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    Minorities And Poor Need A Soda Tax, Say Scholars
    By News Staff | December 16th 2013 04:04 PM | 18 comments | Print | E-mail | Track Comments

    Low-income, Hispanic and African-American Californians need to have a tax on sodas and other sugary beverages if they are going to have reduced risk of diabetes - which could be a substantial cost for taxpayers in a world of government health care.

    Over the course of the next decade, the scholars estimate that lowered incidence of these diseases would save over half a billion dollars in medical costs. 2 or perhaps 3 of each 20,000 people.

    They previously modeled the national health effects of a penny-per-ounce tax over the course of 10 years and found that it would reduce consumption among adults by 15 percent, modestly lower the prevalence of diabetes and obesity and perhaps prevent tens of thousands of coronary heart events, strokes and premature deaths.

    The new analysis considered a range of reductions in sugary beverage consumption among Californians. By assuming a decline of 10 to 20 percent in the consumption of soda and other sugary beverages from the tax, researchers concluded that new cases of diabetes and coronary heart disease would drop statewide, and those health benefits would be greatest in poor and minority communities. The numerical model predicted that one in 20,000 Californians would avoid diabetes. This estimate would double for Hispanics and poor Californians and triple for African Americans.



    Projected incident diabetes decrease at different levels of SSB consumption reduction with variation of BMI effects. Credit and link:
    doi:10.1371/journal.pone.0081723

    "Poor and minority communities in California and nationally have very high rates of diabetes, a chronic condition with potentially devastating health complications," said Kirsten Bibbins-Domingo, MD, PhD, UCSF professor of medicine and director of the UCSF Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center. "Although many steps are needed to reverse the rising diabetes trends in the state, our study suggests that efforts to curb sugary beverage consumption can have a significant positive impact, particularly in those most likely to be affected."

    More than 10 million Californians drink at least one sugar-sweetened beverage, such as soda, fruit punch or sports drinks, every day, and surveys show that blacks, Hispanics and the poor consume more of their daily calories from sugar-sweetened beverages than whites and those in higher income brackets. Higher sugar intake is associated with a variety of health risks, including type 2 diabetes, obesity, high blood pressure and coronary heart disease.

    Many of the predicted health benefits from cutting consumption of sugary beverages depend on the assumption that people will not replace those calories by eating and drinking more of other things. Given this, researchers examined three different scenarios: that none of the calories would be replaced, that about 40 percent of the calories would be replaced and that all of the calories would be replaced.

    Even under the most pessimistic scenario, diabetes and coronary heart disease incidence went down with less sugary beverage consumption, although much less than it would if consumers did not replace all of the calories.

    "Drinking sugary beverages increases the risk for obesity and diabetes," said Claire Wang, MD, ScD, co-director of Columbia's Obesity Prevention Initiative. "This hurts our communities and burdens our healthcare system."

    San Francisco Supervisors are considering two proposals to tax sugary beverages by two cents per ounce. San Francisco has previously sought to ban Happy Meals, goldfish and golf.


    Citation: Mekonnen TA, Odden MC, Coxson PG, Guzman D, Lightwood J, et al. (2013) Health Benefits of Reducing Sugar-Sweetened Beverage Intake in High Risk Populations of California: Results from the Cardiovascular Disease (CVD) Policy Model. PLoS ONE 8(12): e81723. doi:10.1371/journal.pone.0081723

    Comments

    This study is based on the false premise that an excise tax on SSBs would directly increase the cost of SSBs - like a sales tax. In reality, the cost of an excise tax would be spread over a myriad of grocery products so as to have the least affect on any one product. You need only look to the states of West Virginia and Arkansas. Both states have had excise taxes on SSBs for years, and both states consistently rank among the most obese populations. Additionally, it should be pointed out that a penny-per-ounce tax on SSBs (assuming it directly increased the cost) would yield a loss of less than one pound of weight per year, making any changes to BMI undetectable. (Health Affairs, January 2012) Taxings SSBs won't improve health. Diet and exercise remain the answer.

    "Diet and exercise remain the answer". What's the question? If the question is "What's the best way to reverse the high rates of diabetes our nation faces", the Institute of Medicine has answers. You can point to one article in Health Affairs, the Institute of Medicine is made up of our nations most renowned researchers; people who've published hundreds of articles each before the IOM even consider them for membership. And the IOM recommends that we tax sweetened drinks, among other things. It's the first thing they recommend local governments do, in addition to removing vending of these products from public spaces and other things. Maybe Karen Hanretty thinks she knows better than the IOM. I don't.

    Also: SF didn't try to ban Happy Meals: we decided that restaurants couldn't sell high fat, high sugar meals with a toy. McDs and others now provide a salad instead of fries, milk instead of soda with those toys. WHich means the law worked: it got the junk food chains to change what they are marketing to kids so that kids get a healthier meal with that toy. If you have kids, you know that the meal is not the most important thing in that Happy Meal anyway, so I'm very pleased that there is better food in there now. Banning goldfish and golf? Not sure what this reporter is referring to.

    Hank
    Also: SF didn't try to ban Happy Meals: we decided that restaurants couldn't sell high fat, high sugar meals with a toy.
    This is the kind of ridiculous rationalization that has made Frisco famous for being social authoritarian goofballs that let any fringe activist write laws and then happily adopt them. Banning Happy Meals was exactly the intent or Samantha Graff, the attorney who wrote the law, wouldn't have continually called it a ban on Happy Meals. Just because it failed spectacularly does not mean it was not a ban on Happy Meals, now people just have to pay 10 cents more. Good job!
    A Feb 2013 study on the CDC's website also suggests soda taxes won't reduce obesity. IOM says kids need more exercise to combat obesity and recommends 60 min a day and making PE mandatory. There's no one solution. SSBs are only 6% of calories, according to CDC data. And a lot more sugar comes from food than from beverages. In fact, the Dept of Ag finds that the greatest percentage of increase in calories since 1970 comes from fats and oils. The issues of obesity and its related illnesses are more complex than SSBs.

    Please tell us exactly which studies and data you are referring to, because all the studies I've seen point to sugary drinks as contributing way more calories to our diet than any other single food. And that's without all the fiber, vitamins, protein, etc. that most FOOD comes with.

    Sure, I should have included this in my earlier comments.

    NHANES Data Brief No. 87, March 2012. This study references children and adolescents, ages 2 - 19 yrs.
    "Foods contributed significantly more of the added sugar calories than beverages (data not shown
    in figure). Fifty-nine percent of added sugars calories came from foods compared with 41% that
    came from beverages. More of the added sugars calories were consumed at home rather than
    away from home for both beverages and foods."

    NHANES Data Brief No. 122, May 2013 references adults 20 yrs and older.
    "Foods contributed 67% of calories from added sugars compared with 33% from beverages
    (data not shown in Figure 5). Nearly two-thirds of the added sugars consumed from foods
    were consumed at home (67.2%), compared with 58% of added sugars calories from beverages
    (57.8%)"

    Both studies are worth taking a look at. The study on adults finds differences in consumption of sugar based on ethnicity. It states, "No significant differences in percentage of calories from added sugars were found between non-Hispanic white and Mexican-American men or women."

    "Non-Hispanic black men consumed 14.5% of their calories from added sugars compared with 12.8% for non-Hispanic white men and 12.9% for Mexican-American men."

    "Non-Hispanic black women consumed 15.2% of their calories from added sugars compared with 13.2% for non-Hispanic white women and 12.6% for Mexican-American women."

    The NHANES study on children found little differences in consumption of added sugar based on ethnicity, except that non-Hispanic white boys and girls consumed more calories from added sugars than either non-Hispanic black children and Mexican-American children.

    Hope that's helpful.

    One more. I don't mean to inundate the comments section. Just adding to the discussion with (what I find to be) interesting studies.

    "What We Eat In America" is a report from NHANES posted online over the summer that breaks it down:
    This one refers to calories, not specific to "added sugars" like the other studies I posted.
    7% from "cakes, cookies, donuts, snack bars"
    2% from "candy" and another 2% from "other desserts."
    5% from "chips, popcorn, pretzels, crackers"

    4% from "soft drinks"
    4% from "alcohol"
    5% from "milk"
    2% from "juice"
    2% from "juice drinks, sports drinks, energy drinks"
    1% from "coffee and tea"

    Hank
    There is a cost metric that makes sense. Is saving 1 more person out of 20,000 from diabetes worth taxing the other 19999 and creating more bureaucracy to do so? I don't think so, but that is why I am not in San Francisco academia or the government.
    And thank goodness that is probably why you aren't San Franciscan. Tax 20,000 people to save a life? Sure, I'd sign up to be one of them. I'm San Franciscan, and don't mind paying a few cents extra if I decide to drink soda, if it'll pay for more PE, better parks, better school food. I'll pay it. For someone who is so irate about how "goofball" we San Franciscans are, I wonder why you stay up at night commenting on SF politics online. Are you getting paid by the soda industry? Your friend Karen Hanretty is, so I'm guessing you are too. Please, let San Francisco decide what's best for us. We care about health in this City, and we don't like Big Soda trying to tell us how to vote.

    Hank
    I think you can be proud of being one of the social authoritarian elites that have driven out actual diversity in the name of fringe advocacy. I happily agree that you should live in San Francisco and all but about 400,000 people should not. Because I celebrate diversity, I am happy there is a place for you and people like you - but unlike you, I don't feel the need to use judicial fiat to impose my world view and beliefs on everyone else. And that is the big flaw in San Francisco culture and why the rest of us in California make fun of the place.
    McDonald's sidestepped the law by charging 10 cents for the toy, since the law forbid luring kids with a free toy to get their parents to buy a meal that flirts with diabetes. But even McDs own website claims they're now "listening", and making happy meals healthier by nixing soda, offering fruit and smaller portions of fries. That's called a success by those of us who care about keeping kids healthy. And that was the real point of the law. Now, unless you were out there advocating that Junk food retailers sell healthier Happy Meals, I think we can credit Mar and other health advocates. Here's McD's website so you can see what I'm talking about:http://www.mcdonalds.com/us/en/changingtogether.html. As a native San Franciscan, if that makes you think we San Franciscans are "famous for being social authoritarian goofballs" then I'll take it. Yes, we care about children's health here in SF. Call us names if you want, please just don't move here.

    Hank
    Listen, stop patronizing the rest of us with your insistence that you care about kids and anyone who disagrees with your cultural militancy does not. It's a false dichotomy, the kind of nonsense progressive mullahs invented to justify intolerance. And San Francisco is the home of intolerance. You know it, I know it. As I said in my other comment, I am happy you are one of the rich elites who can tell everyone else what to eat - but the culture of SF is oppressive to all but a few hundred thousand people who actually don't need to be told how to live their lives. Banning Happy Meals did nothing at all to help kids - it costs people more and McDonald's gets a tax write-off. Everyone but the lawyers and blind fundamentalists living there knew that was exactly what would happen.
    John Hasenkam
    Sugar is like legislation: beyond a certain point the more you put into society the more problems you create. I like McDonald's: about once a month. I rarely consume soda drinks but I like a little sugar in my coffee. If you want to think of the children then abuse their parents for being so bloody stupid as to promote dietary habits that clearly are dangerous.  Don't let them always eat cake. :) Get to the root of the problem which is the way people are raising their children.




    Why are you scientists at Science20 so worried about ignorant poor people being taxed for poisoning themselves with sugar? Is it just that you are worried about the infringement on your liberties as rich educated people to do what the hell you want to do? Its a shame you can'rt just shoot these bastards who try to impose taxes on the masses isn't it?

    MikeCrow
    I don't need to shoot them, but tazering them would be a very satisfying.
    I don't mind you not wanting to drink anything you don't want, but leave me the frack alone so I can drink my poison in peace, please.
    Never is a long time.
    Padre
    The Institute of Medicine has no answers, and hundreds of articles contains pseudo-science. The education is wrong. The strategies against diseases are wrong. The fats and the sugars are foods, and are sources of our energy. We will be ill, but not from these. We started our devolution, and the salt is the number one cause of diseases, because the salt is perfect food for entropy (perfect food for disorder). We can restrain our devolution only by radical salt reduction. And not by taxes, but by strict laws, this is the only solution.
    Here are the facts and real answers:
    http://www.science20.com/entropy_and_sodium_intakes_wicked_problems_heal...
    --
    I wrote a comment here:
    http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0081723
    What will be its fate?
    Padre (Z. Sandor)
    Diabetes is certainly an important public health challenge. However, it does not stem from a single food, beverage or ingredient, and it is misleading and irresponsible to suggest so. The American Diabetes Association, among other health professionals and organizations, underscore this point, citing age, genetics, and obesity among the condition’s risk factors.

    Yet, this study attempts to suggest that reducing or eliminating regular soft drinks from the diet will lower the risk of type 2 diabetes, reduce heart disease, and combat obesity. This is patently false, and actually studies show soda taxes could have the exact opposite effect.

    Consider this Yale School of Public Health study, for example, which found that: “…any obesity-related benefit of decreased soda consumption that comes from a soda tax is, on average, more than offset by increased caloric consumption from other beverages.” And a study published in The American Journal of Agricultural Economics determined that the reduced calorie intake from soft drinks would cause an increase in calories consumed from other foods particularly those containing high sodium and fat: http://ajae.oxfordjournals.org/. This evidence, along with other examples, shows soda taxes are a misguided and ineffective approach to improving health.

    In sum, restrictions won’t fundamentally change health behaviors, but education-based approaches that counsel a holistic approach to calorie intake and physical activity can make a lasting and meaningful difference.

    Hank
    Yet, this study attempts to suggest that reducing or eliminating regular soft drinks from the diet will lower the risk of type 2 diabetes, reduce heart disease, and combat obesity. This is patently false, and actually studies show soda taxes could have the exact opposite effect.
    It does more wrong than that. It says that charging more money will cause a particular demographic to change their lifestyle enough to offset diabetes - and that raising prices leading to keeping one person more out of 20,000 from getting diabetes is worth penalizing everyone else.

    It's bonkers rationalization and isn't borne out by any evidence.  New York City banned trans fats almost a decade ago but then last year said they needed to ban sodas to curb their diabetes epidemic - which was the reason they banned trans fats.