NYC-style cap on soda size would target the overweight, not the poor, study finds

June 12, 2013

Legislation to restrict consumption of large sugar-sweetened beverages in food service establishments would affect 7.5% of Americans on a given day, and a greater percentage among those who are overweight, including 13.6% of overweight teenagers, according to researchers at Columbia University's Mailman School of Public Health. Challenging criticism that the restriction is discriminatory against the poor, the study finds low-income individuals would not be disproportionately affected.

The proposed restrictions were approved by the New York City Board of Health. They are currently under appeal after being struck down by the New York in March. Oral arguments began yesterday.

The new study looks at national data, but the researchers say the results are a strong validation of the obesity-prevention measure no matter where in the country it is implemented. "Our findings are clear: a law like this would address one of the fundamental causes of obesity—the growing of sweetened drinks," says lead author Y. Claire Wang, MD, ScD and assistant professor of Health Policy and Management at Columbia University's Mailman School of Public Health. The study appears online in the American Journal of Clinical Nutrition.

Dr. Wang and co-author Seanna M. Vine, MPH, analyzed 19,147 dietary records from National Health and Nutrition Examination Surveys in the years 2007-2010 for the demographics related to the consumption of sugar-sweetened beverages, including sodas and other non-alcoholic drinks containing caloric sweeteners.

While 60.5% of Americans consumed sugary drinks on a daily basis, only 7.5% purchased them from a food establishment in portions larger than 16 ounces on a given day. The proportion was marginally higher in some groups: 8.6% of those who were overweight (compared to 6.4% of those who aren't overweight), 13.6% of overweight teenagers, and 12.6% of overweight young adults aged 20 to 44. Americans with incomes less than 130% of the (eligible for the Supplemental Nutrition Assistance Program, SNAP, formerly food stamps) were found to consume large sugary drinks from food service establishments in equal proportion to those with higher incomes.

The results are surprising given that low-income Americans are more likely to consume sugary beverages in a given day than higher-income groups. The difference could be that fewer of these beverages are being purchased in restaurants. "Buying a large soda and drinking it at home costs less," says Dr. Wang.

Until the legislation is enacted, it is impossible to know to what extent the consumption of sugary beverages will change. Under the proposed policy, consumers would be free to drink as much as they would like, and restaurants could offer free refills or discounts on multiple servings. Given these uncertainties, the researchers used a variety of scenarios to estimate how the policy would cut calories and consumption. A reasonable assumption, they say, would be that 80% of large soda drinkers downsize to a 16-ounce soda and 20% splurge on two 16-ounce sodas. In this case, adults would cut 63 calories daily; children and teenagers affected by the policy would cut 58 calories. Both would avoid three to four teaspoons of sugar.

These calorie reductions could go a long way toward reducing the number of excess calories taken in by American youth. Previous research by Dr. Wang found that a reduction of 64 calories per day is needed to reach the country's Healthy People 2020 goal for reducing obesity.

The researchers also looked at where people consumed large sweetened drinks outside the home. Among food service establishments, 65% of the drinks were consumed in fast food restaurants, followed by 28% in restaurants with wait staff; 4% in a sports stadium, movie theater, or other entertainment venue; 2% from a street vendor; and 1% from a bar. These numbers would be slightly different in New York City, notes Dr. Wang, where there are more street vendors and full-service restaurants than the rest of the country.

The portion size cap might also have a spillover effect, influencing behaviors in the home, where most are consumed, says Dr. Wang, who co-leads a Dean's Initiative at the Mailman School focused on advancing research on preventing obesity. "Changing social norms is difficult, but as portion sizes have grown, it's useful to establish a new standard."

When first introduced in 1955, a regular-size soda at McDonald's was 7 ounces. Today the chain offers 12-ounce drinks as the child size, 16-ounce drinks as small, 21-ounce drinks as medium, and 32-ounce drinks as large. In 1999-2004, an average U.S. teen consumed 301 calories in sugar-sweetened beverages, which is 13% of their total daily calories. To burn this off, they would need to walk more than 5 miles.

"This is an important study. It provides critical foundational evidence that the proposed efforts to restrict marketing of large sodas in New York City and elsewhere can have a substantial impact on population health," says Sandro Galea, MD, DrPH, chairman of the department of Epidemiology at the Mailman School and a member of the New York City Board of Health.

Explore further: Black students drink more soda when available at school

Related Stories

Black students drink more soda when available at school

May 15, 2013
The availability of sugar-sweetened or diet soda in schools does not appear to be related to students' overall consumption, except for African-American students, who drink more soda when it's available at school, finds a ...

Court hears arguments on NYC's big soda ban

June 11, 2013
A state appeals court is considering whether to allow New York City to ban oversized sodas and other large sugary drinks at city restaurants as part of its war on diabetes and obesity.

Booze calories nearly equal soda's for US adults

November 15, 2012
Americans get too many calories from soda. But what about alcohol? It turns out adults get almost as many empty calories from booze as from soft drinks, a government study found.

Teen health risk rises with more than a can of soft drink a day

June 10, 2013
(Medical Xpress)—Teenagers who drink more than one standard can (375g) of sugary drinks a day are putting themselves at higher risk of developing type 2 diabetes and cardiovascular disease such as heart disease or stroke ...

People buy more soda when offered packs of smaller sizes than if buying single large drink

April 10, 2013
People buy larger amounts of soda when purchasing packs of smaller drinks than when offered single servings of different sized drinks, according to research published April 10 in the open access journal PLOS ONE by Brent ...

Rationing soft drink sizes: A good public health move

December 17, 2012
New York City's limit of a maximum 16-ounce size of sugar-sweetened drinks for sale in eating establishments is a positive public health move and should be replicated in Canada, argues an editorial in CMAJ (Canadian Medical ...

Recommended for you

Parents have critical role in preventing teen drinking

July 20, 2017
Fewer teenagers are drinking alcohol but more needs to be done to curb the drinking habits of Australian school students, based on the findings of the latest study by Adelaide researchers.

Aging Americans enjoy longer life, better health when avoiding three risky behaviors

July 20, 2017
We've heard it before from our doctors and other health experts: Keep your weight down, don't smoke and cut back on the alcohol if you want to live longer.

Fresh fish oil lowers diabetes risk in rat offspring

July 19, 2017
Fresh fish oil given to overweight pregnant rats prevented their offspring from developing a major diabetes risk factor, Auckland researchers have found.

High-dose vitamin D doesn't appear to reduce the winter sniffles for children

July 18, 2017
Giving children high doses of vitamin D doesn't appear to reduce the winter sniffles, a new study has found.

Scientists develop new supplement that can repair, rejuvenate muscles in older adults

July 18, 2017
Whey protein supplements aren't just for gym buffs according to new research from McMaster university. When taken on a regular basis, a combination of these and other ingredients in a ready-to-drink formula have been found ...

Study: Eating at 'wrong time' affects body weight, circadian rhythms

July 18, 2017
A new high-precision feeding system for lab mice reinforces the idea that the time of day food is eaten is more critical to weight loss than the amount of calories ingested.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.