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One of my favorite television shows is The Big Bang Theory. There is something innately pleasing and humorous about watching geniuses struggle with tasks most of us non-geniuses find simple.
But as I was watching the show the other day, I had a public health freak-out.
The scene took place in the university cafeteria: Along with their explicitly healthy lunches, each of these geniuses was drinking a sports drink. You know, the funky colored, sugar- and salt-filled beverages that athletes drink after rigorous sports activity. Only the most rigorous thing these geniuses had done that day was argue about which was better – string theory or quantum theory.
As he does during many of my public health freak-outs, my husband listened patiently to my rant and then said, “A lot of people think sports drinks are healthy.”
And there’s the problem. Public health officials used to warn of the sugar-overload dangers of soda, and everybody knew what we meant. Given the explosion of new commercial drink products over the past few years, we now talk about “sugar-sweetened beverages,” including not only soda, but also energy drinks, sports drinks, sweet coffee, sweet tea, and even some juices. It seems that with every new addition to the sugary beverage ocean, we have diluted the public’s understanding that drinking sugar is bad for you. It is bad for your brain, your teeth, your stomach, your weight, and if you have a chronic disease, it’s bad for that, too.
With more than 1 million adults either overweight or obese in Bexar County, we all recognize that this is a complicated problem that requires a multi-pronged solution.
First, we need to better educate the public – especially parents and people with diabetes – on what limiting consumption of sugar-sweetened beverages actually means. We also need to counter each brand’s multi-million-dollar ad campaign promoting the good-feeling, popularity-increasing, basketball dunk-improving, wing-sprouting effects of sugar-sweetened beverages. And, much like with cigarettes, the beverage industry has added an addictive substance – caffeine – to many of these drinks, making them even more appealing and difficult to quit.
The San Antonio Metropolitan Health District launched its Viva Health campaign six months ago, and one of the campaign’s three goals is to educate our community on the dangers of sugar-sweetened beverages. In addition to this campaign, we have deployed community health workers in 11 neighborhoods throughout the city with the goal of educating families on the importance of healthy eating and active living.
We are also collaborating with the City’s Parks and Recreation Department to provide nutrition education to the approximately 6,000 children who participate in summer day-camps each year, including the benefits of drinking water and no-added-sugar aguas frescas rather than sugar-sweetened beverages. When we asked children why they thought too much sugar is bad for you, answers included, “It causes diabetes,” “It can rot your teeth,” and “It can make you gain weight,” among others. One child’s answer went right to the heart: “You can lose a leg,” he said. That is an unfortunate reality in a city with high amputation rates due to diabetes.
If we’ve learned anything in public health practice, it’s that education alone is never enough. We need policy changes to help make healthy choices easy choices. Policies limiting access to sugar-sweetened beverages in schools and child care centers have been widely adopted, but are not universal. We also need workplace policies to prohibit sugar-sweetened beverages in work-based vending machines. City Manager Sheryl Sculley implemented such a policy several years ago. These policies have been linked to a decrease in the amount of sugar employees consume, ultimately leading to a healthier workforce.
And, just like with tobacco, we need to tax sugar-sweetened beverages at a higher rate than healthier options. Multiple studies have shown that increasing the cost of sugar-sweetened beverages leads to decreased consumption. Unlike other cities throughout the U.S. that have followed through with this policy, Texas cities do not have the ability to impose such a tax. In order for City Council to consider a local tax on these beverages, our elected officials in the Texas Legislature must first allow cities the right to establish one.
I’ve been San Antonio’s public health director for seven months now, and am encouraged by the pro-health environment here. I have no doubt that if we expand efforts to educate the community on the dangers of sugary drinks and begin implementing policy solutions to discourage over-consumption, we’ll decrease diabetes, childhood obesity, dental caries, and other health hazards associated with consuming too much sugar.
I look forward to working with all our dedicated and incredible partners throughout Bexar County to tackle this tough issue. It will be hard work, but not so rigorous that we’ll need a sports drink afterward.