There are good reasons -- both upstream and down -- why Mayor Bloomberg should want to ban the sale of enormous sodas in New York City.
The distal, downstream reasons are dire health outcomes aided and abetted by soda consumption: obesity, diabetes, and even heart disease, cancer, and stroke in children as well as adults. This toxic tide is well documented, as is the important contribution the empty calories and copious sugar of soft drinks (and related sugar-sweetened beverages that often do a better job of hiding their nature under an evocative name like "sports" drink) make to it.
The proximal, upstream reasons are that people buy enormous sodas in enormous quantities because one, they tend to think more for less is a bargain; and two, they like it!
Mayor Bloomberg presumably has concluded that these are not likely to change, and the only way to get past them and deal with those downstream consequences and their costs is to take the decision out of your hands and into his own, at least partially.
Perhaps he's right, and that's why debate is spirited on both sides of the "Should we ban big sodas?" divide. (My closest colleagues are divided on the issue.)
But I am more sanguine on removing these upstream impediments to healthful change. I think a prod to common sense, and a well-tended meme could do the job. The first of these upstream barriers is obsolete nonsense that doesn't withstand the meanest application of common sense; and the second can be fixed by nurturing our nature.
1) The notion that more -- measured in calories -- is better used to make sense. It made sense throughout the long sweep of human history during which calories were a rate-limiting commodity in the struggle to survive. It made sense even more recently when calories were still relatively scarce and hard to get, and physical activity unavoidable. It made so much sense, in fact, that we equated food/calories with security and success, and spoke of bringing home the bacon, being the breadwinner, and making dough.
It made sense THEN. But now, it makes as much sense as bringing coals to Newcastle!
Getting more of what you don't have enough of is a good thing. Getting more of what you already have too much of is anything but! More calories and more sugar at no or little extra charge means getting fat and probably sick for free -- and winning the opportunity to spend a fortune trying to fix that! Come on folks, wake up and smell the SlimFast -- this is NOT a bargain anymore! In the modern era, nutrients per dollar -- vitality per dollar -- are far better measures of food value than volume or calories. More nutritious foods do not need to cost more, particularly when the right metrics are used -- but they are certainly WORTH more. It's past time for our culture to start acting accordingly.
2) Regarding the second, the fact that people like soda -- I'll start with the personal. I used to drink soda as a kid, being raised on a typical American diet until I was old enough to see the light and take matters into my own hands.
Since I first gave up soda (I have not had one in literally decades at this point), I have had several occasions to taste it -- whether on purpose or accidentally -- and had this basic reaction: yuck. When one doesn't drink soft drinks for some time and then goes back, they taste far more like what they are -- extremely sweet, highly processed and rather dubious concoctions -- than the treat we pretend them to be.
I don't dislike soda because soda isn't good for me. I dislike soda because I dislike soda! Once I gave my taste buds a soda-free holiday, they did the rest. They went through rehab, rediscovered their native predilection for native foods, and made it easy for me to avoid soda for the rest of my life. I don't like it. It's too sweet, too overtly "factory food."
But getting taste buds not to like something isn't enough. The rest of the job is getting them to like foods -- love foods -- that love you back. This, too, is within reach.
A large volume of research I have reviewed for several of the books I've written, 20 years of clinical practice, and personal experience convince me that taste buds are malleable little fellas: When they can't be with a food they love, they pretty readily learn to love the food they're with. And once they do, familiarity becomes a powerful reinforcing agent. We like what we know.
This can work for good, or ill. Bathe your taste buds all day long -- knowingly, or unknowingly -- in copious additions of sugar and salt, and you will come to prefer more and more of these. Dial down your exposures, and you can reverse-engineer this process, rehabilitate your taste buds, and come to love food far more likely to love you back.
Most of the evidence I've encountered -- both published and personal -- suggests that habituation to new and improved versions of foods and recipes happens in as little as two weeks, or even less. A good example is a transition from whole milk to skim milk.
If you like whole milk and try skim, it tastes a bit like dishwater at first. If you stick with skim milk for a few days, it becomes hard to remember what the problem was. Hang in there for a week or two, and you will register the taste and texture of skim milk as just... milk. Retry whole milk at this point, and it will make you think of wallpaper paste.
The same basic principle applies to all foods. And there is enormous opportunity to trade up choices within food categories, and derive stunning health benefits -- acclimation, but no real heavy lifting, required.
So here's the thing: If it takes only about two weeks to adjust to new and better foods, then what stands between us and the dietary promised land where we can all as a matter of routine love foods that love us back, is a hill only two weeks high. For far too long, we have been making a mountain out of this molehill!
But to climb it requires the coordinated efforts of the supply side, and the demand side.
For their part, food suppliers like to contend they are only feeding us what we want, just trying to keep the customer satisfied. But the reality is that they helped create the prevailing palate, and are now profiting mightily from feeding it. They share in the responsibility of rehabilitating it by providing reformulated products that are genuinely better for our health -- not products that merely pretend to be.
But the industry is right to note they can't sell what we won't buy! And the precautionary tales they cite -- the fate of McLean Deluxe or Alphabits cereal (nutritionally improved, only to fail commercially) -- are valid. If we want truly better food choices, we have to choose them when they become available!
So to change demand, we have to change supply; and to change supply, we have to change demand. This has "impasse" written all over it, and it's why we have been stuck on this side of the molehill for so long.
But I believe we can get over it. Imagine a program in which the "taste for change" is shared by both demand and supply. We might, for instance, develop a public service campaign to raise awareness in the population about the adaptability of taste buds, about that two-week-high hill of taste habituation, and about the need to give new and better-for-you products a trial period of a couple of weeks before reaching a verdict.
This campaign could, in theory, be timed to anticipate a whole new crop of better-for-you products released by major food companies -- just like movie trailers are released to build the buzz for a new movie. If you've seen a trailer and think you are going to love a movie, you don't walk out if the first few minutes happen to be slow going. You have expectations, and you give them a chance. By the end, you may well wind up loving the film. Could we perhaps cultivate the same "give it a reasonable chance" attitude about new and better-for-us foods?
Ideally, these products would be subjected to an objective measure of nutritional quality in the R&D phase so we could all be confident they are TRULY better for us, and not merely depend on the company saying so.
If we prime the public reception for such products, perhaps we would see robust sales when they are introduced. If people know to hang in there for a couple of weeks, they could adjust to the new formulations and actually learn to prefer them. And if better-for-you products come to be preferred, it would encourage food companies to produce more of them -- and less of the alternative. Of course we are naturally,
genetically adapted to like sweet -- along with salt, fat, calories, and variety. Predilections for all of these favored survival during the long sweep of human history before the advent of agriculture, and for some time afterward.
Human babies are born with a preference for sweet, and it's a good thing. They might otherwise turn up their tiny noses at the first, critical, life-sustaining substance: mother's milk, sweetened with lactose.
And that preference for sweet is preserved into adulthood -- because it leads away from poisons, which tend to be bitter, and toward the quickly available energy in honey and wild fruits. Our Stone Age ancestors who didn't like sweet might forego such sustenance, making them less likely to survive and reproduce. And let's face it: People who don't survive to reproduce make very poor ancestors!
But this is just our nature -- it ignores the power of nurture! Richard Dawkins, arguably the most influential evolutionary biologist since Darwin, argues brilliantly at the close of his seminal book The Selfish Gene that unthinking genes got us here -- but they do not control our destiny! Units of cultural transmission -- units of choice -- called memes can carry the day.
We can make health a prevailing cultural meme by replacing our unconscious adaptations with conscious choices. It's true, we are adapted to like sweet. But we are also adapted to be terrestrial -- yet can learn to swim, and to hold our breath under water. We are adapted to ambulate -- but can learn to ride a bike. Both require skills we can, by choice, obtain.
We can choose what we chew -- and swallow -- as well! We can replace the thoughtlessness of genes with the thoughtfulness of memes. We can make health a meme. But only by choice!
The current impasse -- junky foods feeding junk-loving palates -- was engineered, and can be reverse-engineered. The hill is not all that high, and the prize on the other side is truly great.
We can get there from here, but only if we acknowledge the interdependence of supply and demand, and share a taste for change.
-fin
Dr. David L. Katz; www.davidkatzmd.com
www.turnthetidefoundation.org
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John Robbins: Why Are Twinkies Cheaper Than Carrots?
Realistically, people aren't thinking "more calories per dollar is a better deal." The (mostly subconscious) thought process is probably more like this: I'm willing to pay some money for soda; soda must be a good thing, or I wouldn't pay ANY money for it; more good things per dollar is a better deal. The same reasoning goes for meat, milk, vegetables, rat poison, television sets, housing, cars, etc.: if you're willing to pay for it at all, "more per dollar is a better deal."
So what's wrong with that logic (once you take the willingness to pay SOMETHING for soda as an axiom)? Well, most "good things" have a bounded utility curve, beyond which more of them doesn't actually make you happier -- but most of our evolutionary history has been far below that maximum-utility point, so people aren't used to thinking about things that way. It's certainly simpler to divide the world into "good things" of which you want more, and "bad things" of which you want less, rather than trying to identify the maximum-utility point of each thing.
If the Bloomberg rule makes people DECIDE CONSCIOUSLY that they want more, AFTER drinking the first 16 ounces, that's good.
And that's just the tip of that iceberg.
"Studies on the link between sugars and diabetes are inconclusive, with some suggesting that eating excessive amounts of sugar does not increase the risk of diabetes, although the extra calories from consuming large amounts of sugar can lead to obesity, which may itself increase the risk of diabetes"
Surely you and I don't.
I am on a fixed income (disability) and pay full rent. No rent subsidies for me. So after paying my bills this month I had 13 dollars left. Before I get my medications (all of which causes dry mouth). Add to that I get $63.00 in food stamps. So add that together and that gives me 76 dollars to eat on for a 30 day month. That is $2.53 per day. I gotta stretch that out somehow so I eat once per day and drink coke a lot, both for the energy and the lessening of the dry mouth. Juice is the only other thing that helps with the dry mouth but I just can not afford it. That half gallon of apple juice was a days meal for me. Volume v price will always be a no brainer for those under the poverty line
I also have to say that the coke will not give you more energy, that's an illusion. You get a short burst of energy and then you are probably getting zapped by a sudden increase in insulin which will cause you to look for more sugar. It's a debilitating downward energy spiral. If you were to go for a week without any sugars or starches you'd get out of this spiral.
Some of the boost (I think) from coke comes from the sugar and some from the caffeine though being hyperactive to begin with not sure how much the caffeine gives me LOL.
Try rice and beans: just as cheap with good nutrition. Takes a lot longer to prepare, though.
Who in their right mind would choose to drink what essentially amounts to flavored water?
If you want a glass a milk, drink it the way nature intended it. Accept No Substitutes.
Nature's intentions seem clear enough: baby mammals drink the milk of their own mothers, then stop drinking milk altogether. The gene that produces the lactase enzyme turns off after infancy in all mammalian species. It requires a mutation to do otherwise.
Were we inclined to leave matters to 'nature's intentions,' we would be obligated to concede we have long since wandered far off that reservation. We are on our own...
My feeling is that if someone has a chronic medical condition, like diabetes, amputation, heart condition, etc. because of poor behavior behavioral choices that affects us all through raising our insurance rates or Medicare rates, the public has a voice in making the behavior difficult that results in those conditions. Until someone signs an airtight waiver that they will not accept insurance payments or Medicare payments for help with conditions that are the result of those behaviors that result the public has a voice in those behaviors. The behaviors must show a true cause-effect through many medical studies. The law that limits cup size for soda is really no different from helmet laws or laws that require warning labels on cigarettes or liquor bottles.
Pure cane sugar vs. high fructose corn syrup? There's a difference, but not much. One 20oz soda a day makes me 3-5 lbs heavier. That's not because HFCS is worse than sugar. That one soda just represents a significant percentage of my daily calorie intake.
Today, the rule is all I want, once a week. I'll buy at lunch on Friday, and gorge on the stuff. Otherwise, I'm a near-vegetarian with a very good diet. I'm extremely active physically. I bike to work and back every day. IMHO, A sticky sweet soda is an acceptable occasional "bad for me" treat. Am I wrong?
I'd still like to quit. I've done it before. The negative health affects may not impact me, but there is still direct cost. A 20oz soda every day is ~$450 a year. D'oh! Even once-a-week costs $100/yr. Double D'oh!
It's just plain stupid to pay money for sweet poison. That's a good reason to quit. I've even gone long enough before to experience the "Eeew, this tastes awful!" effect, but somehow... I was weak.
I think I just talked myself into trying to quit completely again. Thanks Doc!
― Benito Mussolini
But higher obesity rates raise prices throughout the healthcare industry and effect all of us, not just the poor sap that has diabetes or heart problems because of obesity.
Restricting the convenience of buying soda is the same reason that cars have seatbelts or cigarettes and liquor have mandated warning labels. Until people can sign a waiver that they will not receive public medical care or insurance payments for future health problems, your argument is not valid.
People do not know HOW to eat; as far as I know, only WeightWatchers does that job well.
I almost died (sleep apnea that caused obesity). Therefore, I don't drink soda at all, except for the very occasional diet soda in social situations where its the only drink available. I should be offered a job as a canary in the food chain, because I can SMELL high fructose corn syrup and the smell makes me nauseous.
Seltzer water with a few shavings of real ginger, and a Stevia sweetner () calories and actually good for your teeth, I've read) is DELICIOUS. Add some REAL lime to that and you have ginger ale; or just put a half teaspoon of vanilla with Stevia sweetner and and you have coke. I could go on.
I LOVE my real, healthy food. Only Monsanto is destroying that as well, I guess, but not yet.
What I mean is that they teach you how to read the info on the bnack of the package; they teach you about fat, and carbs that are more healthy, like berries and vegs and beans.
I doubt very seriously tht by eating such things you got sick -- but maybe you only ate the "goodies" they sell. That is not what they teach.
Dead is dead and it's in all of our futures. Trying to convince yourself that you can defy it is foolish. Enjoy life.
There is no better drink in the world than a giant glass of pure iced water, although I do like my strong black coffee as well.
Salud!