Smaller drink sizes mean better health: lessons from New York City
22 June 2012
New York City's mayor has taken issue with "super-sized" serves of sugar-sweetened drinks and is proposing a limit on their serving size to a maximum 16 fluid oz (500 millilitres) at fast food outlets, restaurants, cinemas and street-side vendors.
Michael Bloomberg sees this as essential to improving the chance for healthy lifestyles in the obesogenic environment of the United States. Soft drinks and fruit juices will feel the impact of the measure most, as diet soft drinks and dairy-based beverages are exempt.
But is this yet another example of a "nanny state" trying to remove individual freedom to choose and will it do anything to address the obesity epidemic?
The main purpose of beverages is to hydrate us, that is, keep individuals in fluid balance. The average woman needs an intake of around two litres of fluid daily with an additional 700 mL normally ingested from foods (so adequate intake is 2.8 litres). Men require a little more, with an adequate daily intake of 2.6 litres from fluids and 800 mL from food.
What Bloomberg proposes as a maximum serving equates to a quarter of a woman's and a fifth of a man's daily fluid allowance. Given that the average person drinks six or more times in a day, this appears to be a very reasonable, if not high, proportion of daily intake. Some might argue that people who exercise vigorously or are experiencing extreme heat may need more hydration but this is not the case for people sitting in an air-conditioned cinema.
Documentary filmmaker Morgan Spurlock drew attention to the problems of America's "supersizing" culture almost ten years ago. So the reduction in the individual serving size of a soft drink is a sane move for a society bent on over-consumption.
Australians consume less soft drink than Americans but "supersizing" is inappropriate in any country. We can hope that this is the start of a trend towards more snack foods being sold in portions that support getting an appropriate amount of energy.
There's a body of research showing that as portion sizes increase, the norm for what constitutes a serve also increases and people start to consume more at a single sitting and for those who were taught to always clear the dinner plate, larger serving sizes present an additional layer of challenge.
Research indicates calories from sugar-sweetened drinks don't register in the way calories from food do, so people who choose sugary drinks over water or "diet" drinks consume more energy overall. That means there's no compensatory decrease in food intake to account for energy from the sweetened beverage.
Each 500 mL serve of a sweetened drink provides 44 grams of sugar, which means 180 kilocalories (9 percent of the average adult male's energy requirement) without protein, vitamins, calcium, iron or essential fatty acids.
There's also a growing body of literature suggesting that drinking soft drinks and sugar-sweetened beverages are associated with obesity, metabolic syndrome, cardiovascular disease and type 2 diabetes - but we can't yet say that consumption of soft drinks clearly causes these health problems. Obviously, for individuals battling weight gain, consumption of one-litre serves of soft drink several times a day is problematic.
New York is not placing a ban on sales of sugary drinks and if they want, New Yorkers can purchase multiple serves of their favourite sweet beverage throughout the day. This makes it difficult for the nanny-state argument to stick.
Manufacturers and retail outlets might find their profits hurt if they are unable to charge the same price for smaller sizes. But consumers will likely prefer them to lose out rather than have customers foot the bill if the beverages are taxed.
There aren't any negative consequences for the health of New Yorkers from the proposed restriction of the serving size of sugary drinks. Perhaps it would be good to accompany this move with the provision of additional water drinking fountains in the city to quench the opposition.
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