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 The first of these upstream barriers is obsolete nonsense that doesn't withstand the meanest application of common sense; and the second can be fixed by nurturing our nature.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.
For more on David Katz, M.D., click here.
For more on diet and nutrition, click here.