Soda: A sin we sip instead of smoke?

A campaign against childhood obesity would be led by the American first lady

The problem is that at roughly 50 gallons per person per year, our consumption of soda, not to mention other sugar-sweetened beverages, is far from moderate, and appears to be an important factor in the rise in childhood obesity. This increase is at least partly responsible for a rise in what can no longer be called ‘adult onset’ diabetes — because more and more children are now developing it.

Attention is being paid: Last week, the Obama administration announced a plan to ban candy and sweetened beverages from schools. A campaign against childhood obesity will be led by the first lady, Michelle Obama. And a growing number of public health advocates are pushing for even more aggressive actions, urging that soda be treated like tobacco: with taxes, warning labels and a massive public health marketing campaign, all to discourage consumption.

A tax on soda was one option considered to help pay for health care reform (the Joint Committee on Taxation calculated that a 3-cent tax on each 12-ounce sugared soda would raise $51.6 billion over a decade), and President Obama told ‘Men’s Health’ magazine last fall that such a tax is “an idea that we should be exploring. There’s no doubt that our kids drink way too much soda.”

But with all the junk food and UFO’s (unidentifiable food-like objects) out there, why soda? Why a tax? And, most important, would it work?

Not a solution

To the beverage industry, the idea is not worth considering. Susan Neely, the president of the American Beverage Association, acknowledges that obesity is a problem but says: “If you’re trying to manage people being overweight you need a variety of behaviour changes to achieve energy balance — it can’t be done by eliminating one food from the diet.”

Even if soda consumption were to drop, say critics of the tax, a drop in childhood obesity isn’t guaranteed. “Simply pricing one product higher,” says Derek Yach, a senior vice president of global health policy at PepsiCo, the big food company that has spoken the most seriously about building a healthier portfolio, “would lead to unknown effects on total dietary consumption. It may even lead to worse situations: people may stop spending on one food and eat more of another, so taxing high levels of sugar may lead to eating higher levels of fat.”

Still, the idea of a special tax on soda, similar to those on tobacco, gasoline and alcoholic beverages, is attracting more interest. Advocates of a tax note that sugared beverages are the No 1 source of calories in the American diet, representing seven per cent of the average person’s caloric intake, according to government surveys, and up to 10 per cent for children and teenagers. These calories, they point out, are worse than useless — they’re empty, and contribute to a daily total that is already too high.

“What you want,” says Kelly Brownell, director of Yale’s Rudd Centre for Food Policy and Obesity, “is to reverse the fact that healthy food is too expensive and unhealthy food is too cheap, and the soda tax is a start. Unless food marketing changes, it’s hard to believe that anything else can work.”

Advocates argue that a soda tax would reduce consumption and pay for anti-obesity campaigns. In an opinion piece in ‘The New England Journal of Medicine’ last year, Dr Brownell and Thomas R Frieden, the director of the CDC and former New York City health commissioner, estimated that in New York State alone a penny-per-ounce soda tax would raise $1.2 billion annually.

Small excise taxes on soda are already in place in Arkansas, Tennessee, Virginia, Washington and West Virginia, and Chicago imposes a 3 per cent retail tax on soft drinks. Soda taxes were proposed in at least 12 other states in 2009, though none were approved. Mississippi is considering legislation that would tax the syrup used to sweeten soda; the mayor of Philadelphia is weighing a tax on soda and other sugar-sweetened drinks, and Governor David Paterson of New York has indicated that he will recommend a penny-per-ounce tax on sugared beverages in his 2011 budget.

High revenue

The penny-per-ounce tax, favoured by Dr Brownell and others, would produce a significant increase in retail costs: the 12-pack of Coke on sale for $2.99 would go for $4.43 and a 75-cent can would rise to 87 cents. These increases, Dr Brownell estimates, would reduce the annual per capita consumption of soda by more than 11 gallons, to 38.5 gallons. “And the revenue,” he says, “could be used to subsidise fruits and vegetables, fund obesity prevention programmes for children and home economic classes in schools, and more.”

The model, clearly, is tobacco. Dr Frieden, who promoted a soda tax when he was a health commissioner, sees further parallels between soda and tobacco: “There are aspects of the food industry that are reminiscent of tobacco — the sowing of doubt where there’s no reasonable doubt, funding of front groups, use of so-called experts, claims that new products which are safer for consumers are available, and the claim that they are not marketing to children.”

The public war against tobacco has worked, if imperfectly: Americans smoke at half the rate they once did, half of all smokers have quit, and the tobacco companies finance strong antismoking campaigns.

In the case of tobacco, the health risks of smoking were clear. But the beverage industry contends that science does not back up the assertion that childhood obesity is even partly caused by soda consumption, and has sought to make the discussion about personal choice and freedom. “Soda has calories, and food with calories causes people to put on weight when consumed in excess,” says J Justin Wilson a self-described “libertarian consumer advocate” and senior research analyst for the Center for Consumer Freedom, an industry-sponsored advocacy group. “But there is no unique link between soda and obesity.”

Besides, says Susan, the industry is taking measures: “The beverage industry supports real solutions to obesity and continues to step up to do its part. We’ve removed full-calorie soft drinks from schools across the country and, in support of Michelle Obama’s initiative, will place the full calories for our products on the front of our containers.”

Perhaps the process of reducing the drinking of sweetened beverages need not be so contentious. “There are parts of the industry that want to be constructive” says Dr Frieden. “Big Food doesn’t have to become the next tobacco.”

With this Dr Yach agrees, and though he clearly thinks a soda tax won’t work, he’d like to see a greater government role. “The overall governmental voice and investment in solutions required has been stunningly weak. They need to forcibly say, ‘The fundamental issue is one of calorie balance, and here’s what you need to do’.”

The problem, says Dr Frieden, is that, “Obesity is a major health problem that’s getting worse, and it’s clear that exhorting individuals to eat less and exercise more is not going to turn things around.”

It may be time to try something a little more forceful.