RETHINK YOUR DRINK: Going Soda Free in Marin to Combat Obesity

Matthew Willis, MD, MPH

Nearly one in three children in Marin, and nearly one in two adults, is overweight or obese. Local healthcare providers see the impact of obesity every day, across the age spectrum: an 18-month-old whose weight continues to climb above the 95th percentile; a 10-year-old obese boy who is bullied in school and depressed; a 16-year-old girl with hypertension and high cholesterol; an overweight young woman with gestational diabetes; a 50-year-old obese woman with debilitating knee arthritis; a 65-year-old man with congestive heart failure and worsening renal function. These routine presentations are largely preventable.

Obesity is a model condition for partnership between public health and clinical medicine because it is epidemic, preventable and curable. As one important step in combating obesity, public health practitioners in Marin County are taking steps to limit the harmful consumption of sugar-sweetened beverages. According to the CDC, consumption of these beverages (including soda, sweetened juices, and sports and energy drinks) is a major driver of the obesity epidemic. Over the past decade, per capita intake of calories from sugar-sweetened beverages has increased by nearly 30% nationally, partly due to marketing strategies targeted to children and adolescents. For each extra can or glass of sugared beverage consumed per day, the likelihood of a child’s becoming obese increases by 60%.

This summer, the Department of Health and Human Services, supported by a resolution from the county Board of Supervisors, will be partnering with LIFT-Levantate and the Marin City Community Services District to promote Soda Free Summer. This initiative includes education on how to read labels to determine the amount of sugar and how to make healthy refreshing water drinks with the addition of fresh fruit and herbs. The Marin County Nutrition Wellness Program (NWP) will host trainings and events on how to Rethink Your Drink throughout the summer at a variety of community based organizations and summer programs for youth.

In addition, the NWP will be working with community leaders in the Canal District and Marin City to help reduce access to sugar-sweetened beverages in these neighborhoods. Childhood obesity rates are higher in these communities than in other parts of Marin. These high rates increase the risk of diabetes and other strong cardiovascular risk factors, perpetuating the disparities we are already seeing in life expectancy in Marin. The current gap in life expectancy between the wealthiest and poorest neighborhoods in Marin is 17 years.

Another important public health approach to obesity borrows from the success of tobacco control. Tobacco taxes contributed to a significant reduction in smoking rates in this country. State Senator Bill Monning (D-Carmel) has introduced Senate Bill 622 to tax a penny per ounce of sugar-sweetened beverages and to use the money gained from those taxes to fund obesity prevention and treatment programs. California Health Officers and Marin HHS support this tax on sugar-sweetened beverages as a means to reduce consumption and for the price of soda to reflect its true cost to society.

A study published by Columbia and UCSF researchers last year suggested that a penny-per-ounce tax would reduce consumption of sugary drinks by 15% and showed how corresponding reductions in obesity and diabetes rates could save the healthcare system $17 billion.[1] In another parallel with the tobacco-control debate, the American Beverage Association spent about $3.5 million in lobbying efforts and advertising to defeat soda tax initiatives in Richmond and El Monte last year. Soda taxes could fund a massive public health education campaign to guide healthy decisions.

The Soda Free Summer and the proposed soda tax are small but important steps towards changing norms around consumption of sugar-sweetened beverages. The solution to the growing burden of obesity must be multifaceted and long-term, and it will require commitments from healthcare providers, public health advocates, and the communities and individuals they serve. Last year, soda was removed from all vending machines in Marin County HHS buildings. Clinics or hospitals that still sell soda in vending machines are invited to join in the spirit of Soda Free Summer. Removing soda from vending machines demonstrates an understanding of the evidence in combating obesity, and it reminds patients of our role as stewards of their health.

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Dr. Willis is the Public Health Officer for Marin County.

Email: mwillis@marincounty.org

References

1. Wang YC, et al, “A penny-per-ounce tax on sugar-sweetened beverages would cut health and cost burdens of diabetes,” Health Affairs, 31:199-207 (2012).