New York City Hopes to Ban Supersize Sugary Beverages

Given the health consequences and enormous cost of our country's obesity epidemic, it is time to return eating. And banning the large sizes of unhealthy sugar-sweetened beverages is a good place to begin.
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Oversized beverages, including 7-Eleven's Big Gulp and just about all medium and large size beverages sold at fast-food establishments, may no longer be available to consumers in New York City if Mayor Bloomberg's ambitious proposal to limit the portion sizes of sweetened beverages is passed by the city's board of health in June. In fact, the "small" soda at McDonald's may soon become the largest option available. And even Burger King's 22-ounce "small" would be banned. According to the mayor, it is time for food eateries to start shaving down their portions.

The proposed ban would restrict the sale of sodas and other sugary drinks that are larger than 16 fluid ounces in food establishments such as restaurants, movie theaters, sports arenas, delis, and street carts. It would include the popular 20-ounce soda bottle from the corner deli and, of course, oversized fountain drinks available in fast-food establishments and movie theaters. The ban would not affect diet drinks, fruit juice, dairy-based drinks such as milkshakes, or alcoholic beverages. Nor would it affect beverages sold in grocery stores.

It is no surprise that the beverage industry is up in arms about the proposal, and feels that the city's department of health is unfairly singling out soda. Indeed, the ban would affect the sales of their product. According to the New York Times, the New York City Beverage Association criticized the city's proposal:

"The New York City health department's unhealthy obsession with attacking soft drinks is again pushing them over the top," the industry spokesman, Stefan Friedman, said. "It's time for serious health professionals to move on and seek solutions that are going to actually curb obesity."

According to the New York City Department of Health, sugary, sweetened beverages are a major contributor to the current obesity epidemic both in New York City and in the rest of the country. In a phone interview, Dr. Thomas Farley, New York City's health commissioner, indicated that the extra calories from sweetened beverages have indeed contributed substantially to rising obesity rates throughout our country.

This is not the first time the New York City Department of Health has tried to help us trim our portions. In January, they launched a portion-size education campaign -- "Cut Your Portions. Cut Your Risk" -- featuring ads on subways encouraging New Yorkers to trim their portions to reduce their risk of health problems. As I previously wrote, the city's health department has been very proactive in fighting obesity and other public health issues.

So, what should we make of this new proposal to ban oversized sugary drinks?

This campaign makes sense at a time when food portions have increased and so have rates of obesity.

As a researcher tracking portion size trends, food portions have increased steadily over the years, and so have we. We have grown accustomed to oversized portions, and we have come to expect them. My research found that portion sizes are now two to five times larger than they were in the 1950s. When McDonald's opened, for example, the only size soda available was 7 ounces. When Burger King first opened, the company offered a 12-ounce small and a 16-ounce large. Boy have we grown! Burger King's small is now 22 ounces and its large is 42 ounces. I think it is time to return to those more reasonable sizes.

Large portions may contribute to obesity in several ways. Large portions contain more calories than small portions. For example, an 8-ounce soda contains 100 calories, while a 64-ounce Double Gulp without too much ice contains nearly 800 calories. Large portions also encourage us to consume more and to underestimate how much we are really eating. Sugar-sweetened beverages, in particular, provide no nutritional value whatsoever. As a registered dietitian counseling clients on healthy eating, I advise eating a small portion of foods low in nutritional value.

If food companies do not sell large sizes, consumers will not buy them. Of course, you can get around the ban by purchasing several drinks. Indeed, four 16-ounce sodas would amount to just one 64-ounce Double Gulp, but it's going to cost a lot more money. And will consumers want to pay for them?

Part of the portion problem is that the current price structure encourages us to buy bigger sizes. All too often, the bigger the portions, the less we pay per ounce. At a local 7-Eleven, the cost of the smallest size available (20 ounces) is roughly five cents per ounce, but the largest size (64 ounces) goes down to just two cents per ounce. It is hard to resist such a bargain.

As an educator and clinician, I would absolutely continue to advocate for better education and public health campaigns. I would urge such campaigns to begin at home and continue in the schools for our children to receive training on nutrition and health -- in particular, on the relationship between calories and portion sizes. But education has not proven to be the answer thus far. Research looking into the effectiveness of the posting calories on menu boards has not been very promising. The health department found that 15 percent of patrons improved their choices by looking at calorie counts on menu boards. Indeed, we need to take this a step further. And Mayor Bloomberg is taking action.

Given the health consequences and enormous cost of our country's obesity epidemic, it is time to return eating less. And banning the large sizes of unhealthy sugar-sweetened beverages is a good place to begin. The city has unveiled other such public health campaigns, and it appears that they may actually be working. Smoking has declined and so have rates of childhood obesity in New York City. I applaud the health department for its efforts in fighting to improve the public health of New Yorkers and hope other health departments around the country follow New York's lead.

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