Draining soda's impact: Less sugar a sweeter solution

Efforts to limit the availability of sweetened drinks -- especially for young people -- are gaining attention in the fight against obesity.

Posted June 26, 2006.

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A 12-ounce can of regular soda tallies 140 calories. That's a lot. Those cans quickly add up, and those calories typically come from sugars and high-fructose corn syrup. In other words, the nutritional return on this caloric investment is not a positive one.

It is not surprising, then, that research supports a relationship between consumption of these sugary beverages and rising obesity rates. These figures -- especially among children -- mark one of the most disturbing public health problems the nation faces.

That's why the American Medical Association has policy urging schools to promote the availability of nutritious beverages as healthy alternatives to such drinks. The Association views it as an important part of children's education about good nutrition -- an understanding that can lead to life-long healthy eating habits.

It's also why recent actions designed to move toward this objective deserve notice. These efforts won't be easy, but they are critical in the context of certain trends.

During the 1970s, for instance, teens consumed nearly twice as much milk as they did soda pop, according to an AMA Board of Trustees report slated for consideration at this month's House of Delegates meeting. Twenty years later, those figures have flipped. Teens now drink twice as much soda.

The report also notes Dept. of Agriculture statistics indicating that, between 1989 and 1996, children's caloric intake increased by approximately 80 to 230 calories per day, with soft drinks being a key driver. One study even reported data showing the odds of a child becoming obese increased 60% for each additional can or glass of sugar-sweetened drink he or she drank daily.

Thus, there is no avoiding the crux of the problem. Young people are consuming more calories than they burn, and intervention is necessary to change this reality.

The Alliance for a Healthier Generation -- a joint initiative of the William J. Clinton Foundation and the American Heart Assn. -- joined with the soft drink industry to get at this imbalance by establishing guidelines limiting the beverages available to children at school. Their effort is consistent with AMA policy and should be applauded.

The guidelines, which could affect close to 35 million students, would cap the number of calories available in beverages in schools at 100 calories per container, except for certain milks and juices that offer nutritional values that warrant a higher number.

Elementary schools will sell only water, 8-ounce calorie-capped servings of certain juices with no added sweeteners, and servings of fat-free and low-fat regular and flavored milks. Middle schools will apply the elementary school standard with portion sizes increased to 10 ounces. At least half of available beverages in high schools will now be water or no-calorie and low-calorie selections. Light juices and sports drinks will be sold in 12-ounce containers with no more than 100 calories per container, while 100% juices and nonfat and low-fat milks also will be sold in containers up to 12 ounces.

The beverage industry has pledged to work to spread these standards to 75% of the nation's schools by the 2008-09 school year and to implement them fully the following year, provided schools are willing to amend existing contracts.

As we go to press, the AMA's House of Delegates is set to deliberate about a related issue: whether the AMA should support a tax on sugar-sweetened soft drinks. A Board of Trustees report outlines the rationale behind the concept -- specifically, that it likely would raise awareness about the nutritional issues as well as generate money for much-needed obesity prevention efforts, including educational programs, healthier school meals and physical activity programs. We'll report the outcome in our Annual Meeting coverage.

The AMA maintains that there is no single answer to the obesity epidemic. It requires awareness on the part of consumers and physicians about healthy options and nutritional choices. It also demands broad, community-based involvement. Curtailing the availability of high-calorie soft drinks in school is an excellent example of how the continued focus on this national problem is triggering new solutions.

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External links

American Medical Association for AMA Board of Trustees Report 32: Imposing Taxes on Sugar-Sweetened Soft Drinks (link)

Alliance for a Healthier Generation for healthy school beverage guidelines (link)

AMA Roadmaps for Clinical Practice Series: Assessment and Management of Adult Obesity (link)

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