Incentivizing healthy eating

The Times’ Oct. 15 editorial (“Wait a New York minute!”) on New York City’s recent actions to improve nutrition misses the mark on several counts. We disagree with a number of the opinions expressed in the editorial regarding public health efforts by Mayor Michael Bloomberg to reduce the consumption of sodium and sugar-sweetened beverages

First, Americans now consume nearly double the daily recommended amount of salt. More than 75% of this intake comes from processed foods and restaurant fare, over which consumers have little control. Excess sodium consumption is a major cause of high blood pressure, heart disease and stroke. National estimates indicate that population-wide reductions in salt intake could prevent more than 100,000 deaths a year. An effort spearheaded by New York City is underway in which the Los Angeles County Department of Public Health, along with many other health departments and organizations, are collectively working with food and restaurant industries to gradually reduce salt in their products. This approach has worked in Europe, where products similar to those sold in the United States contain far less sodium.

Second, there is compelling evidence that sugar-sweetened beverage consumption is a key contributor to the obesity epidemic among children and adults. These beverages are the single largest source of empty calories in the American diet. And unlike snack foods and other calorie-dense foods that probably contribute to obesity, sodas have the singular quality of loading on pounds without a sensation of satiety.

Education alone is usually insufficient to change behavior. There is a need to complement education with appropriate incentives. How far the government should go in this direction is an important public policy question, but not doing anything will only increase preventable health disparities, with poorer nutrition in lower income groups.

Jonathan E. Fielding is director of the Los Angeles County Department of Public Health. Paul Simon is director of the department’s Division of Chronic Disease and Injury Prevention.

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