales • This is comparable to cigarette/tobacco companies • The soda industry pay a lot of money to stop soda taxes or other initiatives that could decrease • The soda industry has ties to the government and to the Obesity Society (Szabo, 2018) • The soda industry pays for studies that are 4-8x more likely to show a favorable outcome for the industry than independently funded studies (Sugary Drinks, 2019) • The soda industry puts out misleading ads (Sugary Drinks, 2019)
- 8. Health Benefits of Cutting Back on Soda It can lead to better weight control in both children and adults (Sugary Drinks, 2019) Reduces weight gain and fat accumulation in children (Sugary Drinks, 2019) Unlimited amounts of anything is not harmless (LaMotte, 2019a)
- 9. How Can You Cut Back On Soda? To wean yourself off regular soda without too big of a change diet soda could be used This is a strategy recommended by the American Heart Association and American Diabetes Association (Sugary Drinks, 2019) But this should not be used long term as there are negative health impacts with diet sodas as wellAnother choice to wean off is to cut back one soda per day until you only have one per day and then try every other day (LaMotte, 2019b) You can also try replacements!
- 10. What Can You Replace Soda With? If you drank soda for the sweetness try naturally sweet foods such as fruits If you drank soda for the caffeine switching to green or black teas or even coffee Seltzer water can be used if you miss the bubbly feeling. Keep water near you! • If you keep water next to you, you are more likely to drink it (LaMotte, 2019b)
- 11. References
- 12. References Con.
- 13. References Con.
Editor's Notes
- When people think of soda they think of a nice refreshing, sweet, and bubbly beverage. What they do not think of is its relation to public health and how much of a role politics plays in keeping it cheap and available. In this presentation I am going to discuss everything from the effect of soda on health to the politics behind it in terms of the soda industry.
- The obesity epidemic has become talked about everywhere and has been for the past few years. Many people now are very health conscious, yet soda is still a very widely consumed beverage. The dietary recommendation made by the USDA state that at most 10% of daily calories should come from added sugar (Sugary Drinks, 2019). Yet 1 in 4 people get at least 200 calories per day from sugary drinks, for an average woman 10% is 200 calories and for an average man 250 is 10% (Sugary Drinks, 2019). This shows that we are getting just below 10% if not exactly 10% of our daily recommendation limit and that statistic is AT LEAST meaning most people are likely getting more (Sugary Drinks, 2019). There is a lot of evidence that shows that if someone decreases their sugary beverage consumption, they can reduce their chances of obesity and related diseases (Sugary Drinks, 2019). There are many studies that show that the more sugary drinks someone consumes the higher their risk for death (Bakalar, 2019.)
- Soda sizes have only increased as obesity rates have increased before the 1950s the average soda size was 6.5 ounces but after 1950 the 12 ounce can that we still use today became popular and eventually widely available by 1960. By the early 1990s the 20-ounce plastic bottle that we can get from 7/11 became the new normal for soda. Even today we have a 1 Liter bottle of soda (Sugary Drinks, 2019). This is not even to mention fountain drink sizes can be bigger than 30 ounces. Let's be honest if someone puts a 6.5 ounce can in front of you, you will drink it and be satisfied. Same thing if someone puts a 12 ounce can, and people would not think twice drinking it. But a lot of people would not go get another 6.5 ounce can therefore the smaller the size the less people are likely to drink. This increase in sizes definitely supports the fact that obesity and obesity related diseases have increased.
- Soda has so much sugar and provides no other nutrients and due to it being a drink you do not feel as full as if you ate the same number of calories from solid food (Sugary Drinks, 2019). Many studies have even shown that increased consumption of soda is associated with an increase in consumption of calories (Sugary Drinks, 2019). This means that you are not only drinking more calories but eating more as well. There are many studies that have explored the health effects of soda on the body and it seems to be many risks involved in just having a simple drink of soda. The risk of digestive disorders was found in those who drank 2+ glasses of sugary soda (LaMotte, 2019b). The risk of premature death was found in those who had 2 servings a day of sugary beverages. It increased the risk in 63% in women and 29% in men (LaMotte, 2019b). Overall, drinking sugary beverages (about 1-2 cans per day) increases Type 2 Diabetes Mellitus by 26% (Sugary Drinks, 2019). A study from France found that drinking 1 small glass of sugary drink per day (defined as just over 3 ounces) led to an 18% increase in overall cancer risk and specifically a 22% increase in breast cancer risk (LaMotte, 2019b). Studies that lasted over 2 decades found that those who drank an average of one can of sugary beverage per day had a higher risk of heart attack or death from heart disease than those who rarely drank sugary drinks (Sugary Drinks, 2019). Overall, each daily additional 12 ounce serving of a sugary drink is associated with a 7% increased risk of death from any cause. (Bakalar, 2019) It needs to be noted that although many studies do their best to adjust for lifestyle factors and past health histories these studies are observational so the correlation cannot be considered causation for those reasons (LaMotte, 2019b).
- The biggest most talked about attempt and most used attempt for changing our soda habits is a tax per ounce on soda. Each of the US cities have different tax some being as high as 2 cents per ounce where others it is as low as 1 cent per ounce (Szabo, 2018). This is a proven way to reduce consumption of added sugars and dietary factors that have been linked to around 40,000 deaths from heart disease per year in America (Szabo, 2018). The biggest issue with these taxes is that they only cover a specific city so all you have to do to avoid this tax is leave the city boarders which means these taxes really should be made to cover entire states and or countries (Charles, 2019). Another issue is that there are critics of these taxes by people who think that the government should not have any say in what we drink. One city that has had studies done on the effects this tax has had on sales is Philadelphia. The sales of soda in Philadelphia decreased by 51% but just outside the city limits there was an increase in soda sales by 38% meaning the net decrease in sales was 38% according to the Journal of Medical Association (LaVito, 2019). Philadelphia is an interesting example as the money made from this tax will help pay for universal pre-K and improvements to parks and recreation centers (Fandler, 2017). One country that has show success with a soda tax is Mexico which shows that a whole country tax is beneficial. They are predicted to prevent around 134,000 cases of diabetes by 2030 as it has decreased consumption of soda (Szabo, 2018). Making soda less accessible or at least a more thought about choice can discourage consumption of sugary drinks which can decrease rates of diabetes, obesity, among other diet related conditions which would be an amazing feat as these are all big problems. This is not the only way this problem could be approached there are other suggestions.
- Some ideas I have for potential ways to help fight against soda and to warn people of its potential health effects all have to do with limiting access to soda or advertisements for soda. One is that soda could only be purchased by those over the age of 18 but not put an age limit on the consumption of soda. This would make it so that essentially children cannot get soda without parental permission. It also stops children from buying a bottle of soda on their walks home which could encourage them to purchase water instead. Another idea is that soda should not be allowed to be in kids’ meals instead having the only option be milk, water, or a low-sugar apple juice. If they wanted soda, I would suggest either an upcharge or have to purchase the soda separately. This would make it so that they are presented with healthier options and would have to ask about soda and pay more. I also thought about a slight change to the existing idea of a soda tax. I would want it to be nation wide and use the profits to subsidize bottled water making it more available and affordable than soda. If someone has the choice between a 2-dollar soda and a 2-dollar water many people who like soda would go for the soda. But if the choice was a $2.50 soda and a $1.50 water it might make it easier for people to choose the water. Similar to tobacco I thought limiting advertisements for soda may help people stop craving soda and help little kids not be introduced to it so early. Also at the end of an advertisement they should have to have a part where it discusses the dangers of their products which could discourage people similarly to how this discourages people from smoking. These are just my ideas and I do not know if they will work but as I am about to talk about there are more roadblocks then one might think to decreasing people's consumption of soda as all of these would have to be on a state or better a national level to be effective.
- The soda industry does not like the idea of a decrease in their profits which would happen if more people stopped drinking soda. It is safe to say they are not a fan of soda taxes because it may make people think twice about purchasing soda. Their behavior overall is extremely comparable to the tobacco industry as you will see. To start with they launch campaigns against initiatives to tax soda arguing it is unfair to consumers (Charles, 2019). On top of that they argue it can hurt working families and businesses but that has been shown not to happen (LaVito, 2019). In Philadelphia it was shown that the sugary drink tax has not hurt any other aspects of the grocery business, the sales of sugary drinks in the city have fallen but overall business at chain stores has not decreased (Szabo, 2018). Berkley has also had similar results, a decrease in soda purchases but an increase in bottled water sales (Szabo, 2018). The soda industry has spent millions of dollars to fight taxes on sugary drinks and for the most part besides the places mentioned previously they have been very successful in shutting down new taxes, very similarly to how the tobacco company tried to keep their products untaxed (Szabo, 2018). The beverage industry has focused on statewide measures to try and get what they call grocery tax bans that strip cities and towns on their abilities to have a choice in taxing sodas (Szabo, 2018). Due to this Arizona and Michigan already ban towns and cities from putting up a soda tax (Szabo, 2018). In California where 4 cities have taxes on soda the beverage industry pressured their lawmakers into accepting essentially a 12-year ban on taxing sugar sweetened drink (Szabo, 2018). They did this by spending 7 million dollars on an initiative for the ballot that would make it harder for the state to raise any type of taxes whatsoever, once they agreed to the 12-year ban they dropped the initiative (Szabo, 2018). The beverage industry besides getting in with law makers tries to get ins with societies that speak out against obesity in order to have someone reputable on their side to try and spread their misinformation. One example is that they have ties with the Obesity Society. This society prides itself on helping people launch public health initiatives, help take clinical trial results and turn them into interventions in the real world as well as research, educate, and take action against obesity (Obesity Society Home, 2019). All this seems contradictory when you find out that they let PepsiCo underwrite issues of their journal as well as have very close ties to the beverage industry (Szabo, 2018). On a related note studies funded by the soda industry are 4-8x more likely to show a favorable outcome for soda than independently funded studies (Sugary Drinks, 2019). A 2016 analysis of 26 studies that had shown no link between soda consumption and bad health outcomes found that all these studies had received funding from companies in the soda industry (Villines, 2019). This means they are manipulating opinions of soda based on potentially flawed bias studies. Finally, some ads can be misleading where they suggest that soda does not have little to do with obesity which is misleading. A 2013 Coca Cola ad that was anti-obesity suggested that sweetened soda and other foods contribute to the obesity epidemic and then used that opportunity to advertise their calorie-free beverages emphasizing personal responsibility for weight and for drink choices (Sugary Drinks, 2019). It is commonplace for the beverage industry to shift the obesity blame on inactivity and poor energy balance, but we saw in the documentary Fed Up that calories in and calories out is not adequate and that processed foods are a big part in our issues with weight (Szabo, 2018). Although it is true that no single food or beverage can itself lead to overweight or obesity when consumed in moderate amounts, but it is true that one specific food or beverage could exacerbate obesity (Szabo, 2018). Overall, the beverage industry is extremely manipulative and does their best to get what they want similar to how the tobacco industry lobbied the government to try and keep places from passing no smoking laws. As well as how they tried to keep information of the dangers of cigarettes away from the public insisting it was perfectly healthy until there was so much evidence they no longer could. There are so many parallels it is unsettling that people do not realize they are being manipulated. They think that they want to reject these taxes, so the government does not have a hand in what they drink but by doing this they are letting the beverage industry have a hand in what they drink. But the good news is that there are plenty of health benefits of cutting back on soda and many ways in which you can cut back and replace the habit.
- Studies have found that reducing sugary drink consumption leads to better weight control in both children and adults. In a study with normal weight children which is considered a BMI between the 5th and 85th percentile they found that replacing sugary beverages with noncaloric beverages reduced weight gain and fat accumulation (Sugary Drinks, 2019). Overall, it is important to know that unlimited amounts of anything is not harmless and knowing when to cut back or stop having something altogether is extremely important (LaMotte, 2019a).
- Diet soda is recommened by the American Heart Association and the American Diabetes Association as a good way to start cutting back on sugary drinks (Sugary Drinks, 2019). But you need to use caution when using this approach because the chemicals in diet soda that replace sugar can change how the brain responds to dopamine, a neurotransmitter that plays a role in pleasure, motivation, and rewards (Villines, 2019). It can increase cravings for sweets as well (Villines, 2019). Many studies have found a lot of health risks from drinking diet sodas, such as drinking 2+ glasses of diet soda increases your risk from circulatory disease (Reiley, 2019). Two or more is also linked to an increased risk of clot-based strokes, heart attacks, and early death in women over 50, a population very likely to be drinking diet sodas to watch their weight (LaMotte, 2019a). There have also been links found between diet beverages and dementia, type 2 diabetes mellitus, obesity, and metabolic syndrome (LaMotte, 2019b). Finally, another study found a risk between diet sodas and fatty liver (Villines, 2019). This is not to scare anyone away from using diet soda to stop drinking sugary soda, it just means that you likely should not be consuming diet soda long term. Another possibility is that someone can cut back one per day until they get to drinking one per day, from there they can try every other day (LaMotte, 2019b). There are many other replacements that can also be used if these methods do not work for specific individuals.
- If you drink soda for the sweetness of it you could try replacing your can of soda with fruits such as peaches, mangoes, apples, and berries (Villines, 2019). These are not only sweet but also have fiber and vitamins which are good for your health (Gander, 2019). If you drink soda for the rush of caffeine you could try green or black tea which have many antioxidants (LaMotte, 2019b). It was found that replacing one daily serving of a sugary beverage with water, coffee, or tea was seen to decrease the risk of type 2 diabetes mellitus by 2-10% (Sugary Drinks, 2019). There are many healthier replacements for all aspects of soda you can get the sweetness, the carbonation, and the caffeine all from different sources other than coffee which all seem to be healthier options than soda.