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Christina Scirica, MD, MPH, a MassGeneral Hospital for Children pulmonologist and weight expert, answers questions on the potential effectiveness of the New York City ban on the sale of sugary drinks in containers larger than 16 ounces at restaurants that was passed September 7, 2012.

Could a ban on large soft drinks be effective?

14/Sep/2012

Free image courtesy of FreeDigitalPhotos.net

Will reducing the sale of super-sized sugar-sweetened drinks, like soda, have any effect on the growing obesity problem?

Reducing sweetened beverage intake alone is unlikely to reverse the obesity epidemic, but it is nonetheless an important piece of a much larger puzzle that will involve other changes in our diet and activity levels. 

Why start with regulating soft drinks and other sugary drinks instead of focusing on portion control, which many say is larger problem?

Restaurant portion sizes have increased for many, if not most, foods and correcting the perception that these massive servings are appropriate is just as important as limiting super-size sodas. But there are two reasons to start with sodas. The first is that research clearly supports an association between sweetened beverage consumption and obesity. The other is that sweetened beverage containers are more easily measured and regulated than many other foods and so represent an ideal place to begin the effort to reduce portion sizes.

Sweetened beverages are a particular problem for a number of reasons:

  1. Many people don't recognize quite how many calories they are consuming when they drink them, which can lead people to consume more calories than they realize. An excess of only 100 calories per day (the amount in about 8.5 ounces of Coke) can lead to gaining about a pound a month – 12 pounds in one year.
  2. When calories are consumed in liquid form, people don't feel full as quickly as if those calories were eaten as solid foods.  As a result, people are more likely to consume more calories if they drink them than if they eat them. 
  3. Liquids are absorbed more quickly in the body than solids, causing people to feel hungry sooner than if they had eaten the same number of calories as solid foods.  
  4. The large dose of sugar in soft drinks (about 10 teaspoons in a 12-ounce can of Coke) causes a particularly rapid and dramatic rise in blood sugar that then falls quickly. This causes people to feel hungry sooner than they would if they had eaten the same number of calories in complex carbohydrates, protein or fat.  Not only do they get hungry sooner, but they probably eat more at the next meal as well. 
  5. The containers in which beverages are sold can be misleading, since many people assume they contain one serving. Closer inspection of the nutritional information on larger containers often indicates that they contain more than one serving, yet most people still consume all the contents rather than stopping partway. 

The ban only limits the sale of sugary beverages exceeding 16 ounces at restaurants, delis, sports facilities, and street vendors. Won’t people just buy more of the smaller sizes?

When people are given larger portion sizes, they consume larger portion sizes regardless of how hungry they are to begin with. Conversely, if people are given smaller portions, they tend to eat less. Some determined people will buy themselves more containers of soda, but many others will simply drink less.  

Is a ban on sugary drinks really necessary? Isn’t educating people to make healthy choices a better option?

While useful, education and improved access to healthy foods are simply not enough to turn around the obesity epidemic that threatens to cripple this nation. The current environment strongly promotes choices that contribute to obesity, and changes need to be made to the environment that make healthier choices the default rather than the exception

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