RESEARCH PROPOASAL
Bending the Consumption of Sugary Drink Curve
Decreasing consumption of sugary beverages can reduce the obesity and tooth decay
WHAT IS A SUGARY DRINK?
Figure: 1 Sources of calories from added sugar in the
US
A sugary drink is defined as any drink that
contains added sugar or sweetener. It includes
sodas, sports drinks, energy drinks, bottled teas,
coffee drinks, carbonated soft drinks,
vitaminenhanced drinks, juice cocktails, vitamin
waters and fruit-flavored drinks. Sugary beverages
are one of the most abundant sources of added
sugar in the diets of the United States' population. It
accounts for about 47 percent of the daily added
sugar
DATA SOURCE: What We Eat in America (WWEIA) Food Category
consumption (see figure1).1
analyses for the 2015 Dietary Guidelines Advisory Committee.
Estimates based on day 1 dietary recalls from WWEIA, NHANES
2009-2010.
A 20-ounce sugary beverage carries more added sugar that exceeds the amount needed
by the body per day. For instance, one 20-ounce bottle of Pepsi contains 69 grams that is equal to
250 calories2; the daily limit of added sugar according to American Heart Association varies in
men and women. In women, the daily recommended is no more than six teaspoons which is
equal to 25 grams (100 calories).3 However, in men, the daily added sugar limit is nine teaspoons
that is equivalent to 36 grams (150 calories).3
HOW MUCH DO WE DRINK?
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RESEARCH PROPOASAL
Bending the Consumption of Sugary Drink Curve
Decreasing consumption of sugary beverages can reduce the obesity and tooth decay
The portion size of sugary drinks has increased dramatically over the last years. The drink
bottle was 6.5 ounces before the 1950s. Then the markets extended the size to become 12ounces
after 1960.4 By the beginning of the 1990s, 20-ounces became the standard and it continued to
increase till 2011 when it reached 42- ounces. The daily consumption rate has also
increased significantly (see figure 2).4
Figure: 2 Individual daily intakes of sugary drinks in the US.
A factor facilitating the harmful effect of
sugary drinks is when the individuals don't feel as full
as when they had eaten solid food with similar number
of calories. Moreover, reports show that people taking
sugary drinks don’t count the calories in the drinks to
compensate that by reducing their diet.5
WHAT DO SUGARY DRINKS DO TO TEETH?
Sugary beverages have a negative effect on oral health. When individuals have one of
these drinks, the sugar latches on to teeth. Bacteria that are normally found inside the mouth eat
away at the sugar these drinks leave behind. However, as the bacteria consumes the sugar, it
begins to produce acid. Eventually, the acid begins to eat away some of the enamel on teeth. This
makes the teeth thinner and weaker. As the enamel weakens, the likelihood of developing
cavities becomes greater. Sugary drinks are known as one of the most common dietary causes of
tooth decay.
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RESEARCH PROPOASAL
Bending the Consumption of Sugary Drink Curve
Decreasing consumption of sugary beverages can reduce the obesity and tooth decay
EVIDENCE SHOWS THE HARMFUL EFFECT OF SUGARY BEVERAGES
Continuous intake of sugary drinks can cause an increase in body weight. Increased body
weight is a risk factor for many chronic diseases such as diabetes, hypertension and
cardiovascular diseases. And, heart disease is considered the number one killer in the United
States. Studies have revealed a strong correlation between sugary drinks consumption and either
overweight or obesity. Development of obesity during childhood is linked to the risk of obesity
as well as premature death among adults.
A study compared the people who increase their sugary intake by additional 12 ounces
daily and people who did not change their consumption. It concluded that there was a significant
increase in body weight with an extra pound every four years for those who increased their
intake compared to the other group.6 Another study has found that the probability of children to
become obese rose to 60 percent for each extra 12-ounce intake of sugary drink daily.7
The rate of obesity in the United States has risen in recent decades, becoming the highest
rate in the world. The prevalence of obesity is 37.9% in American adults. While 70 percent of
adults in the US are considered either obese or overweight.8
The obesity epidemic, for example, saw a rise in New York State; the rate of being
overweight or obese adults rose to 59.5% in 2015 compared to 42% in 1997.9 In New York City
alone, more than 50 % of the population is either obese or overweight.10 Cutting down the
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RESEARCH PROPOASAL
Bending the Consumption of Sugary Drink Curve
Decreasing consumption of sugary beverages can reduce the obesity and tooth decay
consumption of sugary drinks, therefore, can prevent obesity and promote better health of New
Yorkers.
Obesity as a major leading cause of diabetes is
considered the seventh leading cause of death in the US. The
Uncontrolled diabetes result in:
number of Americans living with diabetes is more than 30
million.11 In New York State, more than 1.6 million people
have diabetes. This number has seen an increase in recent years
from about 6 percent in 2000 to about 10 percent in 2014. Over
•
•
•
•
kidney failure
blindness
limb-amputation
Ischemic heart
diseases
• stroke
2 million New Yorkers are living with diabetes and around 30
percent of them are still undiagnosed.12
Furthermore, uncontrolled diabetes can lead to serious, costly complications. The risk of
this disease increases by 26 percent among people who drink one to two cans of sugary
beverages per day compared to those who rarely consume such drinks.13
Researchers have shown that those who consumed a can of sugary drinks a day had 20
percent risk of developing heart attack than those who rarely consume such drink. An additional
study showed that the risk of gout is much higher with 75 percent in women who consumed one
can per day than others who rarely had such drinks.14 Similarly, this positive association was
seen in men in different studies.14 Moreover, the intake of such empty calories has a negative
impact on dental health resulting in tooth decay, for example.
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RESEARCH PROPOASAL
Bending the Consumption of Sugary Drink Curve
Decreasing consumption of sugary beverages can reduce the obesity and tooth decay
Another study shows that the intake of such drinks affects the health of New Yorkers of
all ages and increases the incidence of cardiovascular disease and type 2 diabetes.15 On the other
hand, other studies have concluded that overweight persons who decreased their sugary
beverages intake were associated with better health outcomes.16
Although obesity is one of the top preventable chronic diseases, the medical cost of
obesity and obesity-related complications is high. The annual cost range between $147 billion
and $210 billion.17 Obesity also causes loss of productivity that costs the United States about
$4.3 billion annually.17 New York State spends about $8 billion annually in treating
obesityrelated illness.18
Similarly, the diabetes-related medical cost has seen an increase in recent decades. In the
US, the healthcare services for diabetes was estimated at about $245 billion in 2012.18 The
medical expenses for diabetes are 2.3 times higher than healthy people. In 2012 the total annual
medical cost of diabetes-related conditions in New York was about $15.8 billion.19
CURRENT POLICIES TO TACKLE THE CONSUMPTION OF SUGARY DRINKS
1. The New York City Health Department has also initiated "The Healthy Food Initiative"
program to ensure the eating of healthy food within the hospitals of New York City.
Enrolled hospitals are strict with the New York Food Standards that provide better
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RESEARCH PROPOASAL
Bending the Consumption of Sugary Drink Curve
Decreasing consumption of sugary beverages can reduce the obesity and tooth decay
healthy choices to people. In so doing, hospitals improve the nutritional component of
foods and drinks in their vending machines, cafeterias, and meals of patients.
2. Initiatives put in place by the New York City's Mayor’s Office of Food Policy 15:
•
Multiple public education campaigns to enhance knowledge by people about the risks of
sugar-sweetened beverages. These campaigns are aimed at promoting a healthy lifestyle
and encouraging consumers to replace sugary drinks with water. Examples of these
campaigns include “Sounds Healthy” which was launched between 2014 and 2015. Also
in 2015, the office introduced “Skinny Kids” campaign and lastly, in 2016 they organized
“Drink NYC Tap Water” campaign.
•
Increased the regulations in Child Care Centers to improve the health of children. These
regulations include increased access to water and the restriction of high energy drinks for
kids. Additionally, they promote physical activity and quality of nutrition to reduce the
prevalence of obesity.
All these policy initiates, laudable as they are, however, are yet to meet the optimal goal
of reducing the risk of sugary drinks consumption by the population. Therefore, additional
aggressive measures should be affected to further control and, or, minimize the adverse
consequences of these sugary beverages on people’s health.
RECOMMENDATION TO RESTRICT THE CONSUMPTION OF SUGARY DRINKS
•
Increased Taxation of Sugary Drinks:
Passing a law that imposes higher taxes on sugary drinks shall result in higher prices for
these drinks. That will ultimately lead consumers to buy and drink less. A study conducted in
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RESEARCH PROPOASAL
Bending the Consumption of Sugary Drink Curve
Decreasing consumption of sugary beverages can reduce the obesity and tooth decay
California shortly after the soda tax law was passed there, concluded that the intake of soda
reduced by 21 percent in Berkeley neighborhoods, the place where the study was performed.20
Furthermore, researchers reported that the participants increased their consumption of
water after the implementation of the soda tax. This then is evidence that such a policy will drive
people to reduce their consumption of sugary drinks and increase their consumption of drinking
water in place of the unhealthy sugary drinks. This will consequently improve the population's
health; giving rise to a more manageable weight control.
In January 2014, Mexico imposed a 1-peso ($0.05) tax per liter of sugarsweetened
beverages to tackle the national obesity epidemic. The results were positive as the purchases of
sugary beverages went down to12 percent by the end of 2014, among those with low income,
the average decrease in purchases was higher with a percentage of 17% in December 2014.21
Lastly, there was an increase in purchases of water and untaxed low calories drinks by 4
percent.21
In 2016, the City of Philadelphia adopted a policy of excise tax on sugary beverages. The
estimated tax revenues of 1.5 cent excise tax per ounce of sugary drink will be around $410
million over the next five years or roughly 92 million annually. If we take this example, we can
benefit from this revenue and use it for further measures to control obesity and improve oral
health.22
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RESEARCH PROPOASAL
Bending the Consumption of Sugary Drink Curve
Decreasing consumption of sugary beverages can reduce the obesity and tooth decay
In conclusion, an excise tax on sugary beverages considered as a dietary causes of tooth
decay will decrease the intake by the population and eventually improve oral health. This, Also,
will be one of the effective means to control the obesity epidemic. As sugar is the primary factor
responsible for the development of tooth decay, any reduction measures will also lower this risk,
particularly for children.
References:
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Mayor Bloomberg and Governor Paterson Propose Excluding Sugary Drinks from Food Stamp Purchases in New York City. The official website
of the City of New York. 2017. Available at: http://www1.nyc.gov/office-of-the-mayor/news/424-10/mayor-bloomberg-governorpatersonpropose-excluding-sugary-drinks-food-stamp-purchases-in#/0. Accessed December 12, 2017.
The Burden of Diabetes. Maindiabetesorg. 2017. Available at: http://main.diabetes.org/dorg/PDFs/Advocacy/burden-of-diabetes/all-states.pdf.
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RESEARCH PROPOASAL
Bending the Consumption of Sugary Drink Curve
Decreasing consumption of sugary beverages can reduce the obesity and tooth decay
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Policy Profile: Mexico Sugary Drink Tax. HEALTHY FOOD AMERICA. 2015. Available at:
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Schwartz M. Moving Beyond the Debate Over Restricting Sugary Drinks in the Supplemental Nutrition Assistance Program. ScienceDirect.
2017. Available at: http://www.sciencedirect.com/science/article/pii/S0749379716304640. Accessed December 12, 2017.
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