Rethink Your Drink: Efforts to Address Sugary Drinks through Education and Policy Changes

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Rethink Your Drink: Efforts to Address Sugary Drinks through Education and Policy Changes May 13, 2015 Janna Simon, MPH Associate for Policy, Advocacy and Organizing Illinois Public Health Institute 1

About IAPO The Illinois Alliance to Prevent Obesity is a diverse coalition of state and local organizations working toward a state-level response to the obesity epidemic through coordinated policy, systems, and environmental changes. 2

About IPHI The Illinois Public Health Institute mobilizes stakeholders, catalyzes partnerships, and leads action to promote prevention and improve public health systems in order to maximize health, health equity and quality of life for the people of Illinois. 3

Session Objectives: Participants will increase their knowledge of how sugary drinks negatively impact our health. Participants will be able to describe the potential benefits of the Healthy Eating Active Living Act for Illinois communities. Participants will be able to describe at least 2 ways they can engage their own communities in the Rethink Your Drink public education campaign. 4

The Facts: OBESITY & CHRONIC DISEASE 5

Obesity in Illinois In 1995, Illinois obesity rate was 15.5%; today it has nearly doubled. Nearly two-thirds (64%) of all Illinoisans are overweight or obese. Illinois is one of the top ten states for obese/overweight adolescents (ages 10-17 years). Nearly 1 in 3 children are overweight or obese. The obesity rate for African Americans is 39%, compared to 26.6% among Non-Hispanic Whites in Illinois. 6

Obesity is linked to early death and over thirty diseases including: -Type 2 Diabetes -Cardiovascular Disease -Asthma -Hypertension -Osteoporosis -Cancer -Arthritis -Poor Diet Quality -Sleep Apnea -Depression 7

Obesity is Expensive Obesity costs the Illinois health care system $6.3 billion per year including over $1 billion to Medicaid. If nothing changes, experts predict the cost of obesity could increase to $14 billion or more a year by 2018; $27 billion by 2030. 8

Sugary Drinks CONSUMPTION & RISKS 9

Sources of Added Sugar in the American Diet: Over 50% of all sugars are consumed in sugary beverages the greatest source of added sugar in the US diet. 10

What is a sugary drink? Any beverage with added caloric sweetener including soda, other carbonated soft drinks, fruit drinks, sports drinks, energy drinks, powdered drinks, sweetened tea or coffee drinks & flavor-enhanced water. Caloric sweeteners include: high fructose corn syrup, cane sugar, fructose, fruit juice concentrate, glucose, sucrose, honey, brown sugar, dextrose, agave syrup and corn sweetener. Does not include water, diet drinks, 100% fruit juice, low-fat or fat-free milk, or unsweetened coffee/tea 11

Consumption Trends 12

Experts believe beverages account for one-fifth of all weight gained by Americans between 1977 and 2007. -Woodward-Lopez, Kao, & Ritchie (2010) 13

SSB Consumption Risks Half of US population over the age of two consumes sugary drinks daily. One study showed that every additional serving of sugary drinks per day increased odds of obesity in children by 60%. Adults who drink one or more sugary drinks daily are 27% more likely to be overweight or obese. Regular consumption of sugary drinks (7 servings or more per week) could increase risk of dying from cardiovascular disease. 14

Sugary Drinks & Disease Direct scientific evidence links sugary drinks, not just to obesity but also to: Type 2 Diabetes Cardiovascular Disease Hypertension Gout Kidney Damage Dental Issues Cancer Sleep Disturbances 15

Numerous negative health impacts Source: Malik, Popkin, Bray, Després, Hu. 2010. Circulation 2010 16

American Heart Association warns the daily intake of sugar for an adult woman should be no more than 6 teaspoons (tsp) and no more than 9 tsp for adult men. BEVERAGE Typical Serving Amount of Sugar COKE 12 oz 10 tsp PEPSI 20 oz 17 tsp SUNKIST ORANGE SODA SNAPPLE LEMONADE ICED TEA 12 oz 13 tsp 16 oz 13 tsp ROCKSTAR ENERGY DRINK 16 oz 16 tsp RED BULL 8 oz 7 tsp ORIGINAL GATORADE 20 oz 9 tsp VITAMIN WATER 20 oz 8 tsp SUNNY D 6.75 oz 4 tsp CAPRI SUN (SMALL POUCH) 6 oz 4 tsp 17

Sugary Drinks MARKETING & ADVERTISING 18

TV Advertising From 2008-2010, exposure to TV ads for full calorie soda doubled for children and teens 2/3 of all radio ads heard by teens were for full calorie soda In 2010, teens saw 18% more energy drink TV ads and heard 46% more radio ads than adults 63% of all full calorie soda and energy drink ads on national TV include sponsorship of an athlete, sports league or team, event or cause 19

Target Markets Beverage companies see Latinos, African Americans and teens as a source for future sales Black children and teens saw 80% to 90% more ads than white youth More than twice as many ads for Sprite, Mountain Dew, 5 Hour Energy & Vitamin Water. Black and Latino youth are twice as likely to drink more than 500 calories a day compared to white youth 20

Target Markets (cont d) Marketing for Spanish market TV is growing. Between 2008 2010, Latino children saw 49% more ads for sugary drinks and energy drinks and teens saw 99% more ads. Latino pre-schoolers saw more ads for Coca-Cola Classic, Kool-Aid, 7 Up and Sunny D than Latino children and teens. 21

Sugary Drinks REDUCING CONSUMPTION 22

Population Impact Individual Impact The Health Impact Pyramid Counseling and Education Clinical Interventions Long-lasting Protective Interventions Context that makes Default Healthy Socioeconomic Factors Education is important, but rarely improves health outcomes alone. Changes in policy, systems, and environments broadly affect the way we live and shape the patterns of our health. 23

Rethink Your Drink Illinois Governor Quinn of Illinois declared February 2014 Rethink Your Drink Month in Illinois Community events, health fairs, educational presentations The Illinois Alliance to Prevent Obesity developed a toolkit! 24

Materials Rethink Your Drink educational brochure Rethink Your Drink poster Rethink Your Drink infographics Rethink Your Drink toolkit Social media examples #RethinkYourDrink http://preventobesityil.org/rethink_your_drink_campaign/ 25

How to calculate sugar content from nutrition labels 4 grams of sugar=1 teaspoon If this item has 44 grams of sugar, how many teaspoons does it have? 44/4= 11 teaspoons of sugar which exceeds all daily recommended allotments for men and women. 26

Rethink Your Drink Healthy Choices Stock the fridge with seltzer, unsweetened tea, low-fat and fat-free milk and other low-calorie drinks. Serve cold tap water during meals. Tap water is delicious, clean and free! Add fresh fruit to your water. Read labels. Choose drinks with no more than 25 calories per 8 ounces. If you buy fruit juice, make sure it s 100% fruit juice. Serve it in a small glass or dilute with water. 27

Stories from the field Evanston, IL Villa Park, IL 13 YMCA Communities Mexican Consulate Event with American Heart Association DuPage County Media attention Ezperanza Health Centers Your Community? 28

Where You Live Affects How You Live Being healthy is not just about individual choices. Due to structural gaps in society, such as poverty and lack of food security, some people don t have access to affordable and healthy foods and beverages. Healthy foods are sometimes more expensive than unhealthy options. 29

Policy & Environment Change Options Worksites can rearrange cafeteria or vending options to promote the healthier choice at eye level Restrict sales of SSBs near schools grounds Prohibit SSBs in afterschool and childcare programs Restrict SSB marketing in schools Limit SSBs in workplaces or conferences Tax SSBs with revenues for prevention 30

Sugary Drinks AN IN-DEPTH LOOK AT THE HEALTHY EATING ACTIVE LIVING ACT 31

Healthy Eating Active Living (HEAL) Act Addresses the future health and prosperity of our communities Estimated to generate over $600 million in the first year to invest in prevention $300 million into Illinois Wellness Fund $300 million to expand prevention and obesity treatment services for Medicaid beneficiaries 32

Wellness Fund Investment (~$300 million a year) Includes funds for: school & early childhood health & wellness public health departments and agencies improved access to affordable local foods nutrition education and physical activity improvement initiatives oral health initiatives plus many additional investments to increase opportunities for healthy living, especially in underserved communities 33

Expand Medicaid Services (~$300 million a year) Includes funds for: All services recommended for pediatric prevention, assessment and treatment of overweight and obesity Medical nutrition therapy, care coordination, weight management programs, diabetes education and multidisciplinary obesity treatment programs Community-based, evidence-based physical activity and nutrition programs, diabetes education & multi-disciplinary obesity treatment Dental prevention services Obesity screening and treatment 34

Funding Mechanism 1 penny per ounce excise tax on sugar-sweetened beverages (excludes diet and low-sugar drinks, 100% fruit juice and milk products) Tax is placed on the distributor of the beverages, powders, and syrups 35

Estimated Impacts Could work to reduce obesity, diabetes, and diseaserelated healthcare costs Could invest about $600 million in new opportunities for health in communities across the state Will have the most benefit in communities disproportionately burdened with obesity and disease 36

Estimated Impacts Cont. Estimated to save at least $150 million a year in Illinois healthcare costs A 5% reduction in adult obesity, and over 9% reduction in childhood obesity No net job loss in fact, a small (4,500) net job increase in Illinois 37

The HEAL Act in Illinois Polls in other states show that people support a tax when the revenues go to support obesity prevention efforts for children and families. As other states have tried, Illinois Senator Hunter and Representative Gabel introduced this bill in the Senate and House in 2014 and again in the spring of 2015 (SB 1584 and HB 2667). 38

Messaging Matters People are interested in what they have to gain in their communities: Community investment is important! While the tax itself could have some benefit, how the revenue is spent is more important to reducing and preventing obesity and chronic disease. 39

Potential Benefits of HEAL Act How could your community benefit? How could you engage others in this campaign? 40

Take Action! Help spread the word. Use the toolkit. http://preventobesityil.org/pdf/rtyd_toolkit.pdf Work in your local community or organization to ensure policies and practices support health Write a letter to your local newspaper or policymaker & advocate for policy change Engage in the Rethink Your Drink social media campaign Go to: www.preventobesityil.org for more information. 41

Thank you! www.preventobesityil.org Illinois Public Health Institute 954 W Washington Suite 450 / Mail Box 10 Chicago, IL 60607 (312) 850-4744 For More Information: Elissa.Bassler@iphionline.org This message was funded by the American Heart Association through the Voices for Healthy Kids Action Center 42