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The Rudd Center Health Digest

April 2009

The Case for Tax on Sugar-Sweetened Beverages

Citing research that shows drinking sugar-sweetened beverages is helping fuel the obesity epidemic, Rudd Center Director Kelly Brownell, PhD, and New York City Health Commissioner Thomas Frieden, MD, MPH, argued for taxing sugared beverages in the April 30 issue of the New England Journal of Medicine.

In their ”Perspective” piece, the two reviewed scientific studies that showed that taxes could substantially reduce consumption of sugared beverages, cut caloric intake, and help prevent obesity and diabetes as well as the consequences of these conditions. Noting that “taxes on tobacco have been highly effective in reducing consumption,” the authors wrote that a penny-per-ounce tax on sugared beverages could both reduce consumption and generate revenue for needed programs to prevent obesity among children and adults.

Soda has become progressively more affordable, while fruit and vegetables have become less affordable, according to data from the USDA. In the past decade, intake of calories from sugar-sweetened beverages has increased by nearly 30 percent and children and adolescents now consume 10 to 15 percent of all their calories in beverages.

Research has linked the consumption of sugar-sweetened beverages to poor nutrition, weight gain, obesity, and diabetes. Likewise, the authors wrote, “interventional studies show that reduced intake of soft drinks improves health.” The beverage industry has vigorously opposed soft drink taxes, but Drs. Brownell and Frieden argued that such taxes “could become a key tool in efforts to improve public health.”

A penny-per-ounce excise tax would raise an estimated $1.2 billion in New York State alone. More important, the tax “could reduce consumption of sugared beverages by more than 10%,” the authors wrote. “It is difficult to imagine producing behavior change of this magnitude through education alone, even if government devoted massive resources to the task.” Drs. Brownell and Frieden noted that taxing on a per-ounce basis is likely to have a much larger health impact than increasing sales taxes. Earmarking some of the tax revenues to address childhood and adult obesity increases public support of taxes on soda, they reported.

Rudd Center Director Gives Testimony to House Appropriations Subcommittee

Capitol
In recent testimony before a U.S. House subcommittee, Rudd Center Director Kelly Brownell, PhD, provided a blueprint for ways the USDA can combat obesity and foster an environment where people can easily make healthier food choices. U.S. residents have become physically and psychologically distant from food, Dr. Brownell told the U.S. House Appropriations Subcommittee on Agriculture, Rural Development, Food and Drug Administration, and Related Agencies.

Little attention has been given to the environmental impact of making foods available at artificially low cost, he said. New agricultural technologies, improved transportation, genetic modification, and subsidy policies have led to massive production of processed foods that are high in sugar, fat, and salt. Dr. Brownell said the challenge is setting a course that helps remedy hunger, helps prevent obesity, ensures healthy food availability, and establishes a new societal relationship with food.

Dr. Brownell said the USDA can play an important role in meeting the challenge and suggested the following changes toward that goal:

  • Use Institute of Medicine standards on permissible competitive foods.
  • Increase reimbursement rates for school breakfast and lunch programs.
  • Strengthen the standards and policies of the Child Nutrition Reauthorization Act; Child and Adult Care Food Programs; Women, Infants, and Children Program (WIC); and Food Stamps.

Dr. Brownell also recommended new initiatives, including:

  • Develop strategies to connect nutrition and environmental issues in the Farm Bill and across USDA programs.
  • Create a commission on hunger, obesity, and the environmental impact of food practices.
  • Increase support for farm-to-school programs.
  • Increase support for school gardens.
  • Commission the Institute of Medicine to complete a thorough economic and health analysis of the impact of subsidies on the nations’ nutrition and health.
  • Commission the Institute of Medicine to complete a study examining the impact of food prices and food access on the health of the nation.

Click here to read Dr. Brownell’s full testimony.

Study Links Practices of Food and Tobacco Industries

In a review and analysis of the tobacco and food industries, researchers identified similarities in marketing and lobbying strategies used by both industries.

The authors, Rudd Center Director Kelly Brownell, PhD, and Kenneth Warner, PhD, Dean of the School of Public Health at the University of Michigan, found that the food and tobacco industries emphasize personal responsibility, influence government and professional organizations, pay scientists who produce favorable research, and market “safer” products. In their article, which appeared in the March issue of the Milbank Quarterly, the authors encouraged the food industry to change both marketing and nutritional practices to avoid negative health consequences for consumers.

“While we recognize the inherent differences between cigarettes and food, the food industry must accept responsibility for what they are selling and how they are selling it,” said Dr. Brownell. “Consumers have a right to accurate information—not just spin—about the safety and nutritional value of the food they are eating.”

Key recommendations for the food industry included:

  • Market the benefits of foods according to their actual health profiles.
  • Sell only healthful products in schools, hospitals, and other places associated with the well-being of children.
  • Fully and publicly disclose names and amounts of money paid to non-industry scientists who produce research.

Click here for Dr. Brownell’s interview with Yale Environment 360 about the common marketing and lobbying tactics employed by the food and tobacco industries.

Upcoming Seminar Speakers:

CANCELLED
April 15: Douglas Rae, PhD

April 22, 12:30 pm: Christina Economos, PhD
New Balance Chair, Childhood Nutrition; Associate Director, John Hancock Center for Physical Activity and Nutrition, Friedman School of Nutrition Science and Policy, Tufts University
Catalyzing Communities to Prevent Childhood Obesity

RESCHEDULED FOR FALL SEMINAR SERIES
May 5: Gary Knell

May 6, 12:30 pm: Michael W. Hamm, PhD
C.S. Mott Professor of Sustainable Agriculture, Departments of Community, Agriculture, Recreation and Resource Studies, Crop and Soil Sciences, Food Science and Human Nutrition, Michigan State UniversitySustainable Agriculture and Public Health: Reciprocity and Opportunity for Transforming Our Food System

Our seminars are held at the Rudd Center, located at 309 Edwards Street in New Haven, Connecticut, 06511. They are free and open to the public. Seating is limited. The full schedule for our Spring Seminar Series is available online and for download as a PDF document.

To receive a weekly email from the Rudd Center detailing upcoming seminars and schedule changes, please click here.

Restricted Access to Healthy Foods in Poor Areas

Baltimore grocery stores in poor neighborhoods are much less likely to sell healthy foods than those in wealthier neighborhoods, according to articles in the American Journal of Preventive Medicine. The studies were the first to explore the trend in a large city.

The studies reinforced the findings of a paper coauthored by Tatiana Andreyeva, PhD, Rudd Center Director of Economic Initiatives. Dr. Andreyeva’s paper, “Availability and Prices of Foods Across Stores and Neighborhoods: The Case of New Haven, Connecticut,” was published in the September/October 2008 issue of Health Affairs. The recent research found that high rates of obesity and diabetes in poor and minority populations are linked to limited access to supermarkets and affordable healthy foods such as fresh fruit and vegetables, low-fat dairy products, trans fat-free products, whole grains, and lean meats.

Policymakers can increase access by improving public transportation to grocery stores, providing lighting and police patrols near grocery stores, offering incentives for purchase of refrigeration equipment for fresher and healthier products, and offering tax breaks to attract supermarkets. Successful initiatives have taken place in cities across the U.S., including New York City, Austin, Milwaukee, and Oakland.

Videos Exposing Weight Bias Available

*A must-see and must-share for teachers and health care providers*
The stigmatization of obese adults by employers, educators, health care providers, family members, romantic partners, and the media is rampant. To help increase public awareness about this issue, the Rudd Center has released two new videos on weight bias. The videos are hosted by Emme, model and women's advocate. They feature Rudd Center experts, including Rebecca Puhl, PhD, Director of Research & Weight Stigma Initiatives. Using expert commentary and dramatic representation, the videos address the obstacles obese individuals encounter at home, in schools, and within health care settings.

The videos can be viewed on the Rudd Center website or Yale’s YouTube channel. To receive a free DVD of the videos, please email the Rudd Center.

Spotlight on Rudd Center Affiliated Faculty: Dana Small, PhD

SmallDana Small’s research focuses on how individual factors interact with sensory coding to influence food selection. The factors include body mass index, smoking status, alcohol use, sensitivity to reward, and genetic makeup. Her research is funded by the National Institute on Drug Abuse, National Institute of Diabetes and Digestive Kidney Diseases, and National Institute on Deafness and Other Communication Disorders.

Dr. Small has collaborated with the Rudd Center by presenting her work in the Seminar Series, participating in Rudd Center workshops, and providing commentary on the Rudd Sound Bites blog.

She is Associate Fellow at the John B. Pierce Laboratory, Associate Professor of Psychiatry at the Yale University School of Medicine, and Associate Professor of Psychology at Yale University.

Dr. Small earned her MSc and PhD from McGill University. She has received the Ajinomoto Award for Research in Gustation, the Moskowitz Jacobs Award for Research Excellence in the Psychophysics of Taste and Smell, and the Firmenich Flavor and Fragrance Science Award.

She serves on the Executive Committee for the Association of Chemoreception Sciences and on the Editorial Boards of Chemosensory Perception, Frontiers in Neuroscience, and the European Journal of Neuroscience.

The Latest Rudd Center Podcasts

David S. Ludwig, MD, PhD
Associate Professor, Pediatric, Harvard Medical School; Director, Optimal Weight for Life (OWL) Program

Steven C. Hayes, PhD
Foundation Professor, Department of Psychology, University of Nevada

Our collection of podcasts is available for download on iTunes U, under the Yale University Health & Medicine – Nutrition & Obesity section, or you may subscribe to a RSS Feed that will automatically update whenever new content is released. Podcasts can be listened to on a computer or downloaded to a music player.

Front Burner News

General Mills Pleads Guilty to Advertising to Kids Violation

Canadian anti-obesity advocates are applauding General Mills Canada’s guilty plea for violating a law that forbids advertising to children under 13. The company created a Lucky Charms website with games that presented the leprechaun mascot. Click here for the full article.

Carrots

Vegetable Names Influence Children’s Consumption

Preschoolers ate almost twice as many vegetables when they had “cool” names, in a study by Brian Wansink of Cornell University. Names included “tomato bursts” and “X-ray vision carrots.” For the full article, click here.

Healthy Food Bills Proposed in Maryland

Maryland legislators are considering several bills that could reduce the state’s obesity rates. The bills include banning trans fats in restaurants and menu labeling in chain restaurants. Read the full article.

More Improvement Needed in School Lunches

School lunches continue to be high in fat, salt, and sugar, according to articles published in a supplemental issue of the Journal of the American Dietetic Association. The researchers recommended requiring schools that receive federal funding for meals to improve their nutrition standards. Click here for the full article.

Trans Fats Banned in Canadian Province

British Columbia became the first Canadian province to ban trans fats in restaurants. The law must be complied with by September. Read the full article.

Kids’ Healthy Eating Affected by Family Meals

Adolescents with regular family mealtime (at least five meals per week) are more likely to have healthy eating habits than those who do not, according to an article in the Journal of Nutrition Education and Behavior. Regular family mealtime declined with age, from 60 percent in early adolescence to 30 percent in middle adolescence. For the full article, click here.

Dietetics Students’ Negative Attitudes toward Obese Individuals

Weight bias affects even those studying to be dieticians, according to research in the Journal of the American Dietetic Association. Most students reported negative views about self-control and overeating among obese people. Read the full article.

Food Prices Associated with Body Weight

Increasing the prices of unhealthy foods and decreasing those of healthier foods are linked to lower body weight and a lower chance of obesity, according to research at the University of Illinois at Chicago. Small pricing changes are unlikely to have a significant effect. Click here for the full article.

Healthy Food Access in New York City Connected to BMI and Obesity Prevalence

Among New York City residents, a higher density of supermarkets and fruit and vegetable markets is associated with lower BMI and frequency of obesity, according to a study completed at the Columbia University Mailman School of Public Health. However, a high prevalence of unhealthy food outlets was not associated with higher BMI. Read the full article.

Few Access Restaurant Nutrition Posters; Menu Labels Needed

A study in the American Journal of Public Health showed that less than 1 percent of customers access nutrition information at restaurants on posters or pamphlets, or in computer terminals. The researchers recommended displaying the information more visibly on menus and menu boards. For the full article, click here.

MeasuringCup

Food Portion Perception Affected by Literacy

A study in the American Journal of Preventive Medicine reported that people with low literacy levels are 50 percent less likely to correctly measure one cup of food than people with high literacy levels. The investigators said food preference did not affect the measurements. Click here for the full article.

Views on Obesity Causes and Policies Related

Researchers at Yale University found that a person’s support of public policies on obesity is affected by her/his personal beliefs about obesity’s causes. Those who view obesity as a personal responsibility are less likely to support government intervention. Read the full article.

Student Obesity Affected by Fast Food Proximity

Ninth graders attending a school a block or less from a fast food restaurant are more likely to be obese than those whose schools are at least a quarter mile away, according to researchers at the University of California and Columbia University. Read the full article.

Fructose Increases Appetite

As compared to glucose, which can decrease food consumption, fructose increases eating, according to research in the journal Biochemical and Biophysical Research Communications. Fructose naturally occurs in fruit and is added as a sweetener to processed foods and beverages. Read the full article.