AMA House of Delegates

Taxes on sugary beverages could fund obesity prevention

The Association also recommends that physicians apply 15 competencies of lifestyle medicine to prevent chronic diseases and supports nutrition instruction in public schools.

By — Posted July 2, 2012

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Sugar-sweetened beverages account for nearly half of the added sugar in Americans' diets, and they contribute to the nation's expanding waistline, an American Medical Association report says. Taxing such beverages is one way states and communities can finance much-needed obesity prevention programs and obesity education campaigns, according to AMA policy adopted by the House of Delegates at the Association's Annual Meeting.

The policy calls for revenue from such taxes to be used primarily for programs designed to prevent or treat obesity and related conditions, and for research into population health outcomes that might be affected by the taxes. It also urges the AMA to advocate for studies on the effects of long-term consumption of noncaloric sweeteners in beverages, particularly among children and adolescents.

As of July 2011, 35 states had taxes on sodas sold in food stores, and 40 taxed sodas in vending machines, according to the AMA Council on Science and Public Health report on taxing beverages with added sweeteners.

“This doesn't state that the AMA is in support of a tax on sugar-sweetened beverages or is in opposition to a tax,” said Robert A. Gilchick, MD, MPH, a delegate for the American College of Preventive Medicine from Los Angeles and a council member. “It states that the AMA recognizes that a tax on sugar-sweetened beverages is one strategy that could be used among a variety of strategies to impact the obesity epidemic.”

Some delegates questioned whether taxing sugar-sweetened beverages is the best way to decrease consumption of the products, saying funds generated from such taxes often are not used for programs aimed at reducing obesity or other related health problems.

The house action comes on the heels of New York Mayor Michael R. Bloomberg's proposal in May to ban the sale of high-calorie drinks in containers larger than 16 ounces in the city's licensed food service establishments.

The American Beverage Assn. called the AMA's policy to help reduce overweight and obesity admirable, but said funding anti-obesity programs through “discriminatory” taxes on sugar-sweetened beverages is “misguided.”

“The body of science proves, and real world evidence demonstrates, that taxes on sugar-sweetened beverages will not have a meaningful impact on obesity,” the beverage association said. “We are committed to working with key stakeholders on comprehensive approaches that will have a lasting and meaningful impact on obesity.”

The impact of sugary drinks

One in three U.S. adults is obese, as are 17% of children and adolescents, according to the Centers for Disease Control and Prevention. The prevalence of obesity in youths has nearly tripled from 1980, when about 6% were obese, the CDC said. Health professionals say drinking sugar-sweetened beverages plays a significant role in the nation's widening waistline.

The American Heart Assn. recommends that most women consume no more than 100 calories per day from added sugar, and men, no more than 150 such calories a day. A 12-ounce serving of most sugar-sweetened beverages typically has 130 to 150 calories of added sugar, the CSAPH report said.

Data show that regularly drinking sugar-sweetened beverages is associated with increased body weight and health conditions such as coronary artery disease, hypertension and type 2 diabetes, the report said.

Increased taxes on such drinks could lead to an estimated 5% reduction in the prevalence of overweight and obesity, and reduce medical costs related to those conditions by $17 billion over 10 years, the report said. Greater health benefits would be realized if the tax revenues were used primarily for obesity prevention programs, according to the report.

Delegates also adopted policy that calls on the AMA to urge physicians to apply the 15 core competencies of lifestyle medicine and offer evidence-based lifestyle interventions as the primary mode of preventing and treating chronic disease. The competencies include assessing a patient's readiness to make healthy behavior changes and working with the individual to develop an evidence-based action plan.

Another new policy directs the AMA to urge appropriate agencies to support legislation that would require yearly nutrition instruction in grades 1 through 12 in public schools. It also asks the AMA to encourage physicians to volunteer to assist with such efforts.

“While there is no silver bullet that will alone reverse the meteoric rise of obesity, there are many things we can do to fight this epidemic and improve the health of our nation,” said AMA Board of Trustees member Alexander Ding, MD, a Boston diagnostic radiologist.

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Meeting notes: Public health

Issue: The popularity of social networking sites among adolescents and youths has created new opportunities for bullying, which can have serious social and mental health consequences for victims.

Proposed action: Urge social networking platforms to adopt terms of service that define and prohibit electronic aggression. That may include any type of harassment or bullying, including but not limited to that occurring through email, chat room, instant messaging, website or text messaging. [Adopted]

Issue: Actors smoking in movies can influence adolescents who see them smoking, and some of those youths ultimately will die of tobacco-related diseases.

Proposed action: Recommend that no tax incentives be given for motion picture productions that show people using tobacco products, nonpharmaceutical nicotine delivery devices or associated paraphernalia. An exception can be made for films that depict tobacco use of a historical person or that portray the dire health consequences of smoking. [Adopted]

Issue: The rate of suicide attempts is significantly higher among lesbian, gay, bisexual and transgender youths compared with the rest of the adolescent population.

Proposed action: Partner with organizations dedicated to public health and public policy to reduce suicide among LGBT and questioning youths, and improve the health of that population. [Adopted]

Issue: Excessive exposure to nighttime lighting can disrupt the circadian biological rhythms of sleep and create potentially harmful health effects. Such health effects could include an increased risk of developing cancer, diabetes and obesity.

Proposed action: Support the need for developing lighting technologies that minimize circadian disruption and encourage further research on the risks and benefits of occupational and environmental exposure to light at night. Adopted

Issue: Health care facilities are increasingly launching antibiotic stewardship programs to reduce the risk that bacteria will develop drug resistance.

Proposed action: Support these programs when supervised by qualified physicians as an effective way to ensure that antibiotic use is appropriate. [Adopted]

Issue: Bioengineered foods have generated a great deal of debate. Some say they are safe. Others say there are not enough data about their impact on human health or the environment to reach that conclusion.

Proposed action: Support mandatory pre-market systematic safety assessments of bioengineered foods and continued research into possible environmental consequences of farming them. [Adopted]

Issue: The James Zadroga 9/11 Health and Compensation Act of 2010 established a program to provide health services for medical conditions related to the terrorist attack on New York's World Trade Center among first responders. Cancer was not on the list of covered health issues, but some research indicates that this group of people is at higher risk.

Proposed action:Encourage further study of the link between cancer and exposure to the detritus from the World Trade Center attacks of Sept. 11, 2001. [Adopted]

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External links

“Physician Competencies for Prescribing Lifestyle Medicine,” The Journal of the American Medical Association, July 14, 2010 (link)

“Dietary Sugars Intake and Cardiovascular Health: A Scientific Statement From the American Heart Association,” Circulation, Sept. 15, 2009 (link)

“Reducing Access to Sugar-sweetened Beverages Among Youth,” Centers for Disease Control and Prevention, June 20, 2011 (link)

CDC on overweight and obesity (link)

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