By Diane Carman
KEYSTONE – A top national obesity expert believes that education programs have “failed miserably” and called for hefty soda taxes that could produce $200 million a year in Colorado to effectively counter the obesity epidemic.
For 30 years, the United States has tried to deal with staggering obesity rates through a variety of forgettable public education programs and occasional mild encouragement by public health officials and concerned leaders such as former Gov. Mike Huckabee and First Lady Michelle Obama.
The tactic has been disastrous, said Kelly Brownell, co-founder and director of the Rudd Center for Food Policy & Obesity at Yale University. He spoke at the Colorado Health Symposium here sponsored by the Colorado Health Foundation last week.
The Centers for Disease Control reports that as of 2010, 33.8 percent of Americans were obese. The cost of obesity in Colorado – statistically the leanest state in the nation – is estimated at $874 million a year.
“We have a toxic relationship with food,” Brownell said. “Knowledge and education are not enough.”
His answer is to implement public policies that make it easier for Americans to make good decisions about their diet and their health. Such policies would create “optimal defaults,” making healthy choices the easiest and most readily available options.
“It’s Public Health 101,” he said. And it’s a marked contrast to the current environment.
Brownell listed some of the profoundly negative diet and nutrition defaults in American society. Among them: oversized portions served in restaurants and in supermarket items from candy bars to soft drinks, too much access to foods with little or no nutritional value and too little access to nutritious foods – especially in low-income neighborhoods, pricing that makes empty calories the cheapest items available, and food marketing that is “powerful, relentless and exploitative.”
Optimal defaults are used in many other aspects of our society, Brownell said. He cited research that found when workers are offered an opportunity to opt into pension programs, only 50 percent of them enroll. In contrast, if they are automatically enrolled and given the opportunity to opt out, enrollment is nearly 100 percent. “It’s an economic homerun.”
Similarly, if fruit salads were cheap and ubiquitous, and French fries were expensive and served only in a few restaurants – none of them with drive-through windows – consumption of fruit could be expected to outpace that of fried potatoes in no time.
While the concept of optimal defaults in health and nutrition applies to farming, urban planning and a wide variety of public policies, Brownell has focused his attention on one particularly insidious part of the equation: sugar-sweetened beverages.
“There are a lot of ways to address obesity,” he said, “but low-cost sugar-sweetened beverages are a very bad default.”
He said they are the single greatest source of sugar in the American diet. The beverages have no nutritional value. Evidence suggests that sugar may be addictive. The body doesn’t recognize liquid calories the same way it recognizes calories from solid foods and, therefore, the brain doesn’t send the message that it’s full. What’s more, the beverage industry targets a vulnerable population (children), and there’s “rock solid proof of harm” in the epidemic of diabetes.
Brownell cited research indicating that 40 percent of the calories consumed by children 2 to 18 years of age are empty, and that sugar-sweetened beverages are the largest contributors to that malnutrition.
Given that the tobacco tax “was one of the greatest health victories of the 20th century,” Brownell believes it’s time for a similar significant tax on sugar-sweetened beverages.
Small taxes of 5 percent or less have been ineffective, he said. In order to reduce consumption, the tax needs to be 20 percent or higher.
“As with many public policies, you don’t know until you try it,” he said. “With the tobacco taxes, there were guesses. But they didn’t really know until they did it. They found it worked better than expected.”
In Colorado, a penny-an-ounce tax could be expected to generate $198 million in revenues annually.
“Everything else you might do, including education, costs money,” Brownell. “A soda tax makes money. That’s why it makes sense.”
Brownell said that those who remain skeptical about the effectiveness of a tax in reducing consumption should study the response of the beverage industry every time tax proposals are debated. Coke, Pepsi and the American Beverage Association spent $37 million lobbying against taxes last year.
“If they wouldn’t work, why are they fighting them so hard?”
Similar lobbying by the tobacco industry delayed tax implementation for several years, but ultimately could not defeat the movement. The same fate is likely for the sugar-sweetened beverage industry, Brownell said.
“It’s just a matter of time. None have passed yet, but they’ve come close.”
Once the tax movement starts, it’s likely to spread quickly, Brownell said. “It’s hard to go first and easy to go second”
But the battle to create the whole range of optimal nutritional defaults is a rugged uphill climb.
Brownell noted that the Robert Wood Johnson Foundation is spending $100 million a year on the problem of childhood obesity. Meanwhile, he said, the food industry spends that much “marketing junk food to children” in the first four days of the year.
Food marketing is “an overwhelmingly negative presence” and has been particularly hard to confront since it is protected by the First Amendment guarantee of free speech. The average preschooler sees 1,000 fast-food ads a year, he said.
While taking on the food industry is a monumental challenge, Brownell said it’s the only way to combat the obesity epidemic.
“Whenever we talk about public policy changes to address obesity, the food industry says it’s just finger-pointing,” he said. Industry officials always divert the discussion to talk about personal freedom and choice.
“They need to be held accountable.”
Katie Kerwin McCrimmon contributed to this report.