Briefing Report: Sugar-Sweetened Beverage Warning Labels - A Sour Solution?

Wednesday, March 19, 2014

$3.99 for all you can eat?
Well, I’m a stuff my face to the funky beat!
We’re gonna walk inside, and guess what’s up?
Put some food in my plate and some Coke in my Cup.
Give me some chicken, franks, and fries.
And you can pass me a lettuce, I’m a pass it by…
We’ll eat everything, an incredible feat.
$3.99 for all you can eat!

From “All You Can Eat” by the Fat Boys

Introduction

Popular music fans everywhere may still enjoy the above whimsical 80’s hip-hop classic, but obesity in America is no laughing matter. In this regard, California is no different than the rest of the nation. By some estimates, approximately 64 percent of adult Californians are overweight1, while the same goes for a third of the state’s low-income children.2

While there may be broad consensus that the problem of obesity must be addressed, the same cannot be said for some of the solutions proposed. For example, let’s examine one concept that has garnered a large amount of notoriety recently: warning labels for sugar-sweetened beverages.

SB 1000 (Monning)

Senator Bill Monning (D-Carmel) introduced SB 1000 on February 13, 2014. The bill prohibits any sugar-sweetened beverage, as defined, in a sealed beverage container from being distributed, sold, or offered for sale unless the container bears the following safety warning:

“STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay.”

In his press release touting the bill, Senator Monning says, “When the science is this conclusive, the State of California has a responsibility to take steps to protect consumers. As with tobacco and alcohol warnings, this legislation will give Californians essential information they need to make healthier beverage choices.”3

The press release goes on to state that “Sugary drinks are the biggest contributor of added calories in the American diet, responsible for 43 percent of the added calories in the American diet over the last 30 years.  Drinking just one soda a day increases an adult’s likelihood of being overweight by 27 percent and a child’s by 55 percent.  Research shows that a soda or two a day increases the risk of diabetes by 26 percent.”4

In its own press release, the California Medical Association (CMA), a co-sponsor of the bill, states that the idea for the bill was part of a CMA contest for medical school students and residents. The contest, called “My CMA Idea,” collected ideas for public health legislation from medical students and residents, allowing future physicians to help craft public policy to better the health of all Californians. The winner of the contest, Tom Gaither, a first year medical student from the U. C. San Francisco School of Medicine, says the idea came to him after teaching high school for two years in San Jose. “Kids would come to class with a soda or sports drink,” he said. “So many of the kids didn’t know how bad sugary beverages were for them.” He found himself so worked up about the subject that he taught a semester on sugar in foods for one of his classes.5

Public Perception

The public appears to support warning labels at this point in time. A February 20, 2014 Field Poll press release states, “California voters endorse a proposal to require beverage companies to post a health-warning label on sodas and sugary drinks to alert consumers that their daily consumption contributes to diabetes, obesity and tooth decay. Statewide 74% of voters back this requirement, of whom 52% do so strongly. Support is bipartisan, with large majorities of Democrats (80%), Republicans (64%) and non-partisans (75%) endorsing the idea.”6

Industry Reaction

Not surprisingly, the beverage industry opposes SB 1000. Californians for Food and Beverage Choice, an organization spearheaded by the American Beverage Association (ABA), states in a message to consumers, “STOP SENATE BILL 1000! California politicians are now considering a new law that would mandate ‘safety warning labels’ on all soft drinks like soda, teas, fruit drinks and sports drinks. No other similar requirement exists anywhere in the world! Send a message to your state lawmakers urging them to say NO to warning labels on soft drinks. And join us as we fight in California and around the country against unfair regulatory burdens on our grocery choices.”7

The organization’s website further states, “Let’s take a look more carefully at the numerous ‘health concerns’ that would be cited on the warning label.

“First, obesity. Obesity is a serious epidemic plaguing millions of Americans. The condition of obesity has multiple risk factors, including genetics, age, stress, and even lack of sleep. To place the burden onto one product is not only counterproductive, but wholly irresponsible.

“As well, the claim linking diabetes to soda is remarkably fragile. According to the American Diabetes Association, Type 2 diabetes is caused by genetics and lifestyle factors, not soda.  In addition, while being overweight increases risk, a diet high in calories from either sugar or fat, can contribute. However, regular exercise and moderation are key to combat the risk of diabetes.

“While these health conditions are serious, the bill proposed by Senator Monning is an extremely sensationalist proposal, and the lack of credible science behind his bill is troubling.

“Obesity, diabetes, and tooth decay are medical issues that need thoughtful and legitimate consideration and study if we are going to tackle them. Senator Monning’s bill will only feed the alarmist hype surrounding soft drinks and further scare consumers without changing their habits.”8

The beverage industry has also more generally addressed the issue of the relationship between sugar-sweetened beverages and obesity. The American Beverage Association (ABA) states on its website, “While beverages and food play a role in determining good health, so do other important factors.  In fact, it is generally accepted that obesity involves three main factors: genetics, diet and exercise.

“We know that obesity is a serious and complex problem that is best addressed by living a balanced lifestyle – consuming a variety of foods and beverages in moderation and getting plenty of exercise. Quite simply, overweight (sic) and obesity are a result of an imbalance between calories consumed and calories burned.”9

It is also important to note that the industry has voluntarily taken steps to clearly show the caloric content of beverages. For example, the Clear On Calories Initiative was launched in 2010 to support First Lady Michelle Obama's "Let's Move!" anti-obesity campaign. A consumer-friendly calorie label was added to the front of every can, bottle and pack produced. The labels display the total calories per container on beverages 20 ounces or smaller. For containers larger than 20 ounces, calories are labeled per 12 ounces in most cases.10

Additionally, the industry’s Calories Count Vending Program offers consumers clear calorie information, encourages lower-calorie beverage choices, and reminds them that calories count in all the choices they make. On the front of vending machines, they'll see Calories Count signs that include one of the following messages: "Check Then Choose" or "Try A Low–Calorie Beverage." The selection buttons also include calorie labels that show calorie counts per beverage container. This program launched in municipal buildings in the cities of Chicago and San Antonio in 2013, and will then be made available to customers nationwide.11

Previous Labeling Efforts

While warning labels on sugar-sweetened beverages may be new, the concept of labeling intended to encourage healthy food choices is not. Several states, including California, have passed laws requiring restaurants to post nutritional information for consumers. California passed SB 1420 (Padilla) in 2008. Restaurant chains of a certain size doing business in California now must disclose calorie content information for every menu item in a specified manner. Even the federal Affordable Care Act contains restaurant menu-labeling requirements.

However, at least one study has cast doubt on the effectiveness of such measures. An October 2009 study entitled Calorie Labeling And Food Choices: A First Look At The Effects On Low Income People In New York City concludes, “We did not detect a change in calories purchased after the introduction of calorie labeling. We encourage more research on menu labeling and greater attention to evaluating and implementing other obesity-related policies.”12

In other words, even when armed with information on calorie content, the study participants made essentially the same food choices they made previously.

Conclusion

As previously mentioned, there is broad consensus that obesity is a major problem that must be addressed. However, as legislators review SB 1000 and other measures designed to encourage healthy food choices, they may wish to consider whether singling out a single product as the cause of obesity is sound public policy. Using this logic, why not place warning labels on video games and sofas? After all, both contribute to a sedentary lifestyle. Perhaps a different course should be charted, one that considers the obesity epidemic in a more comprehensive fashion.




1 2012 Behavioral Risk Factor Surveillance System (BRFSS)
2 2011 National Health and Nutrition Examination Survey (NHANES)
3 Senator Monning press release, February 13, 2014
4 Ibid.
5 CMA press release, February 14, 2014
6 Field Poll Press Release #2461, February 20, 2014
7 http://yourcartyourchoice.com/aba/advocacy/ca/register.aspx
8 http://yourcartyourchoice.com/aba/advocacy/ca/postdetail.aspx?Id=25
9 http://www.ameribev.org/nutrition-science/obesity/
10 http://deliveringchoices.org/#calorielabels
11 Ibid.
12 Brian Elbel, Rogan Kersh, Victoria L. Brescoll and L. Beth Dixon, Calorie Labeling And Food Choices: A First Look At The Effects On Low Income People In New York City, Health Affairs, 2009

For more information on this report or other Health issues, contact Joe Parra, Senate Republican Office of Policy at 916/651-1501.