Let's Make Soda Uncool

You’ve got to hand it to Coke. It did teach the “world to sing in perfect harmony.” Quite an achievement for a bouncy little jingle. The problem is that being in perfect harmony, Coke in hand, made us all fat. Not just in America, but all over the world. I know it is semi-unfair to single out Coca-Cola. There are other companies that sell sugary sweetened drinks. But here we are, in perfect harmony, with two-thirds of American adults and one-third of American children now classified as obese, and overall estimates are that sugar-sweetened beverages make up 7 to 12 percent of the daily calories in a typical American diet. This includes not just Coke, but its friends and relatives — sweetened fruit juices, energy drinks, bottled iced teas and more. This is serious stuff. Obesity is a killer for too many of our children. They face a bleak health future of complications from diabetes and heart disease.

It’s time to make soda “uncool.”

Last week, the drumbeat against sugary beverages became louder, powered by two important studies in the New England Journal of Medicine that tracked teenagers' weight gain when access to sugary beverages was limited.

One study was a “home delivery” experiment, conducted by Dr. David Ludwig at Boston Children’s Hospital, in which one group of teenagers received shipments of water and diet drinks for a year. At the end of the year, the kids in the study group gained 3.5 pounds, versus 7.7 pounds gained among teenagers in a control group.

The other was an 18-month double-blind study conducted at VU University in Amsterdam in which every school day for a year, one group of children was given a can of sugar-free fruit drink, and the other group got a sugar-sweetened can. The cans were identical. The children in the sugar-free sample gained 13.9 pounds over 18 months. The kids in the sugar-sweetened sample gained 16.2 pounds in the same time frame. The kids in both studies didn’t cut out soda drinks altogether, they just reduced their consumption.

According to Kathy McManus, the director of nutrition at Brigham and Women’s Hospital, the typical American today consumes “about 250-300 more calories each day than several decades ago. About half of these additional calories are from sugar-sweetened beverages.”

Professor Eric Rimm, of Harvard's School of Public Health, says “If a typical child consumes between 1,500-1,600 calories a day, one 12-ounce soda sucks up 8 percent of their calories for the day, adding no nutritional benefit.”

What’s interesting about the two new studies in the NEJM is that one small behavioral change — shifting from one sugar-sweetened beverage a day to one calorie-free drink (like water, for example) — has the power to slow weight gain in children. Imagine the multiplicative power if any of the public health initiatives around sugary beverages were put into place? Bans or caps on the size of drinks sold, à la Mayor Michael Bloomberg’s in New York City, or Mayor Henrietta Davis’ proposal in Cambridge? Soda-free zones near school zones? Eliminating soda from Supplemental Nutrition Assistance Program benefits?

Rimm is one of the nation’s authorities on nutritional epidemiology, and he favors a tax on soda, somewhere in the neighborhood of 20 percent, or a penny an ounce for drinks with empty calories.

“You don’t pay tax on Coke, or on blueberries. But you do pay tax on cigarettes and alcohol.” He continues: “It has to be a substantial tax. We know it works on tobacco and alcohol, and arguably sugary soda is more of a public health hazard than either cigarettes or alcohol today.”

Sodas are not evil any more than a good single malt scotch is evil. It’s drinking the entire bottle of scotch or a liter of soda daily that gets you in trouble.

Few of the policies will succeed and move from proposal to law. And yes, the marketing muscle of the big soft drink companies like Coke and Pepsi are in the billions, hard for even the most clever public service campaign to compete with. But if we continue to publicize good research, educate the public, offer up attention-getting policies like taxes, caps on sizes and bans — just generally, turn up the noise level about sugary beverages — we can make drinking gargantuan amounts of soda "uncool." We did it with cigarettes. We did it with seatbelts. Let’s take a lesson from the marketing masters and make drinking Coke (or a Pepsi, or a sports drink) when you are just plain thirsty uncool. Let’s sing in perfect harmony. Coke and Pepsi will get the message.

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