Soda W Wars: Update f from t the Fi Field JIM KRIEGER, MD, MPH ACTION FOR HEALTHY FOOD DECEMBER 7,2015 ACTION FOR HEALTHY FOOD
We are winning ! The drop in soda consumption represents the single largest change in the American diet in the last decade. NY Times, October 2, 2015 ACTION FOR HEALTHY FOOD
Beverage norms are changing http://www.theatlantic.com/business/archive/2013/01/how-america-drinks-water-and-wine-surge-cheap-beer-and-soda-crash/267153 ACTION FOR HEALTHY FOOD
But consumption still at historic highs 45 40 35 Availability 30 triple what it Gallons of Soft Drink Regular soft drinks was 60 years 25 ago 20 6 15 Juice drinks Sports drinks 5 10 4 3 5 2 1 0 0 1954 1956 1958 1960 1962 1964 1966 1968 1970 1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 Sources: (1954-2003): Beverages Table. United States Department of Agriculture, Economic Research Service Food Availability (Per Capita) Data System Website. Updated February 1, 2015. Accessed September 9, 2015. (2004-2014): Beverage Digest annual estimates; Caloric CSDs based on estimate that 70% of CSDs are caloric and 30% are non-caloric/diet. ACTION FOR HEALTHY FOOD
Calories of sugary drinks sold per capita per day, 2014 USA ACTION FOR HEALTHY FOOD
Even the youngest children consume too much 31% of toddlers age 12-23 months consume sugary drinks on any given day. ACTION FOR HEALTHY FOOD ACTION FOR HEALTHY FOOD
Sugary drinks cause chronic diseases 2 sodas/day for just 2 weeks: ↑ LDL cholesterol & triglycerides by 20% 2 sodas/day for 6 months: ↑ Visceral fat, fatty liver disease 1 soda/day: ↑ Risk of overweight/obesity by 55% (children) ↑ Risk of diabetes by 26% ↑ Risk of dying from heart disease by almost 1/3 ↑ Risk of stroke by 22% ACTION FOR HEALTHY FOOD ACTION FOR HEALTHY FOOD
Reminder - why focus on sugary drinks? Primary source of added sugar in U.S. diet o Major source of added calories fueling the obesity epidemic o Consumption higher among low income and minority populations o Cause obesity, diabetes, dental decay, liver, and heart disease o Do not affect appetite o Heavily marketed (and youth and minorities targeted) o No nutritional benefits o ACTION FOR HEALTHY FOOD ACTION FOR HEALTHY FOOD
What do we do about it? ACTION FOR HEALTHY FOOD
Pass taxes Restrict sugary drink Limit marketing & purchases using sales to kids SNAP benefits Cap portion sizes State & local Implement childcare/afterschool strategies nutrition standards Require display of health information Increase awareness Change procurement Increase access to Ban beverage industry policies fresh drinking sponsorships by water schools and government ACTION FOR HEALTHY FOOD
Sugary drink tax o Reduce consumption 20-24% at a penny per ounce o Reduce disease • Taxes are reducing • Diabetes: 3.4% decrease in new cases over 10 years consumption and raising • Obesity: revenue. • 1% decrease (adults) • 1.4% decrease (children) BERKELEY MEXICO o Increase awareness about adverse health effects o Generate revenue to support obesity and chronic disease prevention o Reduce national health care costs by $23 billion over 10 years 6% decrease in Raising $1.5 consumption million per year ACTION FOR HEALTHY FOOD
How to use tax revenue o Promote healthy eating • School food • Improve food quality • Universal breakfast • Support public awareness campaigns • Sustain foundation program investments o Public Health funding o Medicaid funding o General Fund ACTION FOR HEALTHY FOOD ACTION FOR HEALTHY FOOD
People support a tax ACTION FOR HEALTHY FOOD ACTION FOR HEALTHY FOOD
Berkeley & Tax implemented in Berkeley, San Francisco March 2015 BERKELEY SODA TAX o Penny per ounce yes no o Tax is showing up on shelf price o Raising $1.5 million per year 24% o Supporting chronic disease prevention 76% SAN FRANCISCO SODA TAX yes no 45% 55% ACTION FOR HEALTHY FOOD
Where will the next tax happen? Sugary drink excise tax efforts in the US since 2009 Current activity: CA and IL In the running for 2016: o State: HI, CT, and others o Local: San Francisco and several cities and counties across US ACTION FOR HEALTHY FOOD ACTION FOR HEALTHY FOOD
Include health information at point of purchase Consumers lack information on the health effects of sugary drinks. Require health warnings on sugary o Post health information signs on o drinks shelves where sugary drinks are sold • Past: OR & CA • Boston • 2016: CA, HI, NY, and others ACTION FOR HEALTHY FOOD ACTION FOR HEALTHY FOOD
Kids meals A third of all US children and adolescents aged 2–19 consume fast food on a given day. o Ban soda as default beverage option or ban completely o Nutritional standards for kids meals o Some chains are removing soda • Applebee’s • Wendy’s • IHOP • Subway • Dairy Queen • Chipotle • Burger King • Panera ACTION FOR HEALTHY FOOD ACTION FOR HEALTHY FOOD
Kids meals: Local efforts City of Davis, CA – Removes soda as default o beverage in children’s meals o Santa Clara County, CA - Sets nutritional standards for restaurant food that comes with toys or other incentive items o San Francisco County, CA - Prohibits restaurants giving away free toys / incentive items with children’s meals that exceed nutrition standards o Attempts: CA; MA; MI; MS; NE; NY, TX o 2016/2017: a few states and cities (mostly cities in 2016; mostly states in 2017) ACTION FOR HEALTHY FOOD ACTION FOR HEALTHY FOOD
SNAP demonstration projects Sugary drinks account for 58% of refreshment beverage purchases made by SNAP households. o Policy – SNAP benefits cannot be used to purchase sugary drinks (and healthy food incentives could be added) o Senators Harkin and Coburn requested USDA allow demonstration projects in two states o Requested waivers: New York/NYC and MN o Bills considered: CA, FL, ID, IL, IN, ME, MS, MO, NE, NY, PA, SC, TX, VT, WV, and WI ACTION FOR HEALTHY FOOD
Limit portion sizes Larger portion sizes lead to greater consumption. o Limit portion sizes of drinks served in restaurants o Limit portion sizes of bottled SSBs sold in stores ACTION FOR HEALTHY FOOD ACTION FOR HEALTHY FOOD
NYC portion size regulation ACTION FOR HEALTHY FOOD
Checkout aisles 60% of checkout beverage offerings are soda and other sugary drinks. o Limit presence of sugary drinks (and other less healthy foods) in checkout aisles ACTION FOR HEALTHY FOOD Bridging the Gap: Availability of Healthy Food Products at Check-out Nationwide, 2010–2012 ACTION FOR HEALTHY FOOD
Access to drinking water - schools o The policy (Healthy, Hunger-Free Kids Act): • Schools in the National School Lunch & Breakfast Programs must make free water available during meals o The reality: • US: only 9% of districts require free drinking water in cafeterias • King County: only 4% of water fountains/sources met quality standards for flow, temperature, and appearance o What is needed: • Language about quality drinking water access in district wellness policies • Funding for water stations (WA: $5M in 2015-2017 capital budget for healthy kids- healthy schools grants)
Access to drinking water - buildings o Strengthen building codes that affect the availability of drinking water o WA: State Building Code Council considering requirement that a percentage of currently required fountains include filling stations
Organization policy Government solutions Cities State Schools & Early Business Learning Institutional Policies Community Public Aquarium Housing Faith CBOs Healthcare Hospitals Health Centers ACTION FOR HEALTHY FOOD
Government o Vending o Cafeterias o Government programs: • Parks and Recreation Sites • Child care and before/after school programs o Government contracts
New York City No sugary drinks in: o Group daycare facilities o Licensed day camps o Publicly funded meals in: • Schools • City hospitals • Correctional facilities • Senior centers • Daycare centers • Afterschool programs • Day programs for the mentally ill ACTION FOR HEALTHY FOOD ACTION FOR HEALTHY FOOD
Washington Executive Order o All state food venues, including vending machines, cafeterias, on-site retail establishments, and meetings or events meet healthy nutrition guidelines based on the 2010 Dietary Guidelines for Americans o By December 31, 2016, each agency’s policy fully implemented o New vending contracts: 50% foods must be healthy o 31 state agencies have adopted policy o 9 cafeterias implementing guidelines ACTION FOR HEALTHY FOOD
ACTION FOR HEALTHY FOOD
Schools NO SUGARY DRINKS AT SCHOOL NO “POURING RIGHTS” “After listening carefully to the o USDA bans full sugar drinks during class hours for elementary and concerns and information I received middle schools from our students, faculty, and staff, I have decided not to move forward o Allows drinks with <40 cal/8 oz in high schools with the process of establishing a partnership with a beverage o Eliminated from cafeterias company.” - SF State president Les o Permitted off hours, special events, Wong trips, and fundraisers o Work remains: • Assure implementation • Seek total elimination from schools • Address in-school marketing ACTION FOR HEALTHY FOOD ACTION FOR HEALTHY FOOD
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