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Ayala Laufer-Cahana, M.D.

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Would the Bloomberg Soda Ban Unfairly Target Poor People?

Posted: 06/20/2013 1:29 pm

Portion sizes have grown, and so have we. Today's kid-size soda at McDonald's (12 ounces, 110 calories) is 70 percent larger than the default adult size (7 ounces) of the 1950s, and 32-ounce Big Gulps (310 calories) and food buckets couldn't be imagined several decades ago.

Are portion sizes to blame for our overeating? The obesity epidemic has multiple roots, but there's very little doubt that when presented with larger portions people tend to eat more, and that social norms affect what we perceive as acceptable behavior. So yes, most experts do see portion sizes and the attractive prices they're offered at as a culprit in the obesity crisis.

Last year, in an effort to shift the default portion size to something a little more logical, New York City proposed to cap the size of sugary drinks sold in food service to 16 ounces. It's been a bumpy road for this proposed law, which was blocked this spring a day before it was supposed to take effect.

The free-choice and stay-out-of-my-business opposition to the proposed law is understandable, and I'm not going to get into it here. Will the cap reduce waistlines? If such a law ever passes, we'll get to see if the predicted reductions in consumption play out.

The interesting question a new study set out to answer focuses on the argument that the so-called soda ban isn't fair because it disproportionately affects low-income people.

Soda cap would target the overweight

The new study in the American Journal of Clinical Nutrition from the Columbia University School of Health looked at the dietary records of almost 20,000 people, and found that about 60 percent of people consume sugary drinks on any given day, and of those, about 7.5 percent order a larger than a 16-ounce cup. Two-thirds of the large-size cups are bought at fast food restaurants.

The large size purchases were more common in teens, young adults, overweight and obese people. Although low-income people did buy more sugary drinks, they weren't more likely to buy large ones.

This analysis suggests that capping soda at 16 ounces could disproportionately affect young people who are overweight or obese. The researchers calculated that if the cap led 80 percent of the people that order larger drinks to downsize to 16 ounces, it would shave about 60 calories daily.

They of course don't have to. Under the NYC proposal anyone's free to order as many 16-ounce drinks as they wish. The cap would just change the beverage landscape a little bit, and give people pause to consider whether the second 16 ounces is addressing thirst or habit.

Then, of course, even without the law in place, the endless debate and uproar against it is already doing that, so even without passage the sugary drink cap is, I think, already a success.

Dr. Ayala

Full disclosure: I'm vice president of product development for Herbal Water, where we make organic herb-infused waters that have zero calories and no sugar or artificial ingredients. I'm also a pediatrician and have been promoting good nutrition and healthy lifestyle for many years.

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