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Health Justice and the Skinny on Sugar-Laden Beverages

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Recent moves by leaders in New York City and Richmond, Calif., to address damage caused by the dominance of sugar-laden beverages represent brave steps toward addressing mounting health injustice and should be applauded by everyone who supports good health in America.

On May 30, New York Mayor Michael Bloomberg proposed to ban sodas and other sugary drinks in containers 16 ounces or larger. Municipal leaders in Richmond, Calif., also announced a November ballot initiative for a one-cent-per-ounce tax on sugar-sweetened beverages. Both measures aim to stem the growing incidence of obesity, diabetes and other ills linked, in part, to the flood of sugar poured by an industry, some are now calling Big Soda.

As in the case of Big Tobacco, proposals to improve the public's health with awareness campaigns, bans or taxes have prompted the same old defense strategies among soft-drink-industry giants. They typically respond by offering one or more of the following:

• The Corporate Freedom Argument: "Let market forces meet the public's needs."
• The More Research Is Needed Argument: "Where's the evidence of negative health effects?"
• The Affront to Personal Freedom Argument: "Get the nanny state out of the public's way."
• The Class Warfare Argument: "The poor are overburdened by such interventions."

While these arguments may hold some sway -- with government trust at historic lows and faux science in vogue -- they are invalid at best and at worst, represent willfully deceptive diversions.

Regarding business leadership on health, in the face of growing pressure to contribute to the anti-obesity movement, the fast food industry has mostly made self-protective gestures. For example, while McDonald's now offers a variety of salads and added apples to its Happy Meals and oatmeal for breakfast, its core menu remains high in fat and calories. The movie concession vendors push their version of value with soda sizes ranging from a "small" 16 ounce to "upgrades" all the way to 44 ounces (with 550 calories or more). And 7-Eleven's 1.5-liter Double Gulp fountain drink (a repackaged version of the Extreme Gulp) holds up to 800 calories.

In terms of the research, the link between high soda consumption and negative health effects is overwhelming. And there's a growing body of evidence that shows price policies and attention to portion size can and do reduce consumption of sugary sodas and other beverages, which can play an important role in reducing rates of obesity and related conditions like diabetes.

Finally, I find the argument that encouraging the public (including the poor) to substitute soda for healthier choices is a discriminatory burden, to be the most troubling. Richmond, Calif., City Councilor Courtland Boozé, a vocal opponent of the soda tax, is quoted as saying, "We are primarily an economically suppressed community. It will be a huge hardship." I wonder if he's considered the health burden levied on the youth of the Richmond community.

According Dr. Wendel Brunner, the local director of public health, 52 percent of the region's elementary school students are overweight or obese. That's an individual and community hardship that no one can afford.

According to Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, "... sugary soft drinks are the number one source of calories in our diets. We get more calories from sodas and sugary drinks than any other individual food -- cake, cookies, pizza, anything."

My rebuttal to all these arguments against promoting less sugary drinks is that it's time for a bigger helping of health justice. We need to create an environment where living healthy is the default choice. If asked, "Would you and your family like to live in a community where it's easy to find good food that's good for you at a good price?" Most of us would say, "Of course!" We all deserve equal access to the ingredients that help us live a good long life.

The proposed policies in New York City and Richmond, Calif., won't fix the obesity problem on their own. But, they are bold steps in the right directions. Now that we're focused on the value and cost of health and health care, it's time to serve up some real health justice.

Dr. Craig Andrade is Associate Dean of Health and Wellness and Director of Health Services at Wheaton College in Norton, Mass.