Soda Ban: A Drop in the Bucket
They can leave kids wired and nutritionally starved, filling them with calories without suppressing appetite. Soft drinks and school have never been an ideal mix, many nutritionists and educators say, and the Los Angeles Unified School District board’s decision last week to ban soda sales at all district schools was long overdue.
Yet the ban by itself, slated to begin in January 2004, will go only so far to curb what public health officials say is an epidemic of childhood obesity. “The vote was a triumph, and we’re delighted with it,” said Dr. Francine Kaufman, director of the endocrinology division at Childrens Hospital in Los Angeles and chairwoman of a county task force to combat childhood obesity. “At the same time, we have a lot more to do. I consider this a first baby step.”
The prevalence of obesity among children has more than doubled since 1980, to about 12% nationwide, and the rate may be more than twice that in low-income areas of Los Angeles, county officials estimate. Heavy adolescents are much more likely than their peers to become obese as adults, research shows, and this puts them at high risk of developing type 2 diabetes, a progressive condition that can lead to vision problems, heart disease and a shortened life expectancy.
For all that, researchers have been at a loss to identify any one trend or eating habit that accounts for the increase. “There’s a risk of oversimplifying as soon as you pull out one food and say that’s responsible,” said Barbara Schneeman, a nutrition professor at UC Davis who has served on the federal government’s dietary guidelines panel. “It’s a matter of total lifestyle, of changing not only what we eat but how we live.”
Federal regulations already prohibit schools participating in the National School Lunch Program, which provides meals to low-income students, from selling or serving so-called junk food during school breakfast and lunch hours. Districts in Oakland, New York City and Texas also have restrictions in place on soda sales.
But so far there’s little evidence that these measures have had any impact on kids’ health. “The bans are simply too new,” said Adrienne Sobolak, a spokeswoman for the Texas Board of Education, “and no one’s done any studies, as far as we’re aware.”
Appointed in January by the Board of Supervisors to study childhood-obesity prevention, the county’s Task Force on Children and Youth Physical Fitness last week recommended that the county undertake a campaign that goes far beyond banning soda sales. Among the recommendations:
* Increase the amount of time devoted to physical education. Gym classes have been shortened or cut at many schools, and often kids who do have regular P.E. find themselves in classes of 50 or more, the task force reports.
* Create partnerships among parks, communities and schools to make more space available for recreation. In L.A. County, 25% of parents with kids under age 5 say they don’t have access to safe playgrounds, according to a recent Los Angeles County health survey.
* Improve the quality of foods eaten at school lunch. According to a report released last week by the Physicians Committee for Responsible Medicine, a public advocacy group, nine out of 10 of the nation’s largest school districts are failing to provide nutritionally optimal meals. In the study, dietitians analyzed menus from 15 days at each school, rating the food according to government guidelines on the availability of fruit, vegetables and lower-fat meals. Out of a possible 100 points granted for high nutrition standards, Fort Lauderdale’s school district led the group with 85; New York came in at 70; and Los Angeles scored in the middle of the pack, at 60. Many kids who are entitled to a free school lunch even leave campus to eat at fast-food outlets, or just grab a snack and soda from nearby vending machines, teachers say.
Going after sales of those soft drinks made a good first target for a simple reason: sugar. About 33% of the artificially added sugar teenagers consume comes from carbonated drinks, according to the U.S. Department of Agriculture. And when sugar is consumed in liquid form, it adds calories without putting much of a dent in appetite, researchers say.
“Consuming liquid calories may increase how much we eat later in the day, whereas getting calories from solid food reduces what we eat later,” said Megan McCrory, a nutrition researcher at Tufts University. “You’re much better off getting sugar calories in an apple, or even a piece of candy, than from a sweetened drink.”
In one study, researchers in Georgia examined detailed food and drink diaries kept by 323 healthy adults for a week. Drinking unsweetened coffee and tea or diet soda did not affect the overall amount of food the men and women ate. But on days when they drank sweetened drinks they tended to consume more calories, the diaries showed. Eating a 100-calorie solid snack can cut down on the calories consumed at the next meal by more than half; after drinking 100 calories, many people will eat as much as 9% more than usual at their next meal, McCrory said.
This relation holds true for most sugar-sweetened drinks, not just soda pop. In one of the most widely cited studies linking sweet drinks and obesity, doctors at Children’s Hospital in Boston monitored the health and diets of 548 sixth-and seventh-graders for about two years. In this age group about one in 10 children become overweight enough to cause doctors concern. After controlling for the students’ age, body shape and other factors, the researchers reported that each additional sweetened drink consumed daily increased that risk by about 60%. The drinks that had this effect included not only sodas but fruit punch, lemonade, Kool-Aid and sugar-sweetened iced tea.
“The message is: Energy is energy; calories are calories,” said Dr. Mayer Davidson, director of the clinical trials unit at King-Drew Medical Center in Los Angeles. “There’s no difference whether you’re getting them from a Coke or a flavored fruit drink.”
The district’s new policy will allow sales of water, milk, beverages with at least 50% fruit juice, and sports drinks with less than 42 grams of sugar per 20-ounce serving. Board members debated whether milk sales should be banned as well: an 8-ounce serving of 2% milk has 5 grams of fat and 120 calories; flavored milks have about 50 more calories. But the drinks are also a rich source of calcium.
“Ideally we would like to get all junk food out of the schools,” said Kaufman, “but the political process is incremental.”