"Every year, Americans drink 13.8 billion gallons of soda, fruit punch, sweet tea, sports drinks, and other sweetened beverages — a mass consumption of sugar that is fueling soaring obesity and diabetes rates in the United States. 

Now a group of scientists at the University of California, San Francisco (UCSF), San Francisco General Hospital and Trauma Center (SFGH) and Columbia University have analyzed the effect of a nationwide tax on these sugary drinks.

They estimate slapping a penny-per-ounce tax on sweetened beverages would prevent nearly 100,000 cases of heart disease, 8,000 strokes, and 26,000 deaths over the next decade."

Kirsten Bibbins-Domingo, MD, PhD

“You would also prevent 240,000 cases of diabetes per year,” said Kirsten Bibbins-Domingo, MD, PhD, an associate professor of medicine and of epidemiology and biostatistics at UCSF and acting director of the Center for Vulnerable Populations at the UCSF-affiliated SFGH"

What are your thoughts on this?

Please read the rest of the article here: http://www.ucsf.edu/news/2012/01/11267/how-many-lives-could-soda-tax-save
Thank you. Isabella Wiznitzer,RN/CDE

I don't think sin taxes worked out so well with tobacco or alcohol.  Why should we expect them to be any different with sodas?

I'm all for freedom of choice but I think this would be a good idea.  After working in 'the hood' for lack of a better term and seeing the amount of soda that is drank on a daily basis by people with diabetes I am all for it.  Something to indicate to people that a soda is not the best choice-consider water-it's free!  

Until plain bottled water is cheaper than soda, iced tea, sweetened beverages, etc - lots of people are going to go for the less expensive option. I remember when my then 13-year old son came home one afternoon with a 2 liter bottle of soda. He told me he really wanted to buy water, but the soda was only 89 cents. It was a purely financial decision, and viewed that way makes perfect sense.

Instead of a sin tax on soda, why not government subsidies on healthy beverages:  bottled water and fat-free milk for example?

Brian:
So, what do you think about this concept???  Next it might be PWD need not apply???

http://www.boston.com/business/healthcare/articles/2010/12/19/anna_jaques_hospital_joins_growing_number_of_employers_refusing_to_hire_smokers/

Interesting comments. Thank you.

A number of doctors, nurses, RDs, and patients I spoke with about this believe that if Americans finally decide that soda is a societal ill, taxing soda producers could reduce some of its most notorious health effects. 

  Some US states (about 11 or so) actively utilize campaigns/ads to educate people about the ramifications of unhealthy food intake, decreases in nutrients, lack of physical activity, genetic influences, and mindless soda drinking.
Most of us felt that NY state campaigns were and continue to be rather effective, especially when it comes to the successful education of teens and children.

Thoughts?

Can taxing soda lead to significants change in personal behavior?  I don't think so.  So let me explain my position.  I think soda consumption represents an addictive behavior, a chronic desire for sugar stimulation.  And people who are out there buying soda are already paying extra.  After all, soda already costs significantly more than water as an alternative.  Why would we expect any change in the cost to change behavior.  It has been not found to work with tobacco, even though some jurisdictions have raised the taxes to like $8-10 per pack.  If you doubled the cost of sodas it is unlikely to change the behavior of any significant number of people and the worst thing is that to projections that it will cause a windfall of tax revenue also will fall short as many people will find ways to evade the tax.

And Joan brings up a disturbing trend, penalizing workers based on blood pressure, BMI and cholesterol is in my mind morally repugnant and discriminatory.  The argument that it is ok to penalize based on tobacco or drug use seems to be sticking, but it is a slippery slope.  As a society on one hand we reach out to help people who are sick and unable to work and then with the other hand we slap away those who may be unwell from the workforce.  And who gets to decide what are the "health" metrics.  BMI?  Seriously?  What about a world class athlete, BMI too high?  And who would ever hire a Pima indian?  On a western diet, they all get penalized.  How is that not disciminatory?

I am much more in favor of programs which reward behavioral changes that are thought to lead to good outcomes.  It is important to change behavior, not to reward or penalize genetics or dumb luck.

Can you say: Farm Bill reform???

Excellent point Joan! As long as there are government subsidies for ingredients in less than healthy foods, and no price supports for healthy fruits and vegetables, I honestly don't think we're going to see much change in food choices.

I had an interesting conversation today with a woman who is having a 3 hour glucose tolerance test tomorrow for suspected gestational diabetes. She admits that she's addicted to soda (her words) and that in preparation for the test she's cut back on soda, but not eliminated it completely. She knows that the sugar content of soda isn't good for her or her baby, but she said she simply can't eliminate soda completely. Obviously we have our work cut out for us!

Pat: to clarify, it's not all carbs that are thought to contribute to the storage of fat in the abdominal area, but highly processed carbs.  Fruits, veggies and complex carb aren't the ones to worry about as much as the soda, cookies, white bread, sweets.

Thanks for the clarification, Joan

Thank you for the article, Patricia. Your comment is intriguing.

The US is not the only counry that's struggling with its obesity rate. Many countries do.

 Diabesity is a global epidemic indeed!

In September of 2011, Hungary, with a 19 percent obesity rate, imposed a tax on packaged products with high sugar, salt, or caffeine levels. This includes energy drinks with added sugar and caffeine, soft drinks with added sugar, and soup and gravy mixes. The Hungarian government estimates it will collect $100 million a year from the food tax. It will apply the funds to the nation's healthcare budget.

Some other European countries are expected to follow suit.

What will the US and other industrialized countries do?

It will be really interesting to find out if imposing a tax actually causes a decrease in the consumption of those foods and also improves the population's health. The assumption is that it will, but actual proof may encourage other countries to think about similiar programs.

I wonder if at the same time they're taxing foods high in sugar, if they could use some of that money to decrease the cost of healthier foods?

Lynn,

     Apparently some other European countries followed suit already. Denmark instituted a tax on foods containing more than 2.3% of saturated fat "as a way of minimizing the huge and rising medical harm and financial cost to its health service caused by obesity".

""Legislative measures have already worked in France, where food and drink in schools is controlled and all marketing of foods high in fat, sugar and salt is banned unless they are taxed and marketed with a health warning. Studies have shown that following these measures, the number of overweight children in France has dropped from 18.1% in 2000 to 15.5% in 2007". Finland plans to institute a tax on sweets.

Some people feel that "balanced diets and active lifestyles can only be achieved through information and education and not regulation or compulsion."

Interesting indeed.

Source- http://www.guardian.co.uk/society/2011/dec/21/sugary-soft-drinks-obesity-tax?CMP=twt_gu

I think the most important aspect of imposing a tax on soda or other unhealthy foods is that it sends out a message to the general public indicating that those foods are not necessarily a 'good thing'.  I think there are so many mixed messages in the media that people are completely confused by what is healthy and what is not.  I seriously doubt our government would get away with imposing a tax on soda.  The soda industry is huge!  And he who pays the piper tends to call the tune.  

I think the tax may be a good idea. Not for the reasons that they use to push for it though. The benefits will never appear. The money will just go into the general fund and get spent for pork barrel projects.

I remeber the big push for lottery and money to be used for education. If that was true, there would be no tuition or school tax for any of us. But that is not where the money goes.

Education has not soared since the lottery came int existance.

With tobacco, there has been less purchases but are we healthier? Or did we as a general population find something else not good for us?

I trhink the government should maybe spend some energy into finding out why water cost so much to put into a bottle?  Make a bottle a quarter and you'll see much less soda consumption. You can cut the cost of water without subsidizing it, which usually is a bad idea.

Thanks for sharing those statistics Isabella. Of course just because taxing soda/foods high in fat/sugar works in other countries doesn't mean it will work in the US - but it certainly reinforces the theory that this type of tax will help encourage folks to purchase less of these products.

You are welcome, Lynn.

There is another angle to all of this. As I mentioned before-children and adolescents are getting overweight/obese with each passing day per the CDC report. If heathy meals are not provided at home, and school lunches leave quite a bit to be desired, then fast foods are viewed by our children as affordable options indeed. One dollar meals are popular these days... That's our reality.

And frankly, it's not just the junk foods, it's the young people's inability to visualize portions of these foods/drinks and thus overeating on a daily basis.

How do we provide effective education on healthier eating to our children? Where do we begin?

I personally feel that healthier eating starts at home. Few parents cook from scratch these days, however, and family dinners are becoming rare.

Thoughts?

As many of the goverenment researchers say that taxing soda may encourage better nutrition and benefit our "future" selves, then what will be next?  Taxing:

>  Candy?

>  Ice cream?

>  Fried foods?

>  Mind-numbing TV shows?

Here's a better idea.  Let the government subsidize each one of us each and every time we buy:

> Apples

> Celery

> Gym memberships

> Dental floss

Mary Ann Hodorowicz, RD, CDE, MBA, Certified Endocrinology Coder
PresentDiabetes Author of MNT and DSMT Reimbursement Audio Lectures

Eat Well, Laugh Often, Love Much

Is there a 'like' button?  I like your last comment Mary Ann and agree!

Great suggestions, Mary Ann.

The question still remains though.

 How do we go educate our children about healthier eating and being physically active?

I agree Isabella.  I think we need to become better role models for our future generations.  Teach them to eat healthy and be physically active.  Make healthy eating and physcial activity a part of every school program.  Encourage walking and active lifestyles in the communities we build and buildings we erect, etc., etc., etc.    

I think we all probably agree on the basics of living a healthy life, but when we get to the specifics of how to teach that information to a wide variety of people who live in different locations and come from different cultures and backgrounds; that's where we run into trouble. I think the most progress can be made in local communities, or even neighborhoods. I routinely hear about a school that has a fantastic school lunch program, including a garden where all the kids participate in growing and harvesting food that ends up in the lunch meals. Or I visit a community that mandates sidewalks as part of all new development and redevelopment, making it easier for people to walk and bike instead of using their cars. I agree with Mary Ann that some type of subsidy for any type of healthy behavior initiative is a great motivator for change.

Micki,

            Agreed!

Lynn,

        "some type of subsidy for any type of healthy behavior initiative is a great motivator for change". Yes, but this is going to happen when prevention becomes a #1 priority in the US health care system. Unfortunately, we are not there, not yet, far from it.

 I recently provided education to a young person with Type 2 DM . She/he knew little about healthy nutrition and stated: "Will this diabetes thing go away if I cut down on my candy bars and pop? Those things make me happy , you know. It's hard to give them up." Well, when I stated that it was certainly a good place to start, but that no, this wasn't going to make the diabetes go away, the person wasn't happy.

It is rather challenging to deal with people who have difficulties understanding that the damage has already been done , and that the emphasis is on how to manage/ live productively with the condition.

 Unfortunately, once again, the children and adolescents with Type 2DM are the ones who seem to be having a hard time dealing with the consequences of their poor behaviors either due to the peer pressure and/or food addictions they developed.

I think that instead of a soda tax our goverment should end subsidies to large corporate interests who produce tons of uneeded and unhealthy grains which then get turned into terrible products like HFCS.  Corn and soybeans are the two most heavily subsidized crops.  And because they are made cheap, they are then used to feed animals.  I'd much rather have grass-fed beef.  Shut off support for the sugar industry.  Sugar is way too cheap. Why should our government fund this stuff?  Take that money and provide subsidies to small local farms that can provide sources of good and healthy meat, fruits and vegetables.

It is kinda hard to suggest a cosmetic change such as a soda tax when our overal government agriculature policies are so rotten to the core.

Brian,

         Grass-fed beef would be good indeed!

 Let me ask you this -how would you go about educating young children/adolescents about healthier eating and the need to play sports, dance, swim....become active? Please share your thoughts. Thank you.

I think before we start educating kids/teens about healthy eating and activity we first need to get parents on board with these ideas. When parents model healthy eating and regular activity then kids adopt it as part of life. I'd rather see money put toward teaching how to live a healthy life before people have kids.

Lynn,

          You are correct. I came across an alarming article today. Enclosed are some of the details:

"Adolescents consume the most fructose so it's really important to not only measure the levels of fructose but to look at what it might be doing to their bodies currently and, hopefully, to look at cardiovascular disease outcomes as they grow....

 Evidence of cardiovascular disease and diabetes risk is present in the blood of adolescents who consume a lot of fructose, a scenario that worsens in the face of excess belly fat, researchers report. An analysis of 559 adolescents age 14-18 correlated high-fructose diets with higher blood pressure, fasting glucose, insulin resistance and inflammatory factors that contribute to heart and vascular disease.. The association did not hold up for adolescents with more generalized, subcutaneous fat.

It is so very important to provide a healthy balance of high-quality food to our children and to really pay close attention to the fructose and sucrose they are consuming at their home or anyone else's... The best way caregivers can support healthy nutrition is to be good role models. A healthy diet with plenty of physical activity – not dieting – is the best prescription for growing children".

Source: http://www.nutritionhorizon.com/news/High-Fructose-Consumption-by-Adolescents-May-Put-Them-at-Cardiovascular-Risk.html

As an RD and as health care professionals it is important to take advantage of any opportunity you can find to encourage kids. I have found a way to provide nutrition education in the classroom and in an area school by helping with a `Get Movin' night each spring and helping out in the classroom on career days. So far it has been volunteer but I look at it as an opportunity to get the public thinking about the importance of nutrition and the lifestyle choices. I feel we need to capitolize on these opportunities to guide people (children included) in finding the right resouces to make better lifestyle choices. So I would encourage you as well to find out what is happening in your area schools and community activities - finding ways to incoporate nutrition or healthy lifestyle choices as educational opportunity.

Teresa,

             Agreed!

Apparently, there are some researchers out there who want sugar (all forms of it) to be regulated as TOXIN.

"...the fructose element of sugar is metabolized primarily by the liver. This is where the trouble can begin — taxing the liver, causing fatty liver disease, and ultimately leading to insulin resistance, the underlying causes of obesity and diabetes".

SOURCE: http://news.yahoo.com/sugar-regulated-toxin-researchers-180605186.html

And the debate goes on.

I had just heard this on the news, but it's not really news as the AHA has been pushing this agenda for quite some time.  Not as forceful, with recommendations to tax foods, but to get manufacturers to focus on getting the things that are harmful out of our food system.  I still believe that teaching folks to get back to cooking and away from processed foods is a way to better manage vs. taxing the "bad" foods.  I would support incentives if it were on the ballot.

Thank you for your comment, Joan.

Among Lustig's more radical proposals(Dr Lustig is a medical doctor in UCSF's Department of Pediatrics)  are to ban the sale of sugary drinks to children under age 17 and to tighten zoning laws for the sale of sugary beverages and snacks around schools and in low-income areas plagued by obesity, analogous to alcoholism and alcohol regulation.

What do you think of that?

OK, I'm torn between the freedom of choice and the fact that the government (which means US) can't possibly continue to support the health care needs of all.   I bet I may have thought the same of the seat belt law, smoking, hmmmm are we much far from limiting the number of children we can have?