Sugary Drink Webinar Roberta R. Friedman, ScM Director of Public Policy UCONN Rudd Center for Food Policy and Obesity Childhood Obesity Foundation June 23, 2015
Rudd Center www.uconnruddcenter.org
Agenda Latest evidence: health effects Industry arguments and counter-arguments Taxes Promising policy options
Center for Science in the Public Interest, 2013
2013
Obesity SSB consumption promotes weight gain in children and adults. (Malik, 2013) High SSB consumption increased likelihood of obesity in 8 14-year-old children.ssb intake should be delayed and excessive consumption in pre-school period be avoided. (Cantoral, 2015)
Type 2 Diabetes Sweetened beverage consumption associated with higher T2D risk independently of adiposity. (O Connor, 2015) Meta-analysis: higher consumption of SSBs is associated w. development of metabolic syndrome and type 2 diabetes. (Malik, 2010)
Heart Disease Risk of cardiovascular mortality is positively associated with consumption of increasing amounts of added sugars. (Stanhope, 2015) Meta-analysis: suggests higher consumption of SSB assoc. w. higher risk of hypertension/chd, but not stroke. (Xi, 2015) Meta-analysis of 4 studies: suggests that consumption of SSBs may increase risk of CHD, especially men and American populations. (Huang, 2014) Higher % of calories from added sugar associated w. significantly increased risk of CVD mortality regular consumption of SSBs associated with elevated CVD mortality. (Yang, 2014)
Fatty Liver Disease (greater risk of developing T2D and CVD) Regular SSB consumption associated with greater risk of fatty liver disease, particularly in overweight and obese individuals. (Ma, 2015)
Dental Caries Frequent SSB intake during 10-12 months of age significantly increased likelihood of having dental caries among 6-year-olds. (Park, 2015)
Industry arguments Illinois, 2015
Calories from sugary drinks declining; obesity going up. Enhanced waters -1.5% Sodas -1.8% Fruit drinks -4.1% Energy drinks +14.3% RTD coffee +9.5% RTD tea +4.9% Sports drinks +2.3% Total volume sales +1% 2011-2012 Beverage World webcast, 06.13.2013
Calories from sugary drinks are a small fraction of the diet (6%) SSBs 6.6% of total calorie intake but 30.5% of source of added sugar by food sources Welsh et al., 2011
Calories from sugary drinks are a small fraction of the diet (6%) Hu, 2013
(Concerned about children s health)
(We re part of the solution)
(We re part of the solution)
www.cspinet.org
(Diversity)
(It s about personal responsibility)
(It s about physical activity)
(Job killer)
Taxes TAXES
Why Excise? Penny per ounce Bottler, Mfr, Distributor More expensive price on shelves + syrups Raise prices, pass price on to consumer
Why Not Sales Tax? % of price Same low price on shelf Then pay tax; shows on receipt; misses syrups Go to checkout
per ounce excise SSB Tax 10% increase in price = 10-12% decrease in consumption Penny per oz ~ 20% increase Earmark for obesity prevention/health
Penny per-ounce tax could substantially reduce BMI and healthcare expenditures and increase healthy life expectancy. (2015)
Earmark the revenue Concerns regarding the potentially regressive tax may be addressed by reduced obesity disparities and progressive earmarking of tax revenue for health promotion.
Basics of a good campaign Ground softening Coalition with lead partner Lobbying capacity Funds Polling Media strategy
Promising Policies www.changelabsolutions.org
Eliminate from Kids Meals =
Water Filling Stations in Schools
Allow sugary drinks?
Future of taxes? More localities, then states Diet drinks? 100% fruit juice?
Resources Changelabsolutions.org Sugarscience.org Uconnruddcenter.org Voices for Healthy Kids (www.aha.org)
Thank you! Roberta Friedman, ScM UCONN Rudd Center for Food Policy and Obesity Roberta.friedman@uconn.edu www.uconnruddcenter.org
References from Sugary Drink Webinar, Childhood Obesity Foundation Hu, F. B. (2013). Resolved: there is sufficient scientific evidence that decreasing sugar sweetened beverage consumption will reduce the prevalence of obesity and obesity related diseases. Obesity Reviews, 14(8), 606-619. Malik, V. S., Pan, A., Willett, W. C., & Hu, F. B. (2013). Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. The American journal of clinical nutrition, 98(4), 1084-1102. Cantoral, A., Téllez Rojo, M. M., Ettinger, A. S., Hu, H., Hernández Ávila, M., & Peterson, K. (2015). Early introduction and cumulative consumption of sugar sweetened beverages during the pre school period and risk of obesity at 8 14 years of age. Pediatric obesity. O Connor, L., Imamura, F., Lentjes, M. A., Khaw, K. T., Wareham, N. J., & Forouhi, N. G. (2015). Prospective associations and population impact of sweet beverage intake and type 2 diabetes, and effects of substitutions with alternative beverages. Diabetologia, 1-10. Malik, V. S., Popkin, B. M., Bray, G. A., Després, J. P., Willett, W. C., & Hu, F. B. (2010). Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes A meta-analysis. Diabetes care, 33(11), 2477-2483. Stanhope, K. L., Medici, V., Bremer, A. A., Lee, V., Lam, H. D., Nunez, M. V.,... & Havel, P. J. (2015). A dose-response study of consuming high-fructose corn syrup sweetened beverages on lipid/lipoprotein risk factors for cardiovascular disease in young adults. The American journal of clinical nutrition, ajcn100461. Huang, C., Huang, J., Tian, Y., Yang, X., & Gu, D. (2014). Sugar sweetened beverages consumption and risk of coronary heart disease: a meta-analysis of prospective studies. Atherosclerosis, 234(1), 11-16. Xi, B., Huang, Y., Reilly, K. H., Li, S., Zheng, R., Barrio-Lopez, M. T.,... & Zhou, D. (2015). Sugar-sweetened beverages and risk of hypertension and CVD: a dose response meta-analysis. British Journal of Nutrition, 113(05), 709-717. Yang, Q., Zhang, Z., Gregg, E. W., Flanders, W. D., Merritt, R., & Hu, F. B. (2014). Added sugar intake and cardiovascular diseases mortality among US adults. JAMA internal medicine, 174(4), 516-524. Ma, J., Fox, C. S., Jacques, P. F., Speliotes, E. K., Hoffmann, U., Smith, C. E.,... & McKeown, N. M. (2015). Sugar-sweetened beverage, diet soda, and fatty liver disease in the Framingham Heart Study cohorts. Journal of hepatology. Park, S., Lin, M., Onufrak, S., & Li, R. (2015). Association of Sugar-Sweetened Beverage Intake during Infancy with Dental Caries in 6-year-olds. Clinical nutrition research, 4(1), 9-17. Welsh, J. A., Sharma, A. J., Grellinger, L., & Vos, M. B. (2011). Consumption of added sugars is decreasing in the United States. The American journal of clinical nutrition, 94(3), 726-734. Andreyeva T, Long MW, Brownell KD. The impact of food prices on consumption: A systematic review of research on price elasticity of demand for. AJPH. 2010 Feb;100(2):216-222. Long, M. W., Gortmaker, S. L., Ward, Z. J., Resch, S. C., Moodie, M. L., Sacks, G.,... & Wang, Y. C. (2015). Cost effectiveness of a sugar-sweetened beverage excise tax in the US. American Journal of Preventive Medicine, 49(1), 112-123.