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Big Beverage vs. A Big Health Problem
Recently New York City Mayor Michael Bloomberg proposed an amendment to the city’s health code that would prohibit the sale of sugary soft drinks in containers larger than 16 oz. in New York restaurants, movie houses, sports stadiums and other public facilities.
Under the proposed change, if you need to drink more than 16 oz. of soda, you’ll simply have to deal with the inconvenience of getting up and buying another bottle. It is hoped that this extra effort might slow overconsumption of these empty, non-nutritional liquid calories.
The Mayor’s initiative follows an earlier, and unsuccessful, attempt to place a special tax on sugary soft drinks, as a way to make New Yorkers more mindful of the adverse health consequences (e.g., obesity and diabetes) of drinking too many sugary beverages. That effort was blocked in New York and other states by intense lobbying by trade groups such as the American Beverage Association.(1)
Bloomberg’s new health code proposal cleverly avoids the need to propose and pass a new tax. With U.S. rates for type 2 diabetes and obesity rising to epidemic levels, the mayor’s action, from a public health perspective, makes sense. But will the mayor be able to overcome the expected and predictable blowback from the beverage makers and other large food companies who will undoubtedly claim that their brands and their inherent right to maximize profits with large portions and containers are being unconstitutionally threatened?
The fact is we have been here before. Alcohol and cigarettes are, like sugary beverages, health-threatening substances that have as many fans as detractors and powerful business interests with deep pockets and political muscle.
America, The Land of the Big, The Home of the Obese
The problem is Americans have always loved big. We’ve created giant industrial enterprises that made chemicals, steel, refined oil, built transcontinental railroads and highways, mass-produced automobiles and airplanes that carried people to far way lands. We were known and admired for our big cars and big universities and big ideas. From Super Bowls to Big Macs, to 64-oz containers and Grand Mocha Lattes, Coca Cola, PepsiCo, Dunkin’ Donuts, Starbucks and other food companies have each capitalized on the “big” fixation encoded in the American DNA.
The downside of American devotion to “big” is that we eat too much and drink too many calorie-loaded beverages, often because the servings are larger than they need to be to satisfy hunger or thirst. As a consequence, many Americans are obese, and many suffer from type 2 diabetes.
Among major nations, current data from the World Health Organization ranks the U.S. first in the percentage of adults who are obese (33.9%).(2) By comparison, the obesity rate for adult Mexicans is 23.6% and for Canadians 22.9%, almost one-third less than the rate for their North American neighbor.
In 2010, 12.3% of Americans between the ages of 20 and 79 had type 2 diabetes. Though China and India have the highest number of citizens with type 2 diabetes, the U.S. with a much smaller population is in third place.(3) The rate is expected to surge to 14.0% by 2030.(4) Because China and India have substantially lower adult obesity rates, 2.4% and 1.3% respectively,(5) the U.S. can expect to hold onto its dubious obesity first place ranking for the foreseeable future unless we change our nutritional habits.
Can Public Health Officials Protect Us From Big Gulps?
The basic conflict American public health officials face is that large multinational food and beverage companies, many of them U.S.-based, despite their prominent and deliberately well-publicized support for the public health through various forums, alliances and foundations, make and sell products that are not especially healthy.
The top ten beverage companies, for example, captured “52.3% of sales worldwide; Coca-Cola and PepsiCo lead with 25.9% and 11.5% of sales, respectively.”(6) Though Coca-Cola owns Minute Maid orange juice and PepsiCo’s brands include Tropicana orange juice and Quaker Oats cereals, their primary products (Coke and Pepsi) are the drivers of corporate profit and the leading examples of sugary beverages with empty, non-nutritional calories.
These companies are expert marketers and promoters, with armies of lawyers and public relations consultants. They have the clear ability, and goal, as a matter of corporate survival, to stifle all meaningful efforts to restrain and restrict their brands. The practical challenge, then, for governmental health professionals is to find a path that protects the public and doesn’t unduly interfere with corporate strategies and profits. What, then, can be done to address this challenge?