About a year ago, a group of public health researchers at the
University of California in San Francisco, led by Laura Schmdt a Professor of
health policy in the school of medicine was able to convince every vendor on
the University premises from selling drinks and beverages with added sugar having
moved from door to door for about three years with the campaign.
Some people may say ‘how is that
possible’? Especially in an environment of young and ‘sweet toothed’ people whose everyday lives’ involve drinking of at
least one to two bottles or cans of sugar added drinks.
According to a report by the CNN, written by Susan Scutti, it says a research revealed some time ago that
on the average, Americans consume more than 40
gallons of sugary drinks each year which is obviously too much for a healthy
lifestyle given that "It's a sales ban,
which means the university has opted out of the business of selling and
profiting off of sugar-sweetened beverages," said Laura Schmidt, a
professor of health policy in the School of Medicine.
Schmidt spearheaded the
voluntary sales ban, which took effect on July 1, 2015, yet required three
years to get everybody on board. "It's a very, very big institution,"
she said, adding that she and her colleagues went "door to door" to
meet with people.
Visitors are free to
bring in whatever beverage they want -- or leave campus to buy it. The one new
rule is that every food source on campus, from the Subway restaurant to the vending
machine in the lounge, will not sell the usual sugary beverages.
"The definition of
sugar-sweetened beverages is pretty standard at this point: It's beverages with
added sugars," Schmidt explained. These beverages include syrupy coffee
drinks, milkshakes and "natural" juices containing fructose.
However, UCSF has not
banished diet drinks, including zero-calorie sodas, or 100% fruit juices from
campus -- for good reason.
Often, people find diet
beverages as a good way of coping with sugar cravings at trigger times,
explained Schmidt. And though there is accumulating evidence that diet drinks
may be linked to glucose intolerance, there's not enough evidence -- at least
not yet -- to include these beverages in the ban.
"The happy
surprise of it all is people actually realize they can reach for this delicious
tea with a hint of mint in it, and it's got no sugar in it, and it tastes
great," Schmidt said.
Though she hopes to
have a positive impact, Schmidt is not aware of any studies examining whether
sugar taxes or bans have an impact on health. As a member of SugarScience,
a UCSF-led initiative formed in 2014, she should know. SugarScience
has collected and analyzed thousands of research studies examining the health
impacts of sugar over the past two years.
So, with the sales ban
in place on the UCSF campus, Schmidt and her SugarScience colleagues decided to
design their own study.
They enlisted the help
of more than 2,500 university employees and identified a subsample of 214
people who were heavy consumers of added-sugar beverages, drinking a liter or
more a day. With this group, they designed a "sub-study" in tandem
with the larger study.
The purpose of the
smaller study "is to see if we can actually move the dial by using a
workplace policy," Schmidt said.
For this smaller group,
the researchers performed a complete physical, including weight, height and
blood pressure measurements. Blood tests were performed as well. These
employees returned for a physical six months after the sales ban began and once
again at 12 months.
"We're in the
process of analyzing that data right now," Schmidt said, though she said
that after six months, a 25% decline in consumption had occurred among those
who drank the most sugary beverages.
She is eager to see the
latest results, noting that if she and her crew can show changes in consumption
sustained over a year, "you know you're making an impact."
In the past, amid
epidemics of cancer and tobacco-related diseases, the medical system seemed to
be the last, not the first, to raise the alarm, according to Schmidt. In fact,
hospitals used to openly sell cigarettes, even delivering packs to patients in
bed.
Today, there's a crisis
of obesity, so it's an opportunity for the public health sector to act as the
leader, not a follower, she suggested.
Public health officials
across the nation, including Dr. Bruce Lee, director of the Johns
Hopkins
Global Obesity Prevention Center at the Johns Hopkins Bloomberg School of
Public Health, see her point.
"A third of our
population is obese. Two-thirds is overweight or obese. There's been a lot of
studies that have shown that leads to both immediate, as well as long-term
problems," Lee said. Estimates suggest that one in four children will
develop diabetes in their lifetimes.
"Diabetes is just
one chronic disease that is associated with obesity," Lee said. Many other
conditions, including cardiovascular disease, multiple cancers and mental
health disorders, also are associated with obesity.
"It seems like
every year, we're seeing more and more connections between obesity and
different health problems," he said. "The thought is, obesity is the
result of things being off-kilter with the body. So it's a precursor to many
different types of problems."
Meanwhile, it's obvious
to patients that hospitals and health care systems openly offer junk foods,
soda and sugar-sweetened beverages. The message that obesity is unhealthy is
getting lost. To change this, an increasing number of hospitals and health
systems are moving toward at least providing more healthy options, said Lee.
Though public health
officials are mostly in agreement with the UCSF sales ban and similar policy
changes, Lee cautions that it is necessary to provide alternatives for people
and execute the policy successfully. Some failures have occurred in schools, he
noted, where "kids just leave the grounds" in order to get junk food
that has been banished from the school environment.
"It's important
whenever you make these changes that you think about what might be the
compensatory responses," Lee said.
Added sugar is any
sugar put into food or beverages during processing, during preparation or at
the table, according to the website for SugarScience. There
are 61 names for sugar used in food processing that appear on ingredient lists.
Added sugar is not the same as naturally occurring sugars in fruit, vegetables
or other foods that don't have ingredient lists.
Sugar limits apply to
added sugar only. Although there is no single government-recommended daily
value for sugar in the United States, the American Heart Association advises
limiting added sugar to less than 6 teaspoons (or 25 grams) a day for women, 3
to 6 teaspoons (or 12 to 25 grams) each day for children, and 9 teaspoons (or
38 grams) a day for men.
Among SugarScience's
most important discoveries: There are clear links between sugar consumption --
particularly in liquid form -- and diabetes (independent of obesity),
cardiovascular disease and liver disease.
In 2012, when New York
City attempted to restrict restaurant sales of large sugary drinks, an appeals
court ruled the regulation "arbitrary and capricious" adding the
board of health "failed to act within the bounds of its lawfully delegated
authority."
Schmidt emphasizes that
the UCSF ban was voluntary. Every vendor on campus, as well as the chief
financial officer, willingly agreed to go along with it, she said.
"Everyone was
worried they'd lose money, but no one lost money," she said.
The American Beverage
Association, an industry group, is nonplussed by the ban.
"America's leading
beverage companies offer a wide variety of beverages -- including no- and low-
calorie and smaller portion sizes -- to suit all tastes and lifestyles,"
said Lauren Kane, a spokeswoman for the organization. "These companies are
always innovating to meet consumer preferences, and in fact, nearly half of the
beverages they sell contain zero calories."
As far as the
association is concerned, universities should feel free to choose the beverages
they want to offer.
In fact, an observer
casually walking around campus would see nothing unusual. Everything still looks
pretty much the same, Schmidt said: "The shelves are filled with stuff.
It's just stuff that isn't loaded with sugar."
"Our current food
environment is rigged to make the unhealthy choice the easy choice,"
Schmidt said, adding that in many retail operations the placement and pricing
of sugary beverages is intended to create more sales.
In the end, the sales
ban is "not moralistic" or about trying to "constrain
people," she said; it's really just that a health institution should not
be profiting by selling unhealthy beverages. That said, she understands
people's concerns: "We like our freedom. We want our individual choice. I
don't want anyone to telling me what to eat. I'm an American."
