Prevention Matters

The announcement by PepsiCo that it plans to remove sugary drinks from schools worldwide was named the “Best Prevention Idea of the Week,” while women in Wales smoking during their pregnancy has been named the “Worst Prevention Idea of the Week.”

The “Best/Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. Nominees are submitted by Partnership staff as well as the general public, and are voted on by the staff. Partnership for Prevention is a nonpartisan organization of business, nonprofit and government leaders who are working to make evidence-based disease prevention and health promotion a national priority. More information is available at http://www.prevent.org/.

BEST

PepsiCo to stop selling sugary drinks from schools worldwide by 2012

Drinking as little as two soft drinks a week appears to nearly double the risk of getting pancreatic cancer, according to a new study. ''People who drank two or more soft drinks a week had an 87% increased risk -- or nearly twice the risk -- of pancreatic cancer compared to individuals consuming no soft drinks," says study lead author Noel T. Mueller, MPH, a research associate at the Cancer Control Program at Georgetown University Medical Center, Washington, D.C. The study is published in Cancer Epidemiology, Biomarkers& Prevention, a journal of the American Association for Cancer Research. The beverage industry took strong exception to the study, calling it flawed and pointing to other research that has found no association between soda consumption and pancreatic cancer.

In his latest budget proposal, New York Gov. David Paterson has proposed a tax on sugared drinks that would amount to about a penny an ounce. According to The Wall Street Journal's Jacob Goldstein, "the basic argument is that taxing soda and other sugared drinks would be a way to fight obesity while raising money to fund health care (the money raised by the proposed tax in New York would go into an existing pool that funds some of the state’s health expenses)."

The proposed tax (explained on  p. 130 of this PDF) would be levied on drinks "that contain more than ten calories per eight ounces, such as soda, sports drinks, ‘energy’ drinks, colas, fruit or vegetable drinks containing less than 70% natural fruit or vegetable juice, and bottled coffee or tea. Milk, milk products, milk substitutes, dietary aids, and infant formula would be exempt."

The New York City Department of Health and Hygiene raised a lot of eyebrows last summer with a subway advertisement that showed a soda bottle pouring globs of human fat into a drinking glass. The intent was to  shock New Yorkers into choosing low calorie beverages over soda and sweetened juices.

A recent blog posting by Partnership's Alyson Hazen Kristenson on propsals to tax soft drinks elicited an online comment by the American Beverage Association (the original post and the ABA's comment can be read online here). Needless to say, they were against a soda tax, and repeated the industry's recent assertions that taxes don't educate consumers.

Their comment drew the following response from Partrnership President Robert J. Gould:

Dear American Beverage Association,


We appreciate having an association whose members' sales total $110 billion a year drop by our humble blog. But the points you offered were a bit hard to swallow. The next time you want to engage in a discussion with a group that is dedicated to evidence-based prevention, you should consider bringing along some facts.

Here are a few facts:

1. To your claims that taxes don’t help educate people, we’d respond that they have often been a very important tool in helping to steer people to education programs about healthy lifestyles. For example, in the year after the state of New York nearly doubled its cigarette tax in 2007, calls to the state's smoker's quitline increased from 9,900 calls a month to 23,100 calls a month. Nationally, after Congress increased federal tobacco taxes effective April 1, the American Lung Association reported that its quitline had received 553,000 calls by the end of May - nearly equal to the 591,000 calls it received in all of 2008.

2. The environment in which people make decisions can greatly influence the outcome of those decisions. When unhealthy choices provided within an environment are cheaper or cost the same as healthy alternatives, there is less incentive to try healthy alternatives. However, by increasing the price of the unhealthy choice, you change the environment in a way that not only discourages unhealthy behavior but also provides an incentive to try healthier alternatives.

3. A review article in the Sept. 16 edition of the The New England Journal of Medicine stated: ”The science base linking the consumption of sugar-sweetened beverages to the risk of chronic diseases is clear,” and then went on to cite the findings of numerous studies. The authors offered a “conservative” estimate that an excise tax of 1 cent per ounce would lead to a minimum reduction of 10% in calorie consumption from sweetened beverages, “a reduction that is sufficient for weight loss and reduction in risk.”

4. And as for your assertion that a tax on beverages “won’t make a dent in paying for improved healthcare or addressing obesity,” the NEJM article predicts a 1 cent per ounce tax would raise $14.9 billion in the first year alone. That amounts to around one-sixth of the estimated annual costs of the health reform bill being crafted by the Senate Finance Committee. I’d call that a pretty good-sized dent.

Even so, there are actually some points upon which we can agree: 1) obesity is a serious and complex problem that requires thoughtful and comprehensive solutions, and 2) education, exercise and balanced diets are critical to solving this problem.

It’s not necessary to raise taxes on all your members’ products to put such incentives into play. According to your web site, the industry’s single-serve bottled water products already account for 19.3 percent of sales and diet sodas accounted for four of the industry’s top 10 carbonated soft drinks and another 19 percent of that market. Any changes produced by a tax would not leave your members high and dry, but instead would help them grow the markets for their healthier alternatives.

Whether or not the tax would “make a dent” in improving the health care system, $14.9 billion a year would certainly be enough to fund precisely the type of public education effort that you say is needed to persuade people to pursue exercise and a balanced diet.

Could we count on you to support such a proposal? If so, we’d love to meet with the beverage industry to discuss it. If you don’t mind, we’ll supply the drinks.

Robert J. Gould, Ph.D.
President and CEO
Partnership for Prevention

Soda taxes have been in the news a lot lately. On one side are public health experts who say that soda taxes could address our nation’s obesity problem. They cite the success tobacco taxes have had in reducing smoking rates and the relationship between soda consumption and body weight. An article in this month’s issue of the New England Journal of Medicine touts the health and economic benefits of taxing sugary drinks. The Institute of Medicine also recently released recommendations for local governments to combat childhood obesity that include implementing taxes to discourage consumption of foods with minimal nutritional value, which certainly include sugar-sweetened beverages.


Such taxes are also being discussed by policymakers. San Francisco’s mayor announced plans to introduce legislation this fall that will impose a fee on retailers selling sugary drinks, including soda. And President Obama was quoted as saying that soda taxes need to “be explored” as a way to reduce childhood obesity.

Not surprisingly, these proposed taxes are facing fierce opposition. This past Sunday’s Washington Post contains an opinion piece dispelling the 5 “myths” about soda taxes. Coca Cola’s CEO has weighed in on the issue calling a soda tax “socialist.” And anyone who reads a Sunday newspaper has surely seen the full-page ads run by Americans Against Food Taxes (aka, the beverage industry).

Opponents say that recent tax proposals aren’t large enough to impact obesity. That might be true, but they are missing the point. Drinking fewer sugary drinks has no downside (except possibly to the reduced profits of the beverage industry). These drinks push out healthier options like low-fat milk or water, and flood the body with excess calories that are rarely burned off and increase blood sugar levels. Teens consume the most soda and other sugary drinks, and are also historically price sensitive. Limiting their consumption of sugary drinks would cut their risk for obesity, diabetes, and cardiovascular disease, all costly health problems. And with states cutting essential programs and services, they should be looking to increase revenue wherever possible. Soda taxes seem like a win-win situation.


Alyson Hazen Kristensen, MPH

Senior Fellow & Program Officer
Partnership for Prevention

A first-of-its-kind study released definitively links soda consumption and an obesity epidemic. Using interviews with 43,000 adults and 4,000 adolescents in California, the UCLA Center for Health Policy Research analyzed the correlation between soft drink consumption and weight. It found that adults who drink at least one soda or sugar-sweetened energy drink a day are 27 percent more likely to be overweight or obese. For children, the risk of obesity soars 60 percent with each daily serving of soda or sugary beverage.

President Obama hinted he could support a "sin tax" on fizzy drinks to help lower high rates of US obesity, but admitted it would be an uphill battle against corporate and economic interests.