San Antonio Needs Policy Changes to Reduce Sugary Drink Consumption

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A gas station worker stocks grape soda in a display case. Overconsumption of sugary drinks are a major contributor to adult and adolescent obesity in Bexar County. Photo by Scott Ball

Scott Ball / Rivard Report

Overconsumption of sugary drinks is a major contributor to adult and adolescent obesity in Bexar County.

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.

15 thoughts on “San Antonio Needs Policy Changes to Reduce Sugary Drink Consumption

  1. This just doesn’t work. There are many venues for sugar consumption. Plenty of blame to spread around. People Neto be educated and allowed to make their own choices. One more example of Big Brother.

  2. While yes I had worked in other areas. This is borderline intrusion into people’s own choices. By saying we will tax this more because of high sugars is like saying we will tax all sports cars more or we will tax all fashion clothes more. You can not keep forcing your beliefs in others even if it means well. All these products have the information right in them if puerile choose not to read them that is THEIR choice not anyone else’s.

  3. If you want to de-incentivise sugar consumption then Colleen’s suggestion will work. And it can be effective based on implementation. I would support it.

    The challenge that is really hard to overcome is that a sugar tax is a regressive tax and it directly affects lower socioeconomic citizens. But thats the intent. That is kind of a tough selling point. I believe the messaging kind of needs to focus less on nutrition and more on corporations who continue to sell the sugar drinks in massive quantities.

    So, I have been noodling on an alternative. A corporation sugar cap policy that would impose a max amount any one corporation can sell in a given location per year. Anything over the limit they would impose a fines paid to the city for helpful initiatives in food nutrition. Now I know corporations could move the price down to the consumer via price per unit. However, it would now be a corporations choice to do that. That shift is important in the narrative because people are not suffering at checkout counter via a tax but corporations are on the hook instead to focus on their products sugar content

    Could it work? No clue but I definetly appreciate the discussion on sugar consumption.

    • Andrew, I appreciate your alternative thinking 100%!

      People shouldn’t be told what to do (i.e. a consumption tax) but companies large and small should produce and market their products responsibly to ensure they aren’t causing ‘undo harm’ to their consumers (i.e. obese or diabetic consumers with an unhealthy soda habit).

  4. This is not a nanny state.
    I myself have been sugar free for 6 yrs, but you have NO RIGHT WHATSOEVER to tell people what they can or cannot put into their own bodies.

  5. Actually this is a nanny state. The State of Texas hasn’t given the city authority to tax sugary beverages. Its just a little tax on sugary drinks that will reduce healthcare and economic productivty costs that we all share in society. Texas is nanny state numero uno. Thanks Colleen for trying to make it happen!

  6. People will retain the right to consume as much sugary cola as they desire, they will just have to pay an extra quarter or two for the beverage. The “nanny state” complaint completely overlooks the pubic cost component of health care expenses down the line.

    • By this reasoning every aspect of our lives would have to regulated by the government because every choice we make can potentially “cost us all” eventually (you may be ok with that—I am not). Do you get less than 7 hours of sleep? Then you should want government oversight of sleep because you (and your sleep deprived neighbors) are at increased risk for:
      Heart disease
      Heart attack
      Heart failure
      Irregular heartbeat
      High blood pressure
      Also, drowsiness can slow reaction time as much as driving drunk.

      Not drinking enough water? Guess you need government oversight of your water intake too. Because dehydration slows the metabolism, it could have adverse effects in the body’s ability to burn fat. When you are dehydrated, your brain may confuse thirst with appetite causing you to over eat. Your dehydration also makes you a risk to others on the road; according to a study published in the journal Physiology and Behavior, dehydrated drivers made twice the amount of errors during a two-hour drive compared to hydrated drivers.

      Do you realize what is costing us now? Regulations. Federal regulations (primarily environmental regulations, followed by financial regulations and Obamacare) alone cost the US tax payers 1.9 trillion a year.

  7. Educating the public is a worthy goal but to reduce sugary drink consumption, I think we need to educate our educators. The sign for Mark Twain Middle School is emblazoned with the logo for Coke. Is our school district so dependent on funding that we must accept advertising from a sugary drink manufacturer? Is the economic benefit to our school worth the health of our youth? The middle school sign on San Pedro says, “Catch the wave.” I’d rather not!–language-acquisition-seventh-grade.jpg

  8. Strongly disagree about a “sugar tax” or any other unnecessary tax. Sugar is not the only culprit that contributes to obesity. Why single out sugar, when fat contains more than twice the calories. Pasta also contains a substantial amount of carbohydrates which the body turns into a blood sugar. If a tax is levied against sugar, then a tax should be levied against everything that causes obesity, including inactivity. Its sad to see children being used to push a one-sided and unjustified issue.

    • After further study; there is a lot of information regarding soda taxes that isn’t included in this article. Some points to consider:
      1. While a tax on soda does equate to less soda consumption, there is not as direct a correlation to actual lowering obesity.
      2. In research that does show a drop in weight due to a soda tax, the drop is minescule…less than a quarter of a pound over a year.
      3. States with no soda tax have lower obesity rates.
      4. There is no accounting for the millions of soda drinkers who are not overweight but would also be affected by the tax.
      5. The one clear thing a soda tax does is fill the state coffers with tax payers money.
      I’m not sure if a soda tax is a good thing or not…I actually don’t drink much of it myself, but there is certainly more that needs to be considered.

  9. What we should do is eliminate the governmental agency that comes up with, ideas like this. Then redirect the tax funds to something useful. No one needs the government to “educate” them regarding their drinking choices.

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