Thursday, May 31, 2012

A New York State of Mind - Ban Soda!

The big health related headline today is that New York City is banning the sale of cups larger than 16 oz. of sweetened sodas. NYC's plan to enact a far-reaching ban on the sale of large sodas and other sugary drinks at restaurants, movie theaters and street carts, in the most ambitious effort yet by NY Mayor Michael Bloomberg to combat rising obesity.
The New York Times

"The proposed ban would affect virtually the entire menu of popular sugary drinks found in delis, fast-food franchises and even sports arenas, from energy drinks to pre-sweetened iced teas. The sale of any cup or bottle of sweetened drink larger than 16 fluid ounces — about the size of a medium coffee, and smaller than a common soda bottle — would be prohibited under the first-in-the-nation plan, which could take effect as soon as next March. 

The measure would not apply to diet sodas, fruit juices, dairy-based drinks like milkshakes, or alcoholic beverages; it would not extend to beverages sold in grocery or convenience stores."

Is this a good thing? I am reluctant to criticize any measure or effort to combat obesity, but I am on the fence here. If this is merely the next salvo in the battle to incrementally decrease the consumption of unhealthy food by bringing attention to it and making its consumption more labor intensive, I vote thumbs up.  I applaud Mayor Bloomberg's desire to do something that is readily available to him without getting legislative consent.

My issue is that while sweetened sodas and drinks are an easy path to consumption of unhealthy calories, they may drive higher consumption of unhealthy fruit juices and smoothies (concentrated with fructose), which can also be counted as contributing to the excessive weight epidemic. I would prefer to see warning labels prominently displayed that identify foods that contain an unhealthy amount of simple carbohydrates of a processed nature with a viable alternative available. You can't sustain bans without making sure that a viable alternative is immediately accessible. 

I also prefer education and coaching over food bans (except in the case of the silent killer -- trans-fats.)  We need to educate the populace more explicitly regarding the harms perpetuated by all these sugar-heavy beverages. 

What's the big deal with high sugar consumption? In each of the past few days, I've diagnosed a patient with pre-diabetes. Everyone knows about the dangers of diabetes, but there is not enough discussion about pre-diabetes and that is a huge problem. Yesterday's blog covered the increased benefits of exercising while still pre-diabetic versus diabetic. With nearly 80 million pre-diabetics already in the U.S. and that number steadily climbing, we need to do a lot more than just force people to get refills (still allowed) of sweetened drinks.

Given the nature of this public health crisis, the government should declare war and wage battle as it would against any real enemy of this country. The threats to our nation based on the rising levels of obesity, diabetes, pre-diabetes, depression, dementia,etc. are as threatening to our safety and security as any faced by Homeland Security.  Isn't it time we treated it as such? 


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