NYC Soda Ban – A Small Step on a Long Journey?
When Mayor Michael Bloomberg announced his intention to ban the sale of sodas larger than 16 ounces at some establishments in New York City, it caused a huge kerfuffle. Businesses under the auspices of the city’s health department, which include movie theaters, restaurants and arenas, would be subject to the ban. Public hearings were held this past Tuesday and the Board of Health will vote on the measure on September 13.
Some detractors don’t think the proposal will help American’s shed pounds, while others simply feel they have a right to eat and drink what they want. Supporters say soft drinks are a large source of excess calories in the diets of Americans, more than two-thirds of whom are either overweight or obese.
Among all of the craziness of the debate, I couldn’t help but wonder whether or not this kind of policy really makes a difference. Will people just purchase more than one 16-ounce drink to get their fix? Is this just one carbonated raindrop in a proverbial ocean of obesity?
A letter to the editor published in the July 23 New England Journal of Medicine, posed an answer to the efficacy question. I spoke with one of the authors, who also testified at the NYC Board of Health hearing, and got some insight into whether, and how, a ban on what kinds of products the public can buy might actually help Americans lose weight.
Brian Elbel, assistant professor of population heath and health policy at New York University School of Medicine in New York City, said this ban is unique because it attempts to change the food environment on a large scale.
He crunched some numbers on data that might help shed light on whether this ban could reduce calorie intake. He looked at receipts from two other studies he previously performed at fast-food restaurants in New York City, Newark, N.J., Philadelphia and Baltimore, Md. between 2008 and 2010.
He determined that 62 percent of drinks sold at fast food restaurants would be greater than the allotted 16 ounces. If 100 percent of consumers drank 16 ounces as opposed to the larger drinks, a consumer would average about 63 fewer calories per trip to a fast food restaurant. He also found that if 80 percent of consumers purchased two drinks, or 32 ounces, to supplement the smaller drink, calorie consumption would increase.
“If we just sort of take 63 calories at face value and ask if it will solve the obesity epidemic, the answer is ‘no,’” Elbel said. “We think people are overeating by about 250 to 300 calories a day. If this is combined with a few other policies, then we are getting somewhere. We see enough evidence to think it will help.”
At the NYC soda ban hearings on Tuesday, Elbel said there were some arguing for more education about what is and isn’t good for us to improve our health. That strategy alone won’t help, Elbel says.
Even with the mountains of information we have on what is and isn’t good for us, we continue to often make unhealthy choices – people know that smoking, drinking sugary soda and eating fatty foods can be bad for their health. Yet they continue to do it.
“Information isn’t going to be that influential by itself,” he said. “We have tried education-based approaches and we have a food pyramid and education in schools and we have done nothing in recent decades but get fatter.”
Elbel said Food policies like Bloomberg’s work in a few ways. Here are some angles to think about when covering this, or other similar, topics.
1. They create a discussion point: The hearings were heavily reported on and the doors were bulging with spectators and others trying to make their opinion heard on the topic.
2. When something is banned, Elbel said, it can move to the “thing you should not be consuming” category. It is similar to what happened with smoking – when it started being taxed and banned in certain areas, it was more taboo.
3. Consumers are lazy and will often choose a “default” option if provided with one. Studies of consumer choice have repeatedly shown that people, for example, will enroll in 401k programs if it is automatically done for them, but if they have to actively enroll, many don’t. One study found that “401(k) plan administrators can manipulate the path of least resistance … to powerfully influence the savings and investment choices of their employees.” That’s much like what Bloomberg is trying to do with this policy.
“People will just eat whatever you put in front of them,” Elbel said. “It also helps frame it as the right choice (a smaller size) and becomes the choice that is the most common. Default can be powerful.”
Image by the NYC Department of Health and Mental Hygiene