Real Life Nutrition

By Maryann Tomovich Jacobsen, MS, RD

If you’ve been keeping up on health news, you know that Mayor Bloomberg is attempting to ban large-sized sodas (16 ounce or bigger) in New York City. It appears most people do not agree, with a recent survey showing two-thirds don’t support the ban.

I’m not bringing this topic up to stir the age-old debate of government’s role in food choice.  Instead, I think everyone needs to take a step back to see if tactics like this are effective in the first place.

Will these changes work?

“Taxes on unhealthy foods have been around a long time, at least 90 years,” says David Frisvold, PhD, Assistant Professor of Economics at Emory University. “And complete bans have been used in schools.”

Frisvold explains how restrictive policies can result in substitution patterns, blunting their effects. For example, when soft drinks are less accessible, people tend to substitute by consuming other high calorie beverages.

“What we found for kids is that when taxes go up kids drink less soda,” he says.  “But total calories don’t change and there is no real effects on obesity.”

He also explains that bans on sodas in schools have not resulted in less consumption, as research shows that children and adolescents simply go elsewhere to buy drinks and often have access in their own homes.

Frisvold makes the point that “single policies won’t work,” and that multiple, more broad ones (on more food items for example) have the best chances of success.  But even with that he admits that “You don’t know it will work until you try it.”

Comparing tobacco to food (apples and oranges?)

Using tobacco as a model for public policies around food doesn’t work because they are different beasts. Frisvold says, “dealing with excess of food is harder than with cigarettes where any amount is bad.”

Another key factor driving policies for cigarette smoking was the data showing negative health effects to others. The argument regarding obesity is that while it doesn’t affect the health of others, it can affect people’s wallets in the form of excess healthcare costs.

But the biggest difference may be that obesity has many influences in addition to food.  Lifestyles have changed — more stress, less sleep, less activity, and a technology boom that has kids glued to iPads, Facebook, and X-boxes. And anyone who works with individuals struggling with weight knows that no two people are alike.

For example, a 2012 study in Obesity Review looked at various studies and found only small or inconsistent evidence for a relationship between excess weight and skipping breakfast, eating frequency, snacking, irregular meals, eating away from home, consumption of fast food, and large portions and eating style.

A call for new ideas

I think we are in need of new ideas and solutions to this issue. One example is what Brian Wansink is doing with Smarter Lunchrooms, making small changes in how food is presented, resulting in better food choices for students.

Frisvold mentions government programs like Head Start having a positive impact with low-income families. And according to a 2010 article in Harvard Business Review, when done right, corporate wellness programs can have a big impact on health and productivity of employees, as well as healthcare costs to companies.

If I thought that banning large sodas would quell obesity, I would be for it.  But it’s going to take a lot more than this ban to create a culture that values health and wellbeing.

What is your take on all of this?