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Nanny-State Authoritarianism of the Day

[ 167 ] June 2, 2012 |

Yes, Mayor Rich’s big soda ban is really dumb. Informing consumers about the content of products is a good thing, and I was willing to make an exception for the trans-fat ban because the health benefits were clear while the effect on consumer choice is negligible. But this kind of thing can bring out my inner libertarian. There’s also a clear class element here too; two glasses of red wine have more calories than a 24 oz. Coke, but I don’t think we’re going to see a “one and done” ban on wine service in Manhattan. (Although I probably shouldn’t be giving him any ideas…)

Update: [PC] “Per capita consumption of carbonated soft drinks has declined for 11 straight years, according to data from Beverage Marketing Corporation. Per capita consumption of sugary soft drinks is 22 percent below its peak in 1998, according to the trade publication Beverage Digest and calculations by the Center for Science in the Public Interest.” April 2010

March 20 (Reuters) – U.S. carbonated soft drink consumption fell faster last year as strength in energy drinks failed to offset weakness in traditional sodas from Coca-Cola Co and PepsiCo Inc, according to a leading beverage industry newsletter.

Total sales volume of soda fell about 1 percent in 2011 to 9.27 billion cases, according to Beverage Digest, about the same level it was in 1996. Sales volume fell 0.5 percent in 2010. Excluding energy drinks such as Red Bull and Rockstar, soda volume was down 1.5 percent last year, Beverage Digest said.

“Carbonated soft drinks, while still the biggest category, are playing a declining role in Americans’ beverage consumption,” the newsletter said on Tuesday. [Per capita soda consumption in America is now at the lowest level it's been in 25 years]

Here’s the most comprehensive meta-analysis yet of the relationship between sugary drink consumption and BMI in children and adolescents.
“Conclusion: The quantitative meta-analysis and qualitative review found that the association between [sugared beverage] consumption and BMI was near zero, based on the current body of scientific evidence.”

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  1. owlbear1 says:

    Soda Pop Cops?

  2. DivGuy says:

    My wife works at a public hospital in Brooklyn, and it’s really hard for her to be convinced by the libertariany reasons to oppose the ban. Basically, on her clinic days, she spends half her time explaining to people that two-liter sodas are full of sugar, and drinking a two-liter bottle of soda per day is actually unhealthy. Given the public hospital system, the city of New York is ultimately picking up the tab for health care, as well.

    Rates of sugar-soda intake in poor neighborhoods dwarf rates of wine intake in wealthy neighborhoods, so I don’t think that’s an entirely fair critique.

    Public health education is the best solution, but it’s not actually working terribly well. A ban that doesn’t do much more than inconvenience people (you can still buy as much soda as you want at the Duane Reade), as part of a public health education campaign, seems not like a terrible idea.

    I dunno. I was opposed until I asked her about it, now I’m not so sure.

    • Scott Lemieux says:

      Anybody who buys a large soda in these venues is informed of the calorie count.

      • Rarely Posts says:

        Which shows that disclosure is insufficient to reduce consumption.

        Also, I don’t think that the public health benefits are so unclear. I would recommend watching HBO/CDC’s the Weight of the Nation.

        http://theweightofthenation.hbo.com/

        Sugary drinks are incredibly unhealthy and are a major source of the obesity/diabetes problems that we have in this Country. There’s massive evidence that personal choice is insufficient to address this problem and that environmental effects are massive in creating the problem. One of those effects is the widespread availability of massive portions of sugary drinks. Moreover, consumption in restaurants/public places may be higher than at home because of portion size.

        Size control is a major way to discourage unnecessary consumption of goods. I doubt that people can consume nearly the calories of wine because the alcohol content in wine makes it the case that people consume less of it and, more importantly, consume it less often (not the middle of the day, etc).

        I’d shape the policy approach a lot differently: taxes, equal application, etc. I’d also focus on other aspects of the environment: encouraging walking, reducing work hours/stress, etc.

        But you often have to choose between policies that aren’t ideal to get buy-in. A good example is the 5 cent bag tax in DC-it doesn’t apply equally across all bags, it captures paper and plastic bags, which may be unfair to paper (which is probably less environmentally harmful), and that unequal application involves some political compromises that are probably irrational from a public policy/fairness perspective (but not from an interest group perspective). At the same time, it’s massively changed behavior in a way that, on balance, is very socially beneficial.

        You readily recognize that compromise is important in electing government officials; you should apply the same reasoning to legislation.

        • Rarely Posts says:

          I now see that Lindsay Beyerstein down-thread does a much better job of explaining why regulating portion size makes a lot of sense, so I would refer to her over my shoddy explanation on that point.

    • Tcaalaw says:

      Basically, on her clinic days, she spends half her time explaining to people that two-liter sodas are full of sugar, and drinking a two-liter bottle of soda per day is actually unhealthy.

      And the ban will have precisely zero effect on that behavior because, as I understand it, it applies only to sales of softdrinks in open-topped cups, not re-closable bottles.

      • DivGuy says:

        And “two-liter sodas” is a shorthand for large containers of sugar soda, of which a subset are affected by this ban.

        To Scott, I don’t know of much (any?) evidence that listing calorie counts is effective as public health education.

        • Scott Lemieux says:

          If people are making informed choices, that’s fine with me. I don’t think it’s the role of the state to compel people to live particular lifestyles.

          • DivGuy says:

            Ok, I think I see the point. This is probably the argument I was grasping for when I was talking to her last night.

            We don’t actually ban the sale of cigarettes, we just tax the crap out of them and ban smoking in places where other people will be put at risk. If we haven’t crossed the ban line with cigarettes, we shouldn’t do it with sugar-soda.

            I will say, though, that she would strongly dispute the notion that people are making informed choices, just because there’s a calorie listing posted on the premises. The public health problem is significantly one of lack of knowledge/education rather than one of personal choice.

            • DivGuy says:

              Ok, I looked it up. We do ban the sale of cigarettes based on volume. We ban the sale of cigarettes in packs of under 20, with a goal of preventing people from making a cheap purchase of just a couple of cigarettes.

              This seems quite directly parallel. I take back my partial agreement – banning the sale of harmful things in certain amounts is a public health weapon the government has wielded before. I’m back to thinking it’s mostly reasonable.

          • jefft452 says:

            “I don’t think it’s the role of the state to compel people to live particular lifestyles.”

            So, as was obvious, “inner libertarian” means inner child

            Of course the large container ban does not in any way compel people to live particular a lifestyle, or even prevent them from drinking enough soda to fill a swimming pool if they want

            It does, however, regulate the manner in which resturants sell products to the public

            “If people are making informed choices, that’s fine with me”

            Those traveling medicine shows sure were informative, if the nanny state hadn’t interfered, we could have wiped out disease by drinking turpentine

            • Murc says:

              Those traveling medicine shows sure were informative

              … no, they weren’t. They were filled with outright lies, both on the product labeling and on the claimed effects.

          • Pith Helmet says:

            I don’t think it’s the role of the state to compel people to live particular lifestyles.

            LOLWUT? The state does this all the time. Look at age restrictions on alcohol, cigarettes and gambling, for instance.

            • Scott Lemieux says:

              I didn’t think it was necessary to add “for consenting adults,” but apparently some people are determined to be obtuse.

              • Rarely Posts says:

                Because children don’t purchase sugary drinks or have them purchased for them by consenting adults? It’s the child’s fault that they’re consuming sugary drinks, and we shouldn’t regulate businesses to discourage selling them to children (directly or indirectly)?

                • Scott Lemieux says:

                  If the ban is applied only to people under 18 your analogies will become relevant.

              • Rarely Posts says:

                I don’t claim the analogy is perfect. Moreover, I don’t rely on the analogy to build my major case in favor of restrictions on purchases like this one (I discuss some of my reasons above, and Lindsay lays out a strong argument below). But to suggest that analogies to age restrictions have no relevance in a context where an over-broad regulation may be the only way to impose age restrictions is a little strong, don’t you think? I suppose your position may be that it’s never acceptable to pass an overbroad regulation that captures adult conduct to protect children when that’s necessary from a practical perspective (obviously we’re not going to ban children from restaurants, as opposed to gambling establishments, etc.), but that strikes me as utterly unpersuasive.

                If you want to persuade people who disagree with you, you’d respond to the stronger arguments, not the weaker ones. You’d also foresee obvious rejoinders to your responses. But, if you’re not interested in persuading others, I suppose that’s your business.

                • chris says:

                  (obviously we’re not going to ban children from restaurants, as opposed to gambling establishments, etc.)

                  If we weren’t going to ban smoking in restaurants entirely, banning children from restaurants that allow smoking seems to me like a perfectly reasonable middle ground. Although it would sit a little oddly with the fact that smoking around your children isn’t officially recognized as child abuse.

              • Bart says:

                You seem to have eaten the same cranky bars that Eric was into concerning the VN vets.

              • Dave says:

                Oh well, there goes socialism…

          • Murc says:

            I don’t think it’s the role of the state to compel people to live particular lifestyles.

            Uh.

            No offense, Scott, but you absolutely do. You’ve made posts to that effect.

            If you’re in favor of eliminating the structural factors that compel suburban sprawl with structural factors that compel denser, walkable urbanism, you are in fact in favor of the state compelling particular lifestyles.

            I for one don’t have a huge problem with the state doing so, I’d just prefer it do so in productive ways. The soda thing seems dumbassed to me, because there are no significant externalities involved, which tends to be my personal litmus test. I’m opposed to the aforementioned sprawl because it is unsustainable and is contributing to destroying the planet we all live on; I have a hard time being convinced we should give a damn about soda as long as people are entirely informed as to what’s in it and have other options to pick from.

            Which they do. You want to suck down a ton of sugar water, restaurants should be able to pack a wading pool full of the stuff to your table should you so choose.

            • Scott Lemieux says:

              ?

              I may have blogged against subsidizing suburban sprawl in some ways, and I may have blogged about ended certain kind of regulations that make density impossible even where there’s demand for it, but I’ve never suggested that the state should actively compel people to live in dense urban areas. The big soda ban is consistent with what I opposed.

          • Bijan Parsia says:

            I think other people have jumped on it, but again, what’s the lifestyle that’s being compelled? Being able to buy 32oz cups? Presuming that the actual lifestyle is “drinking such and such amount of soda”, then this isn’t banning it but trying to align the incentives and affordances against it. Since the sellers are trying really hard to align the incentives and affordances for it, and the behavior has negative externalities, I don’t see what the problem is, per se.

            (Whether it’s effective compared to e.g., taxing or direct price regular, or whether it’s worth the backlash is a different issue.)

        • Tcaalaw says:

          And “two-liter sodas” is a shorthand for large containers of sugar soda, of which a subset are affected by this ban.

          I’m curious as to where you find anybody selling “two-liter sodas” in open-topped cups. Two liters is a larger volume (68 ounces) than even a 7-11 “Double Big Gulp” (64 ounces).

    • Lindsay Beyerstein says:

      I don’t buy the red wine/classism argument.

      Liquor serving sizes have been regulated for ages. A lot of liquor laws ban double shots in a single drink, even though you can buy two rounds in a row. Bloomberg is borrowing that model for soft drinks. You can buy two large Cokes if you want, but not one huge one.

      That makes sense from a public health perspective. The consumer gets to decide how much to drink, but if s/he wants more, s/he has to choose to order another round. There’s a ton of research that shows that people drink or eat what’s in front of us, regardless of our internal cues. So, a person is way more likely to finish a double they’ve already ordered, even if they would have stopped after a single.

      Brian Wansink’s research on mindless eating has found time and time again that we regulate our consumption by the number of units, rather than the absolute amount of food or drink. So, someone who normally eats 3 slices of pizza for dinner will eat 3 huge slices or 3 medium slices, or 3 small slices and rate themselves equally full and satisfied at the end.

      If Bloomberg’s experiment works, it will be a real-life test of Wansink’s theories. I predict that people will find themselves equally satisfied by drinking the same number of “large” Cokes as they ever did, even though those drinks will contain fewer ounces of soda.

      • LeeEsq says:

        I think the theory behind the law is that even though people can theoretically get around it by buying two cokes rather than one larger one, very few people are going to do this for various reasons. So ultimately, calorie consumption will go down.

        And Scott’s argument about it not being the states role to compel people to live certain lifestyles makes no sense from a public health perspective. Proper public health requires a certain amount of forcing people into healthier lifestyles by at least making bad choices inconvenient. Smoking wasn’t banned put by various measures, we were able to reduce it by making it inconvenient.

        • DivGuy says:

          While we don’t ban cigarettes entirely, we do indeed ban the sale of cigarettes in certain volume. Packs of under 20 cigarettes are banned. This seems pretty comparable to that law.

      • Jamie says:

        I hav to wonder, what is the lower bound to this sort of thng? And what sort of research should be considered sufficient for enacting an artificial constraint like this?

        If “nudges” are to be the rule on public health, let’s keep in mind how often the officials have been completely wrong, have other motives (“pork- the other white meat” was heavily state sponsored), or (perhaps closer to the instant situation) a hobbyhorse of some dude with power.

        I’d also note this is a wonderful reason to support various efforts to make purchases on EBT/other forms of food assistance more restrictive. After all, if we are dictating portion size to consumers with their own money, shouldnt we spend at least as much time policing those who require public assistance?

    • David M. Nieporent says:

      The “best solution” is to mind your fucking business. Only a liberal could think aborting a fetus is a matter of personal choice of nobody’s concern except the woman, but what that woman eats or drinks is a matter of “public [sic] health.”

      • Bijan Parsia says:

        Abortion and family planning in general are quite obviously part of public health (not sure why the “sic”; “public health” is a well understood and useful concept). I’m not sure who would deny this.

        I’m pretty sure that liberals want abortion providers to be as tightly regulated as any other health providers.

        I’m also pretty sure that liberals support contraception and, in particular, measures to increase availability and safety of contraception. In general, avoided pregnancy is safer than terminated pregnancy.

        • David M. Nieporent says:

          Public health is a useful concept that has been distorted beyond all recognition. It originally referred to infectious diseases like smallpox, or ones like cholera in which the transmission vector was public infrastructure itself (i.e., the water supply). But since those types of ailments were mostly controlled, the public health establishment needed to find a new arena in order to keep themselves employed, so they expanded the term until it encompassed the most private of matters, like one’s diet. Obesity is not “public health.” If obesity were ‘public health,” then the term would have no meaning, as there would be nothing left of private health.

          • Bijan Parsia says:

            That’s clearly wrong:

            Public health is “the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals” (1920, C.E.A. Winslow)

            Public health is closely related to population health. Since we have population level increases in obesity (pace measurement issues), it’s clearly a public health issue.

            Besides, you are being very silly with your wordplay. It’s not “public” vs. “private” health issues and diet clearly isn’t “the most private of matters”, certainly no more than any other health issue. (Esp. since what we eat is massively guided by subsidies, education, regulation, etc.)

      • Anonymous says:

        So you don’t believe there is such a thing as public health. It’s nice to know that you’re not merely a prick, but a dumb one as well.

        • David M. Nieporent says:

          See above: I do think there’s such a thing as public health. I just don’t think that lifestyles that affect only one’s own health could possibly be deemed issues of public health.

      • Jamie says:

        I agree that what the woman eats is her own business, but your non-sequitur about abortion is fucking weird, though. [sic]

        But much like Bloomberg, you seem to be consistent with your own pet control issues. Unlike Bloomberg, yours are very harmful, whereas his are just stupid any annoying.

        • David M. Nieporent says:

          My comment about abortion is to show a contrast between the attitudes towards regulation of one private behavior and another. Most liberals think that not only should abortion be readily available, but that the government has no business trying to paternalistically “nudge” women into making a particular choice. Why? Because it’s a personal matter, and nobody’s business but the woman’s.

          But when she’s choosing what to eat, all of the sudden the government should be throwing up all kinds of obstacles towards the disfavored choice?

  3. Manju says:

    But this kind of thing can bring out my inner libertarian.

    Careful, Scott. This is how it starts. Next comes rent control and before you know it you prefer Neil Peart over Ginger Baker.

  4. 33lp says:

    How many of the calories in wine are delivered in the toxic form of high-fructose corn syrup? Have grape farmers been receiving massive federal subsidies to stabilize wine prices to be artificially low year after year, resulting in wine pervading industrial food production as a key ingredient in everything from bread to salsa?

    I refer you to the findings of Dr. Lustig at UCSF as presented in this concise (ha!) 90-minute video: http://www.youtube.com/watch?v=dBnniua6-oM A calorie is a calorie, except when it comes from fructose, and then it metabolizes in unfortunate ways. [Yes, sugar (sucrose) is just as metabolically evil as fructose (sucrose = glucose + fructose), but historically, the price of sugar has been volatile, making the food industry wary of incorporating it as a key ingredient in anything it doesn't have to.]

    But yeah, the mayor’s approach to dealing with this seems sorta dumb. Probably has something to do with aspirations of higher political office.

    • Scott Lemieux says:

      1)Is there real evidence that corn syrup is worse for you than any other kind of sugar?

      2)I agree that subsidizing the production of sugars and starches is a terrible idea. The solution to this is to end the subsidies (or, more realistically, subsidize the production of vegetables), not arbitrary, class-targeted local regulations.

      • DivGuy says:

        I think the argument isn’t that fructose is a bad kind of sugar, but that sugar is a bad kind of calorie. (The linked video is “Sugar: The Bitter Truth”.)

        • Richard says:

          That was the argument presented on 60 Minutes about two months ago. Calories obtained from sugar are worse for you than calories from other sources and that calories obtained from fructose are worse than calories obtained from sugar found in fruit because the fruit pulp somehow allows the body to asborb the sugar better (I’m a lawyer, not a scientist, so the fine points of the argument went in one ear and out the other)

      • owlbear1 says:

        A Princeton University research team has demonstrated that all sweeteners are not equal when it comes to weight gain: Rats with access to high-fructose corn syrup gained significantly more weight than those with access to table sugar, even when their overall caloric intake was the same.

        In addition to causing significant weight gain in lab animals, long-term consumption of high-fructose corn syrup also led to abnormal increases in body fat, especially in the abdomen, and a rise in circulating blood fats called triglycerides.
        http://www.princeton.edu/main/news/archive/S26/91/22K07/

        A recent study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM) found that adults who consumed high fructose corn syrup for two weeks as 25 percent of their daily calorie requirement had increased blood levels of cholesterol and triglycerides, which have been shown to be indicators of increased risk for heart disease.
        http://www.sciencedaily.com/releases/2011/07/110728082558.htm

      • R Johnston says:

        1)Is there real evidence that corn syrup is worse for you than any other kind of sugar?

        When it comes to sodas at least, the evidence is pretty conclusive that there’s no meaningful difference at all. In sodas made with sucrose the sucrose slowly hydrolyzes into 50% fructose and 50% glucose, but slowly is fast enough given the typical length of time between production and consumption that hydrolysis is complete. HFCS, contrary to popular belief, is only 55% fructose, meaning the chemical composition by the time you drink the soda is almost exactly the same whether the soda is made with HFCS or with sucrose.

        • owlbear1 says:

          And what actual “evidence” is that?

          • R Johnston says:

            That would be people measuring the level of sucrose in sodas on supermarket shelves made with sucrose and finding almost none left. Links not turning up in a quick google search, but neither are contrary links.

            The fact is also that there is a lot of woo about HFCS and a lot of obviously poorly designed and controlled “experiments” to justify the pre-existing conclusion that HFCS is especially bad for you. The HFCS hysteria is highly reminiscent of anti-vax bullshittery.

      • Richard says:

        Yes. The research shows that sugar through fructose corn syrup is worse for you than sugar acquired through plants or fruit that has pulp. Sugar from diet coke seems to be much worse for you than sugar through oranges. And the research shows that sugar calories are worse than regular calories. Wine has no sugar and it appears that two glasses of wine, despite the caloric intake, is nowhere near as bad as two liters of diet soda

        • Richard says:

          60 minutes did a show on this about two months ago. Convinced me to give up sodas

        • DivGuy says:

          Diet soda has no sugar. Artificial sweeteners aren’t sugars. I know of no evidence whatsoever that sugar-free drinks are bad for you in a bad way at all comparable to sugar drinks.

          • Richard says:

            Watch the Sixty Minutes show from a couple months ago and see if you have the same opinion after watching it. It presented the view that sodas and diet sodas are deadly . Since I don’t need sodas to survive, I gave them up.

            • R Johnston says:

              Pop science bullshittery is bullshittery. If you get your science from 60 minutes you’re doing it wrong.

              Megadoses of artificial sweeteners in lab rats and poorly controlled surveys of people that don’t account for the overall diet that tends to correlate with drinking lots of diet soda really have nothing to say about the health effects of drinking diet soda rather than water, and you’ll find that every pop-culture scare about diet soda resolves down to being based on one of those two inherent flaws if they’re based in anything at all.

            • elm says:

              Whether or not diet soda are deadly is not the point: diet sodas contain no sugar and are, therefore, irrelevant to the question of whether one type of sugar is worse than another type of sugar.

            • djw says:

              Are you actually claiming that a 60 minutes segment proved that diet soda does, in fact, have sugar in it? Because that would be quite a scandal.

      • 33lp says:

        I agree with point 2, so, addressing Point 1: No.

        While fairly well-informed, I am not an expert, but to my knowledge, there is no evidence that high fructose corn syrup is worse for you than table sugar (sucrose), which is the relevant comparison for this discussion.

        (There are many kinds of sugars, e.g. glucose, which is in mother’s milk, and is “good for you,” so let’s limit this to sucrose/fructose.)

        Comparing table sugar (sucrose) and fructose metabolically, it’s a wash. The short version is, A sucrose molecule consists of a glucose molecule and a fructose molecule connected by a weak ether bond (which is immediately broken in the digestive process by the enzyme sucrase). Half of whatever table sugar you ingest is fructose. Metabolically, sucrose and fructose are close to equally evil. (I think of it this way: table sugar is AS BAD FOR YOU as fructose.)

        Fructose, however, is far more economically evil than table sugar because it is consistently cheap on an industrial scale. It’s consistently cheap because it’s subsidized, and has been so for decades. Its consistent cheapness makes it a viable option for the manufactured food industry to put in EVERYTHING (which they have to do to balance all the sodium they put in EVERYTHING, which they have to do to obscure the shitty taste of the low-quality ingredients they put in EVERYTHING).

        Chronologically, the pervasivenes of HFCS in the American food supply correlates with the American obesity epidemic.

        • 33lp says:

          While I was composing my response, owlbear1 was making significant contributions upthread. In light of those contributions, I would like to amend the preamble of my response to Point 1 to “Yes.”

          Thank you, owlbear1.

    • Ronnie Pudding says:

      You could also argue that corn syrup in soda is a less worthy target because people know it’s there. My problem with our corn sugar policy is it encourages industry to put it in unexpected places.

      And this has nothing to do with aspirations for higher office. For what office could Bloomberg possibly think this will help him?

  5. West of the Cascades says:

    Also, isn’t there something just fundamentally stupid about banning a particular size of a product? What is to stop someone from ordering TWO 16-ounce drinks at the same time? I see that “free refills or purchasing additional beverages” would be allowed.

    I guess perhaps this is about symbolism and raising awareness rather than actually preventing some harm, but it seems sort of pointless if that’s the main purpose.

    • Lindsay Beyerstein says:

      Actually, there’s a lot of research that shows that we regulate our consumption by the number of units rather than the absolute quantity of food.

      The goal isn’t to forcibly keep people away from soda, if that’s what they want. The goal is to create an environment where people have to think about how much soda they want. Right now, it’s advantageous for the soft drink companies to vastly upsize the containers because the raw ingredients are basically free and even the pittance that it costs to super-size a drink is pure profit for them.

      This is being framed as an issue of “freedom” to buy the largest size available, but we didn’t choose the sizes, the soft drink companies did. They’re playing on consumers’ well-documented tendency to buy more than they actually want if the larger amount seems like a better deal. Of course, once we buy too much, we’ve got a separate–and fattening–tendency to drink it because it’s there.

      Companies know our cognitive biases and limitations and exploit them to the hilt for their profit, often to our detriment. You could just as easily argue that a restriction on maximum cup size is a hack to expand our freedom of choice by engaging our higher cognitive faculties instead of relying on our unreliable instincts.

      • CashandCable says:

        Sarah Kliff made the same argument over at Wonkblog. As long as they don’t try to regulate your actual consumption of soda (as opposed to container size), I think we’ve got a real chance to make a positive impact on health without unduly impinging on rational individual decision-making. I think the knee-jerk reaction against this can be ascribed to the increasingly obsolete libertarian notion that day-to-day decisions are always driven by calculation rather than perceptual cues. In many ways, this legislation uses Thaler and Sunstein’s idea of Libertarian Paternalism – if you really want to have that extra soda, you can do it, but you have to make a little more of an affirmative expression of will to override the default settings created by smaller portion sizes.

      • John says:

        Yeah, exactly. The point isn’t that they’re forbidding people from buying 24 ounces of soda. They’re forbidding retailers from selling cups that contain 24 ounces of soda.

        And, of course, they already do this with alcoholic beverages, so Scott’s wine analogy is ridiculous. You can’t buy a “super-gulp” glass of wine that’s twice the size of a normal glass of wine. If you want two glasses of wine, you have to order two glasses of wine.

        All the people saying, “Well, I’ll just order two medium sodas,” are missing the point. Of course you can do that. The point is that people who aren’t being purposefully petulant are much less likely to do that.

        • Bijan Parsia says:

          I certain observe that it’s REALLY HARD for me to not by the next size up if the price difference is really low (as it typically is). As a first approximation, 2 mediums of any drink costs nearly twice as much as any large, regardless of the comparative volumes. Both the bargin aspects and the avoiding getting “ripped off” aspects are pretty powerful. I had to work pretty hard to train myself to decide what I actually wanted and buy only that. Doesn’t always work, if only because what I “actually” want is partially guided by what’s available.

        • djw says:

          You can’t buy a “super-gulp” glass of wine that’s twice the size of a normal glass of wine.

          If true, that must be a New York rule. A disreputable bar I used to frequent in Seattle would sell their “duct tape wine” (mystery red wine, bottle covered with duct tape) by the pint glass for $5 dollars.

    • Anonymous says:

      “What is to stop someone from ordering TWO 16-ounce drinks at the same time?”

      Nothing at all
      I guess the “nanny state” isn’t trying to micromanage every aspect of your life after all

  6. Incontinentia Buttocks says:

    Like Scott’s, my inner libertarian is troubled by this.

    But I agree with Lindsay that this makes sense from a public health perspective. And given that I feel perfectly comfortable with any number of other portion-related regulations on the sales of, e.g., cigarettes and alcoholic drinks, I think my inner libertarian is being unreasonable (or at least very inconsistent) in objecting to this.

    (Of course I’ll feel differently when the Broccoli Mandate arrives! ;-) )

    • Bill Murray says:

      I think inner libertarians are usually just as bad as outer libertarians

    • Bijan Parsia says:

      What’s the libertarian story that should be troubling?

      I mean, qua consumer, I don’t see what the big deal is. Most every bit of what is offered to me is out of my control, even in some aggregate sense. The decisions of what is offered to me is made by powerful people in charge of huge organizations with little democratic control. Now some other powerful person in charge of a huge organization with somewhat more democratic control is tweaking the decision some other way and I’m supposed to get all bent out of shape?

      Wait! Ignoring the de facto power of corporations is pretty libertarian.

      (All this is orthogonal as to whether the ban is a good idea. I think tackling portion size is probably the right place to focus. Portion sizes have been ratcheted up and it’s well known that portion control is important.)

      • Cody says:

        Obviously you’re missing the point of those huge “non-democratic” corporations! Thanks to our wonderful capitalism you’ve elected those CEOs who gave those orders by spending the money in your wallet on products they successful oversaw.

        Really, the CEO is more democratically elected then the President, because his is based on “Real results” (really emphasize those quotes…) of increased profits, where as the President is elected by how much money large donors are willing to give.

  7. wengler says:

    If people here want to support this ban, go right ahead but the politics on this are terrible.

    I remember going to Brooklyn last year and the calories were spelled out on the menu in the fast food restaurants. I thought ‘this should be everywhere’. This drink ban, however, is very much in the same vein as states with arbitrary liquor laws from mini bottles to 3.2 beer. If you want to make an argument that these are effective policies in the realm of public health, good luck to you. I just see the sniveling little mayor that loves to beat up and arrest protestors and frisk every black person on the street sending down another policy from on high restricting something he doesn’t use.

    • ploeg says:

      Well, then you have the people who will be pleased that restaurants are no longer selling containers of soft drink that are so large that the purchasers of said containers end up losing control and spilling half the contents all over the subway and the folks next to them. People will learn to cope with it.

    • JL says:

      “I just see the sniveling little mayor that loves to beat up and arrest protestors and frisk every black person on the street sending down another policy from on high restricting something he doesn’t use.”

      Thank you. I was starting to think I was practically the only lefty who had this reaction.

      And where does it stop? People do all sorts of things that might lead to bad health outcomes that the public has to help pay for.

  8. MPS says:

    I don’t think this is true.

    Online search says 5 oz of wine is 106 calories. That’s a full glass I believe.

    Online search says 24 oz of soda is 290 calories.

    This isn’t to say it’s not stupid to ban large sodas.

  9. greylocks says:

    A reasonable compromise might be to require sellers to price their drinks relative to their size. If a 16 oz is $1.29, require that the 32 oz be no less than $2.58. And maybe collect some of the difference as tax to use for public health education.

    Much of the problem is the perception that the larger sizes are a much better value.

    At the gas station down the road from me, the pricing is .99 for 20 oz, 1.09 for 32 oz, 1.19 for 44 oz, and 1.29 for 54 oz. The only reason I can think of not to buy the 54 oz is cup is hard to hold onto.

    • Bijan Parsia says:

      Yes exactly.

      I expect loss aversion is a big component. If you buy the 20oz one and end up wanting a bit more, then you’re out at least another .99. If you bought the 32oz and only wanted 22oz, then you are out maybe a nickel.

      Of course, once you bought the 32oz, the inclination is strongly to drink it all.

  10. Jhaygood says:

    Part of the problem is the bizarre pricing at places like movie theaters: $3.00 for a small drink, $3.25 for a medium and $3.50 for extra large. The skewed pricing encourages buying big, and you kind of feel like an idiot buying a small.

    • Pinko Punko says:

      Movie theaters are the ones that invented giant portions. Popcorn and soda are pure profit, so they can give you the appearance of “value” for quantity because it costs them nothing to put it in a larger cup. The soda and popcorn are that cheap.

  11. AcademicLurker says:

    Regarding your “most comprehensive meta-analysis:

    Gotta be careful picking and choosing studies.

    • Paul Campos says:

      The majority of studies that have looked at the relationship between sugary drink intake and BMI have found no statistically significant correlation between them, let alone a causal relationship. The evidence, such as it is, for diet soda (which has no sugar in it) correlating with obesity is actually better. So apparently diet soda “causes” obesity, while obesity “causes” declines in sugared soda consumption, which is down 25% per capita since the late 1990s.

      • 33lp says:

        On the related point of sugar and HFCS consumption, sugary beverage consumption is only part of the story, because HFCS pervades our “manufactured foods” supply. It has made its way into just about every kind of food you did not personally make from scratch.

        For example, McDonald’s menu has only seven items that don’t have HFCS or sugar: french fries, hash browns, chicken mcnuggets (w/o dipping sauce), sausage, diet Coke, coffee, and iced tea (the first four are health disasters for other reasons).

      • DivGuy says:

        So, you linked to a study which had been demonstrated to be faulty, a study for which the meta-analysis if done correctly actually showed a significant relationship between sugar-soda intake and BMI, and now you’re claiming without evidence that a “majority” of studies don’t show a relationship. Ok.

      • Bijan Parsia says:

        Since I’m nitpicking…what’s your search that yields a set of studies such that the majority fail to show a correlation? Cf the USDA systematic review below and even the blog post I found.

  12. I don’t think anyone’s referenced libertarian paternalism yet, so Imma do that.

    It’s the idea that in some situations forcing people to make choices among a limited set of options is inevitable. And sometimes the way those options are presented has an influence on citizen/consumer behavior. So the state can try and get more people to choose the choice which makes the most sense from a pragmatic/public policy standpoint based on the way those choices are presented.

    The classic example is presenting people the option to contribute to a 401K / retirement plan offered by their employers automatically from their paycheck. You can opt in or opt out, completely your choice. But a fairly sizable number of people just do whatever the default option is. If the program default is “opt in”, they keep the opt in setting. If the default is “opt out”, they keep the opt out. Because there is a significant public policy interest in getting people to contribute to these retirement programs, it just makes a lot of sense to make the default “opt in”. That’s the theory, anyway. Preserving choice while also using choice architecture to advance public policy goals. (The two dudes pushing it are Richard Thaler, behavioral economist, and Cass Sunstein, law professor/current head of federal office which sets regulatory rules. Their book is called Nudge.)

    And it seems like the soda thing is an ok application of that general idea (I think several comments have danced around the idea). People are going to consume different sizes of soda, that’s inevitable. But, as Lindsay Beyerstein pointed out, there’s just a fuckton of research which indicates people aren’t thinking about what they’re consuming when they buy the megagulp in a whole host of ways, that they would be just as happy with smaller portions, and that there is an undeniable public health interest in seeing that people don’t mindlessly consume 2.5x the amount of HFCS they’re satisfied with.

    So. Preserve choice by letting people buy as much soda as they want, but apportion it in smaller sizes. This makes people think about what they’re actually buying, and think about how much they’re consuming while they’re consuming it.

    This application even avoids the general critiques of the libertarian paternalism idea that are, in general, pretty devastating.

    There is something this overlooks, which is that there is an implicit tax on larger amounts of soda since you now also have to by the containers for multiple smaller portions instead of just one container you pour a small pond into. But if you accept the public health indictment of HFCS there isn’t much of an argument against taxing that stuff anyway, especially when you’re just taxing high levels of consumption of the stuff.

    I don’t know if I fully buy in to this analysis, but it’s a way to think about it that I didn’t think had been brought up yet.

    • tonycpsu says:

      I expected a ton of push-back against this from the usual suspects (“I’ll wash my 16 ounce burger down with a 32 ounce soda and then wipe my ass with a photo of Michelle Obama growing arugula in her garden, because THIS IS AMERICA, DAMN IT!”), but to see so many prominent liberal outlets bashing it even after the initial knee-jerk period has expired has been a genuine surprise.

      Yes, the optics of the state getting involved in drink sizes are pretty awful at first, but why should we as a society stand idly by while consumers are pushed toward the profit-maximizing drink size when it causes demonstrable societal harm? Beyerstein (above) and Kliff (linked above) have the right idea — give people a better “default” option and they’ll make better choices. The only real incursion upon liberty is that soft drink makers and theater/restaurant owners can no longer profit by steering customers toward drink sizes they don’t really want.

      I think all the bickering about whether HFCS is worse than regular sugar, or whether sugary soft drinks are the evilest of all evils is pointless. We all know that Americans drink too many sugary soft drinks, and that they provide no nutritional value, so why not give this a shot and see how the experiment unfolds. We can watch how the prices change, see if drink purchasing decisions change, see if consumption changes… I don’t think anyone including Bloomberg is selling this as the solution to the obesity problem, but as an attempt to do something. Where is the down side, other than attacks from wingnuts who have to sleep with the lights on to keep the nanny state from strangling them at night?

      • JL says:

        What liberal outlets are bashing it? Please point me at them. I would love to see some fellow liberals agreeing with me on this one. I’m bewildered that so many liberals appear to want to be libertarian caricatures of liberalism.

        Also, I thought that vendors had higher profit margins on smaller-sized drinks, not lower.

        • Bijan Parsia says:

          I think it’s perfectly reasonable to look at the food chain for possible public health interventions including nutrition based ones. Whether this one makes sense is an open question, though given the negative optics and the (afaict) weak outcomes, I’m not yet a fan of this one. (To compare, calorie labeling is really awesome but doesn’t seem to have any population level benefits.)

  13. Joe says:

    a “one and done” ban

    I thought the idea is portion size, not the inability to buy two sodas instead of one big one.

    And, what about beer? Is beer less calories? I guess the next target are large beer cans.

  14. Joe says:

    Why exactly is he doing it now?

  15. 33lp says:

    And here is the critical debunking of the flawed industry-funded meta-analysis Scott cites in his Update.

    • 33lp says:

      Or is that Paul Campos doing the updating? I dunno what the [PC] is supposed to indicate.

      • Joe says:

        From the NYT article:

        “The sale of any cup or bottle of sweetened drink larger than 16 fluid ounces — about the size of a medium coffee, and smaller than a common soda bottle — would be prohibited under the first-in-the-nation plan, which could take effect as soon as next March.”

        It depends on where you get the “medium” coffee. A large coffee often is less than 16oz, unless you get it at a chain. Also, “a common soda bottle” is what now? The bottle there is for several people, right? For one person, isn’t 12-16oz the “common” size?

        Anyway, I get diet soda anyway. I can’t deal with the sugar in a regular, especially from the tap. Also, it doesn’t cover “milkshakes, or alcoholic beverages.” You know how fattening over 16oz milkshakes are? Though less people get them.

      • Paul Campos says:

        It’s to say the least extremely unclear if differential consumption levels of sugared beverages play any causal role whatever in weight gain at a population-wide level.

    • elm says:

      Here’s an editorial in the same journal, unfortunately behind a paywall: http://www.ajcn.org/content/94/5/1161.full.pdf+html

      Take home quote: “Although more research is needed, the weight of the evidence based on previous systematic reviews and meta-analyses of prospective studies shows clear and consistent associations between SSBs [Sugar-Sweetened Beverages] and obesity and related cardiometabolic diseases. This evidence is also supported by findings from mechanistic and experimental studies…Statements from the American Heart Association, the American Academy of Pediatrics, and the US 2010 Dietary Guidelines technical review committee (14)
      all call for reductions in intake of SSBs to prevent obesity and improve health. These recommendations are based on previous
      systematic reviews and meta-analyses. Despite attempts from the beverage industry to obfuscate the issue by funding biased analyses and reviews, and by providing misleading information to consumers, many regulatory strategies to reduce intake of SSBs are already in place.”

    • elm says:

      Same journal, same damn paywall, from this year: Adam M Bernstein, Lawrence de Koning, Alan J Flint, Kathryn M Rexrode, and Walter C Willett “Soda consumption and the risk of stroke in men and women,” J Clin Nutr 2012 95: 1190-1199.

      Conclusion: “Greater consumption of sugar-sweetened and lowcalorie sodas was associated with a significantly higher risk of
      stroke.”

      This is just one study, though, and the authors themselves acknowledge it is one of the first to look at the relationship between soda and stroke, so I wouldn’t want to make too much out of the results.

      Personally, I’m not really fond of this ban and I drink a whole lot of (low calorie) soda, but it doesn’t seem like Paul is providing an accurate state of the literature on the health effects of sodas.

      • Paul Campos says:

        Elm there are a lot of studies on this and they don’t add up to anything even remotely like a scientific consensus that sugary drinks cause weight gain (or diabetes etc).

        There’s nothing approaching anything like a rigorous demonstration that fat people drink more soda than thin people, for example.

        • elm says:

          Fair enough. There does seem to be debate, even in the pages of the American Journal of Clinical Nutrition where we found articles articulating each view point. However, you said above, “The majority of studies that have looked at the relationship between sugary drink intake and BMI have found no statistically significant correlation.”

          This appears to be false: the reviews and meta-analyses published in the past couple of years suggest that the majority of studies have found a correlation. From what I can tell, though I’m not expert on this topic, the weight of evidence seems to be that soda is bad for you, though not everyone agrees with this. (There are also accusation that those who don’t agree are being funded by the beverage industry. In the study you cited, the research was done at an institute that has taken money from Coke and Pepsi and one of the co-authors has since been hired by the American Beverage Association. While industry funding doesn’t always lead to bad science, I think we are rightly skeptical when oil companies tell us there is no global warming and I think we should probably be skeptical of the beverage industry telling us soda isn’t bad for you. On the flip side, I’d be skeptical of studies from the diet industry telling us that soda is bad for us.)

    • Pinko Punko says:

      The update is Paul Campos, and unfortunately I am not comfortable (in either direction) in his citations from the literature. I would certainly love to have some actual expertise on these issues. Also the slippery slope argument he makes below just doesn’t cut it. A stick of butter has more calories that a giant coke. So what? An Awesome Blossom and sauce at Chilis has like 1 billion calories per serving. The way to deal with these is display calories prominently on menus. This is a start. I really don’t care about the ban. It is in essence a tax that does not cost money. It is a behavior tax. “I’ll have three cokes and a #2 value meal”

  16. David says:

    Calorie comparison between wine and soda is terribly off. SOMEONE IS WRONG ON THE INTERNET!!

    No, really, most sodas are in the 120-160 calorie range per 12 ounces. Red wine is 85-110 ( and white wines are less caloric generally) per 5 ounce serving.

    The ban is a dumb idea, but there’s no need to slander delicious red wine.

  17. DocAmazing says:

    All this is leaving out the destructive effects of phosphoric acid on your bones. Virtually all brown sofas (colas, cheap root beers) contain significant amounts of phosphoric acid. That crap’ll give you osteoporosis.

  18. BradP says:

    I appreciate that portion caps are a subtle nudging. It is a clever method for shifting behavior without greatly infringing on the actual choice.

    A lot of these really clever ideas, however, can convince people that there will be profound effects, when the complex factors at hand can really undermine them. I thought this was a pretty interesting critique.

    And I know the feeling doesn’t really register on here, but the whole idea seems perverse to me. The combination of the scope and pettiness: Making sure millions of people cannot be served a soft drink in a container bigger than 16 ounces? Wow

    • Pinko Punko says:

      I love the things that generate “wows” for BradP. I also love the things that somehow do not generate wows from BradP. Some things are more perverse than others.

      • BradP says:

        Controlling the soft drink portion sizes of all the vendors in a city of 8 million is no small task. Doing so in order to bring about a slight shift in a consumer’s perspective seems like some serious overkill. It gets a wow.

    • joejoejoe says:

      Mayor Bloomberg is nudging people to believe that all government is capable of is small-bore nonsense like regulating cup sizes. This microgoverning teaches voters that government really doesn’t matter, not that government can do great things.

    • I’m down with the “complex effects undermine intended outcome” thing, but that argument you link to is very “Econ 101″ that doesn’t take a step back and think about what it’s actually saying. (This is probably a more elaborate response than is called for but given the topic: fuckit, I’m gettin the large).

      His entire spiel is about restaurants which both offer refills and differently-sized units of soda consumption. So, a portion of McDonalds et al’s soda business which itself is a portion of the overall market that is being targeted.

      He makes a big deal about how people will be able to refill their sodas to get as much as they would have drank before hand only at a lower price. Well, they can, but they won’t, see Lindsay Beyerstein above.

      Then he talks about wealth transfers between people who are drinking the same amount of soda at a reduced cost and people who would have only drank 16oz is fairly small because the difference to the consumer in the price of small and large drinks is fairly small. So even if he’s completely right the consequences he’s talking about are very small. If the cost of a soda goes up five cents, how many people are no longer going to buy that soda? Very few. If there’s subsidization going on, how much money are we talking about? Very small overall, very very very small per person. Fairly meagre health benefits would swamp out these concerns in a New York minute.

      Second, some of the consequences he’s worried about are the goals of the program. They want to get people to stop drinking soda. Pointing out that the program will lead some people to stop drinking soda is . . . silly. And even though the total amounts of soda the <16ozers are foregoing aren't that big a deal health-wise, the less of an unhealthy thing a person consumes at any particular point, the less she incorporates it into her diet overall and in the future. From this standpoint any reduction is a good thing.

      And before you point out that it's not the <16ozers we're worrying about, it's the big gulpers, the big gulpers will be consuming less soda too (that's the Lindsay Beyerstein stuff).

      I think the way to attack this thing is through the supposed health benefits like Campos has been doing, which would also do more good for advancing the discourse on health in general. Going after the economics of it in such a slipshod manner won't advance public ideas on anything, and won't even be that useful on its own terms since various schemes can always be engineered to get around even these feeble critiques.

      • Pinko Punko says:

        Actually, I think refills kind of behave like larger sizes- people get refills [I think this, can't say I know it] because they can, not necessarily because they are thirsty. The same as getting the large, you think you are passing up value. The same way some people who don’t mind ice ask for no ice. MORE VOLUME FOR SAME PRICE=VALUE MONSTER SATISFIED. It is a mess.

      • Tcaalaw says:

        He makes a big deal about how people will be able to refill their sodas to get as much as they would have drank before hand only at a lower price. Well, they can, but they won’t, see Lindsay Beyerstein above.

        I’d say that research is profoundly flawed in that it assumes that consumers are incapable of changing their behavior. Over the past several years, I’ve successfully converted at least two dozen people (including all members of my immediate family) to buying the smallest size beverage and getting refills as a cost saving measure when eating in a dining establishment that offers multiple beverage sizes and free refills.

  19. joejoejoe says:

    I hate this chicken-shit public health noodling from elected officials.

    If Bloomberg really gave a shit he’d work to try and pass something like Healthy San Francisco, a rudimentary universal health care system. Instead he’s waterboarding Big Gulps in the name of America.

    What’s worst of all is this kind of penny-ante move gets Mayor Bloomberg portrayed as a health hero and Mayor Newsom painted as the Patron Saint of Overreach for actually providing health care.

    A Venti Mocha at Starbucks has more caloreis than a 32 oz. Big Gulp but you won’t see Bloomberg telling people at cafes they are too stupid to manage their own diet. This is some classist bullshit.

    I hate autocrats of all stripes.

  20. Matt Heavner says:

    I like facts. The “American Beverage Association” ran a June 1 full page NYT ad full of “facts” that were, in fact, not so factual. The ad said something along the lines of:

    “FACT: … sugar-sweetened beverages are not the No. 1 source of added
    sugars in our diets — food is.” (THIS IS NOT A FACT!)

    Coincidentally, I saw a Nat’l Academy of Science tweet claiming:

    “FACT: Sugar-sweetened beverages represent largest share of calories
    in diets of individuals aged 2 and up”

    This tweet was from The National Academies of Science and references
    an Institute of Medicine Report of May 8. The tweet is:

    “National Academies (@NASciences)
    5/31/12 12:10
    RT @theIOM: FACT: Sugar-sweetened beverages represent largest share of
    calories in diets of individuals aged 2 and up ow.ly/bgGz8 “

    “Consumption of sugar-sweetened beverages is the single largest contributor of calories and added sugars to the American diet (HHS/USDA, 2010; NCI, 2010b; Welsh et al, 2011)”

    The specific citation is on page 167 of the IOM report. See http://books.nap.edu/openbook.php?record_id=13275&page=167

  21. owlbear1 says:

    Conclusion: The quantitative meta-analysis and qualitative review found that the association between SB consumption and BMI was near zero, based on the current body of scientific evidence.

    Received July 3, 2007.
    Accepted February 13, 2008.

    Really Scott? Latest?

    • 33lp says:

      Owlbear1, it was actually Campos who offered up that flawed (and industry-funded) meta-analysis in the “update.” He is really, really committed to his no scientific consensus position, except when he finds studies that say sugar don’t make you fat.

      The deeply flawed Forshee study he cited was destroyed here. Some highlights:

      Overall, our findings, in contrast to those by Forshee et al, clearly suggest a positive association between SSB intake and BMI among children.

      and

      [...] discouraging consumption of sugary beverages is an important way to achieve and maintain a healthy body weight in children and adults.

      Am J Clinical Nutr, first published 12/3/2008

      Yay for peer review.

      • Paul Campos says:

        [...] discouraging consumption of sugary beverages is an important way to achieve and maintain a healthy body weight in children and adults.

        Putting certain words in a certain order does not constitute evidence. “Evidence” means studies demonstrating that discouraging consumption of sugary beverages actually leads to long-term weight loss among children and adults. In fact there is no evidence that [...] “discouraging consumption of sugary beverages” leads to “achieving and maintaining a healthy [sic] body weight in children and adults.”

        This is folk psychology masquerading as science.

        • elm says:

          Paul, you’ve yet to address the fact that your linked study is four years old (not a bad thing in itself, but much more has been published on the topic since, including by the authors), been criticized in print for significant methodological flaws, and has ties to the beverage industry. Instead, you insult readers (and published academics in the field!) for not simply agreeing with your argument.

          • elm says:

            In other words, the article in the American Journal of Clinical Nutrition that agrees with you is “the most comprehensive meta-analysis yet.”

            The article in the American Journal of Clinical Nutrition that disagrees with you is “folk psychology masquerading as science.”

            This sure makes it seem like you’ve made up your mind in advance and are simply advocating for your point of view.

            • Paul Campos says:

              Elm, the “folk psychology” I’m referring to are statements such as that discouraging SSB consumption leads to significant long-term weight loss. There’s really no evidence for this. There’s some evidence of a (weak) association from some observational studies (contradicted by other similar studies) between lower levels of SSB consumption and slightly lower BMI levels.

              It’s a huge methodological leap from that to the statement from the article I quoted, which seems purely faith-based.

              As for the industry funding of the meta-analysis, I should have noted it, but OTOH *most* obesity research is industry funded, and it’s usually funded by interests (pharma in particular) which want to increase social anxiety about higher weight for profit-driven reasons. This doesn’t invalidate the research in either direction, but I rarely see any skepticism triggered by the fact that, for example, the International Obesity Task Force (which wrote the WHO report on the global obesity epidemic) was funded almost wholly by two drug companies.

  22. Joe says:

    Paul Campos calling someone “alarmist” sort of is less convincing than that coming from someone who doesn’t come off as a hack himself at times.

    I’m not overly keen on this idea, but there has been a serious increase on large portion size and the places this would apply to would be the usual suspects. Heck, I recently saw an ad from some industrial group that patted itself on its back for regulating portion size.

    It is not some big drain on liberty to require people to get refills or buy two sodas if they want over 16oz. It doesn’t even apply to diet soda or soda from various locations. Calling it a “soda ban,” full stop is misleading.

    • Paul Campos says:

      Do facts ever mean anything in this area? Soda consumption among Americans is down 25% since 1998. “Obesity” rates have not risen since then. The notion that sugar has no nutritional value (repeated endlessly in this thread) is unscientific nonsense, probably born of the puritanical idea that anything that is pleasurable is automatically bad for people. Etc.

      • Marc says:

        The scare quotes around obesity are revealing, but not in the way that you intend them to be. You honestly come across on this subject in the same way that Republicans do on climate change.

      • tonycpsu says:

        Sugar has nutritional value, but Americans don’t exactly have a problem getting enough sugar into their diet before they buy the 48 ounce soft drink at the movie theater because the pricing structure is set up to push them towards the highest-markup item. I don’t think a rigorous study demonstrating a causal link between HFCS or sugar consumption and increased obesity rates is a prerequisite for trying this out and seeing what happens. What exactly is the down side here?

      • Joe says:

        The first sentence really improves my opinion of your tendency to sneer at people. How also does said facts actually challenge what I said?

        Who is saying sugar has no nutritional value? The concern, like for salt and processed foods, is TOO MUCH sugar.

        I manage to get enough of the stuff without big gulps all the same. Hyperbole is not really a convincing argument for some of us. Don’t like it when “they” do it; don’t like it what “we” do it.

        The 25% doesn’t tell me much. If it was real high, it still might be high. Where did it drop? Did health campaigns help? If it is moderate, where is all the demand for 32oz sodas or such coming from?

        Remember the saying: a LITTLE bit of sugar helps to keep the medicine down. Can we have Prof. Carpenter back yet?

      • Bijan Parsia says:

        Paul, you’ve clearly read up more than I have, but I didn’t find the original study that contains that claim, but I did find a paper claiming:

        Conclusions: Over the past decade, US adult SSB consumption has increased. SSB comprises a considerable source of total daily intake and is the largest source of beverage calories. SSB consumption is highest among subgroups also at greatest risk of obesity and type 2 diabetes.
        Received August 26, 2008.

        And another:

        Per-capita daily caloric contribution from sugar-sweetened beverages and 100% fruit juice increased from 242 kcal/day (1 kcal = 4.2 kJ) in 1988–1994 to 270 kcal/day in 1999–2004; sugar-sweetened beverage intake increased from 204 to 224 kcal/day and 100% fruit juice increased from 38 to 48 kcal/day. The largest increases occurred among children aged 6 to 11 years (∼20% increase).

        (Dietary recall is not the most reliable method, but it does tend to underestimate.)

        • Bijan Parsia says:

          Also, I’d like to know on what basis you rate the Forshee study as “most comprehensive meta-analysis yet of the relationship between sugary drink consumption and BMI in children and adolescents”.

          This editorial suggests otherwise:

          For example, the meta-analysis of
          SSBs and BMI in children and adolescents by Forshee et al
          (12), which was supported by the beverage industry, was one
          of the few reviews to receive an AMSTAR score 7, despite
          having gross errors that fundamentally changed the findings
          (5).

          This paper claims likewise:

          One example is the research on the connection between the consumption of soft drinks and health. A meta-analysis of available research showed clear relationships among the consumption of soft drinks, poor nutrition, and negative health outcomes (Vartanian, Schwartz, and Brownell 2007). Within this meta-analysis, which was not funded by industry, those studies with stronger methods were more likely to show these negative outcomes. Furthermore, a comparison of studies funded or not funded by industry showed that the former were more likely to find results favorable to industry. An analysis of studies of the health effects of secondhand smoke produced similar findings (Misakian and Bero 1998).

          The soft drink industry, through the American Beverage Association (ABA), responded swiftly by supporting a group of researchers to conduct another review of the link between soft drinks and body weight. Two of the authors had conducted multiple industry-funded studies in the past, and one was employed by the ABA when the study was published. This study found that the consumption of soft drinks is not related to negative outcomes (Forshee, Anderson, and Story 2008).

          That certainly is prima facie problematic. What do you think of the earlier study?

          The Malik study (cited above several times) seems to quite ably crush the study you cite.

          (By the by, I realized after digging all these out that they were already dug out by other commenters. I’ll leave them in for the quotes. AFICT, there is a pretty strong consensus on the correlation. You certainly don’t help your credibility on this topic by 1) citing industry backed sources exclusively and 2) not addressing the actual content of the other papers presented to you.)

          • Bijan Parsia says:

            I mean, OUCH:

            Because Forshee et al expressed their results as the change in BMI units per 12-oz serving of change of SSB, scaling factors were applied to estimates from some studies to obtain unit consistency. However, estimates from Blum and Newby, both of which are expressed as change per 1-oz serving of SSB in their original publications, were not scaled.

            …Overall, our findings, in contrast to those by Forshee et al, clearly suggest a positive association between SSB intake and BMI among children.

            It may be “the most comprehensive” but, if this is correct, it is also a giant pile of crap

            • Bijan Parsia says:

              Malik seems pretty good from what I can see.

              Forshee et al do have a reply to the scaling question:

              Fifth, ignoring the 4 studies that collectively showed a −0.03 association (95% CI: −0.11, 0.04)—as proposed by Malik et al—and placing all of the weight on the 5 studies that collectively showed a 0.08 association (95% CI: 0.03, 0.13) does not present an accurate picture of the overall body of evidence.

              Tricky!

              (Delcaration:

              he original research was conducted while all of the authors were affiliated with the University of Maryland and was supported with funding from the American Beverage Association (ABA). RAF is currently a Senior Risk Assessment Expert with the US Food and Drug Administration (FDA), Center for Biologics Evaluation and Research. MLS is currently a Senior Vice President for the ABA. PAA is a consultant for the ABA. The views expressed in this article are those of the authors and may not represent those of the University of Maryland, the ABA, the FDA, or any other organization with which any of the authors may have been affiliated in the past. RAF declared no conflicts of interest other than the original source of funding for the project. MLS is employed by the ABA but had no other conflicts of interest. PAA is a consultant for the ABA but had no other conflicts of interest.

              Malik is pretty central to the pro-association side, but it does seem that other meta-reviews confirm their results.

              • Bijan Parsia says:

                Hmmm. This is interesting:

                “Not conclusive” (Bachmann et al. 2006, no declared industry funding)
                “Equivocal” (Pereira et al. 2006, no declared industry funding)
                “Strong” (Malik et al. 2006, no declared industry funding)
                “Probable” (World Cancer Research Fund, 2007, no declared industry funding)
                “Strong” (Vartanian et al. 2007, no declared industry funding)
                “Near zero” (Forshee et al. 2007, industry funded)
                “Limited evidence” (Gibson S, 2008, independent consultant, industry funded)
                “Open to debate” (Wolff et al. 2008, no declared industry funding)
                “Moderate epidemiologic evidence” (USDA dietary guidelines, 2010)
                “Difficult to discern” (Mattes et al. 2010, partly funded by National Institutes of Health; authors declared previous industry funding)

                Hmm.

                One of the reviews that found “strong” evidence (Malik et al., 2006) reported several studies as showing a positive correlation, writes Gibson, when only some of the findings within these studies were, in fact, positive. Two of the 30 studies in this review were also confounded by the inclusion of diet drinks.

                I’ll try to track down a Malik et al response.

                I would note that the “Near zero” is a bit more of an outlier as the “Strong”, but read the rest of the blog post.

                • Bijan Parsia says:

                  This USDA review seems quite good. It discusses both Malik and Gibson (but not Forshee) which are ranked as neutral quality. The overall results:

                  A moderate body of epidemiologic evidence suggests that greater consumption of sugar-sweetened beverages is associated with increased body weight in adults.

                  A moderate body of evidence suggests that under isocaloric controlled conditions, added sugars, including sugar-sweetened beverages, are no more likely to cause weight gain than any other source of energy.

                  My general understanding is in accord with these, from what I’ve seen.

                  (Need to read through it more carefully.)

                • Paul Campos says:

                  Note that the USDA statements are not at all equivalent. The first statement is that there’s moderate observational evidence that an association exists between SSBs and increased body weight.

                  The second statement is that there’s moderate clinical evidence that there’s no causal relationship between relative consumption levels of sugars, including SSBs, and weight gain.

                  From an evidentiary perspective the second statement is much stronger than the first, as it involves a much higher standard of proof.

                  Edit: Addressing Elm’s question, it’s true the two statements don’t address precisely the same issue, but my point was that the second statement is a far stronger one scientifically speaking.

                • Bijan Parsia says:

                  One annoying thing about this USDA report is that the Forshee didn’t get in and it’s unclear why. There’s one Forshee et al paper in the examined but excluded list (due to being a narrative review). I got that and the one Paul pointed too out of the USDA search from PubMed. I’m not clear why it wasn’t included or explicitly excluded. (The 2010 search surely should have gotten it.)

                • Incontinentia Buttocks says:

                  So do you have anything to say to Paul besides all this handwaving?!? [/snark]

                • elm says:

                  Paul, I actually read the second quote differently: it seems to be saying to me that if you take in, say, 2000 calories a day, it makes no difference if 0 of it comes from SSBs or 1000 comes from SSBs in terms of weight gain. The first quote suggests, though, that those drinking a lot of SSBs are likely taking in more calories than those who aren’t.

                  In other words, it’s the number not type of calories that matter. Am I reading these quotes wrong?

                • Bijan Parsia says:

                  Yes, Paul, I fully understand the difference between the two statements. I agree, in general, that calories per se are calories and that the evidence that a specific source in isolation is different that other specific sources with respect to weight gain is not remotely established. (It is, of course, complex. Obviously, what else you are eating can affect things such as absorption.) But that’s the isocaloric point, yes? If you control the calories, that’s (generally) sufficient. But there’s roughly the same evidence that SSB consumption is associated with increased body weight. Now, prima facie, that doesn’t say which way the causality might run (if there is any causality). But the report doesn’t suggest that that’s a likely scenario (i.e., that heavier people are more likely to consume more SSBs):

                  Thus, there are mixed results on this topic. Randomized controlled trials report that added sugars are not different from other calories in increasing energy intake or body weight. Prospective studies report some relationship with SSB and weight gain, but it is not possible to determine if these relationships are merely linked to additional calories, as opposed to added sugars per se.

                  The Prospective Observational Studies all suggest a SSB -> weight gain direction. Reid 2007 is perhaps the most supportive of your view, but even that is not strongly supportive of a lack of (potentially causal) association (4 weeks, there was a trend).

                  I’m not sure why you think the latter is so much stronger and requires a higher standard of proof, or, for that matter, what difference that makes.

                  While I recognize that there were a flood of claims in this thread, you did make some rather strong claims wrt the Forshee study, ones that seem rather beyond what is appropriate or representative of the literature. After all, here’s your core claim:

                  Here’s the most comprehensive meta-analysis yet of the relationship between sugary drink consumption and BMI in children and adolescents.
                  “Conclusion: The quantitative meta-analysis and qualitative review found that the association between [sugared beverage] consumption and BMI was near zero, based on the current body of scientific evidence.”

                  That claim is rebutted by the USDA report directly. It is the first claim of the report. That you like the second claim of the USDA report better is immaterial, I would think. That the second claim rebuts some things said in this thread is of interest (and I’m glad to put it out there), but none of those claims appear in the post itself. I would think that a modest update to the post itself is in order.

                • Bijan Parsia says:

                  Let’s just consider “comprehensive meta-analysis yet” claim (quotes hacked from abstracts but mostly from the USDA report):

                  Forshee: Twelve (10 longitudinal and 2 RCT) studies were reviewed.
                  The MEDLINE database (National Library of Medicine, Bethesda, MD) was used to identify relevant English-language articles published between 1966 and October 2006 about studies of the intake of SBs and BMI, obesity, or both.

                  Malik et al, 2006: Thirty original studies (15 cross-sectional, 10 prospective and five experimental), including nine adult comparisons, were included in the review.
                  English-language MEDLINE publications from 1966 through May 2005 examining the relation between SSB and the risk of weight gain, obesity or both were examined

                  Ruxton et al, 2010: The search was limited to English-language, human studies of sugar and sugar-containing foods and beverages. Dates of publication were restricted to January 1995 to March 2006. This process was supplemented with a hand-search and a check of reference lists from pertinent reviews. All studies were ranked separately by two reviewers with the higher ranking prevailing in the case of disagreement. Eight studies were included in the review of SSB and obesity. Of these, three were considered primary studies and were included in the review, while five were tertiary and not considered in conclusions.

                  Vartanian et al, 2007: (Rated postiive quality) Eighty-eight studies were included in the meta-analysis; approximately 30 comparisons were available for soft drinks and energy intake or body weight in adults.

                  Gibson 2008: Database searches up to July 2008 of Medline, Cochrane Reviews and Google scholar were conducted to examine the association of sugar-sweetened soft drinks (SSD) with body weight, BMI or adiposity in adults or children…forty-four original studies (23 cross-sectional, 17 prospective, four intervention) were included. Eleven of these studies were conducted with adults. In addition, six review articles were considered.

                  Even if we let you claim that you were specifically focusing on meta-analyses per se, surely Vartaian 2007 with 88 studies vs. at most 12 makes a strong prima facie case against your “comprehensive”.

                  (Note that GIbson is somewhat supportive of your point of view and is clearly prima facie more comprehensive.)

                  Unless you can provide some reasonable substantiation of your “most comprehensive”, I have to conclude that it was just “most happy-making for you”. It would be really nice if you updated the main post to reflect this.

                • elm says:

                  Unless you can provide some reasonable substantiation of your “most comprehensive”, I have to conclude that it was just “most happy-making for you”.

                  Ouch, Bijan, that’s gonna sting! Remind me never to get in a data fight with you. Though, in fairness to Paul, he may not have been aware of the more comprehensive recent analysis when he posted his update. What’s the old saying: never ascribe to malice what can be explained by ignorance?

                • Bijan Parsia says:

                  elm, thanks :)

                  I don’t think Paul selecting the study which confirms his preferred conclusion need be malicious on his part. It’s just confirmation bias.

                  And he doesn’t get a “best at the time” pass either, since Malik, Vartanian, and Gibson are all roughly contemporaneous. Malik antedates Forshee, even. (Malik is also far more cited.)

                  It’s hard to escape the conclusion that Paul really liked the conclusion of the Forshee and thus saw it as much better than it was. (I can’t adjudicate between the Malik and Forshee wrt whether adjusted or unadjusted studies are overall appropriate per se. HOWEVER, I think Forshee et al are nuts to combine the studies. This, afaict, conflates whether SSB in an isocaloric setting increase BMI with whether there’s an overall association with SSB intake and BMI. GIven these, as we now all painfully understand, rather different claims, merging studies addressing each of them seems quite dodgy. I’m back to thinking Forshee et al is crap.)

                  Of course, if Paul updates his update and acknowledges the USDA study and is generally more careful with his claims, there’s no problem. Heck, I’m genuinely open to some reading wherein Forshee is “most comprehensive”. And clearly some of the claims Paul was countering in this thread are not so great (“toxic HFCS”). But as the author of a book on this topic who presents himself as 1) expert enough and 2) attendent to the facts, I think he should do better, esp. when corrected.

  23. [...] not much of a fan of Bloomberg’s soda ban. But I have to say that I like it being struck down by Lochner-like [...]

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  25. Live Free or Die says:

    Yeah! Why is there no Arsenic Cola available?!?

  26. Holden Pattern says:

    This is what makes you a REAL MAN!

  27. GeoX says:

    Actually, I’d strongly encourage you to waste money by using all the energy you possibly can and destroy your body by eating and drinking all the horrifically unhealthy shit you want. All day, every day. Seriously: go for it. I’ll be cheering you along all the way.

  28. Holden Pattern says:

    How does this make all restaurants Taco Bell? This may be the dumbest analogy ever.

  29. Spud says:

    You know, all the good mayors of NYC had a little bit of banana republic dictator in them.

    I like the guy, he has done well by the city on enough occasions that I can overlook this little bit of silliness.

    He’s like Lex Luthor without Superman to bug him.

  30. Holden Pattern says:

    Well, Edgar, now you’ll just have to two-fist sodas while you smoke that cigar, and you won’t be able to blow the smoke in everyone else’s face. Inconvenient, I know, but such is the price of modern life. You want more freedom? It’s for sale in the USA, just get rich enough.

  31. John says:

    You do realize that that passage is a long quotation from “Demolition Man,” right?

  32. Spud says:

    Yeah! Why is there no Arsenic Cola available?!?

    Damn FDA.

    Why haven’t conservatives destroyed this organizations yet?

    Our inherent liberties demand a free market with Hemlock herbal tea, Coca-Cola with cocaine, and over the counter laudanum.

  33. Dave says:

    I believe many commentators would agree that over-the-counter, clean, reasonably-priced opiates would do an awful lot to lower crime and improve social well-being.

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