Childhood Obesity, The American Way

Anyone following the growth in consumption of fast food over the past 10 or 20 years knows the influence that industry has on our eating habits and lifestyles. No matter how tasty, salty, fatty, sugary, and generally satisfying junk food may be, too much is damaging to health, and it's many people consume too much. Public health experts know this, as do producers of popular books such as "Fast Food Nation" and movies such as "Supersize Me", as do politicians, as do the soda drinking public. If it's so obvious, then, why isn't government more proactive?

Sometimes we don't recognize clout of the industry in the debate. For instance when the US threatened to withdraw from the FTA (Free Trade Agreement) with the Dominican Republic in September 2004 over a proposed bill to tax sodas, the event barely made news. But when it comes to sugar and fast food consumption of our nations children, let the fighting begin.

Beverage, corn, sugar and grain industries have a lot to gain or lose over soda sales. Coca-Cola's ever increasing sales in the U.S. are surpassed only by it's sales in Mexico. Coca-Cola sales revenues worldwide were $21,000,000 in 2004. Fast food, soda, and junk are mainstays for investors, and there's no limit to market potential.

The U.S., in turn, has a lot to gain from preventing obesity and diabetes. In 2003 the nation spent $11,000,000,000 on obesity related medical costs according to information in a bill (S.799), "Prevention of Childhood Obesity", that will fund research, now being considered by the Senate. The bill notes:

  • Obesity rates have doubled in preschool children and tripled in adolescents in the past 25 years
  • 9,000,000 young people are considered overweight
  • 60% eat too much fat.
  • Fast food outlets spend $3,000,000,000 in advertisements targeting children.

Fat and sugar, often considered the pyramid building blocks of the American diet, especially for kids, have increased dramatically with the help of product endorsements.

Last May, a brouhaha erupted when the American Diabetes Association (ADA) "partnered" with Cadbury Schweppes, allowing the company to advertise its association on diet drinks. Corporate Crime Reporter (CCR) later interviewed Robert Kahn, the director of the American Association for Diabetes (ADA), and took him to task for accepting money from Cadbury Schweppes, albeit for education programs.

Kahn repeatedly asserted in the interview that sugar cannot necessarily be linked to diabetes and that excess weight is the result of greater intakes of calories vs. a lesser output of calories. CCR pursued Kahn's arguments with tenacity.

CCR: "I'm saying that liquid candy [soda] is a major issue."
KAHN: "I don't know if it is a major issue. What's turning out to be a major issue is excess caloric consumption. That's the major issue. That has to be much more of a major issue than sugared drinks. Look at all of the weight loss companies."
CCR: "Let's focus on children. If in fact a big chunk of their calories come from sugared drinks"
KAHN: "I don't know whether in fact that is the case. Do you know it is a fact?"
CCR: "I don't know, but if in fact."
KAHN: "I don't want to go down that line if I don't know that it is true...."

Soda consumption is about 2 sodas per day for youth, 20% of total calories...10% is recommended. The American Pediatric Association states that "Each 12-ounce soft drink contains approximately 10 teaspoons of sugar and 150 calories. Drinking just one can of soda a day increases a child's risk of obesity by 60%". Therefore increased sugar intake leads to obesity, leads to increased risk of diabetes.

CCR tried to get Kahn to acknowledge that ADA's partnership with a large candy maker may not be in the public interest-

CCR: "Is there an epidemic of that type of diabetes?"
KAHN: "Absolutely".
CCR: "And what is causing it?"
KAHN: "People in this country are gaining too much weight."
CCR: "Why are people gaining too much weight"
KAHN: "Because total caloric intake exceeds total caloric expenditure."
CCR: "Does sugar have anything to do with that?"
KAHN: "If you are eating only sugar, yes."
CCR: "No, does sugar have anything to do with that kind of weight related diabetes?"
KAHN: "No more than fat or protein does."
CCR: "Do sugary drinks have something to do with it?"
KAHN: "No one has a clue of whether they do or don't."

Kahn is superficially correct. Sugar, protein and carbohydrates are all metabolized by the body to provide predictable sources caloric energy. Weight loss does depend on lowering the ratio of caloric intake (food) to caloric expenditure (exercise, heat generation, metabolism). However Kahn chooses to ignore studies that consistently connect increased soft drink consumption with decreased quality nutrient consumption, weight gain and diabetes risk. A meta-study published by the Journal of Pediatrics in June reviewed previous research and confirmed the link between excessive sugar, obesity, and diabetes. Another study published in August of 2004, researchers at Brigham and Women's in Boston of 90,000 woman found that drinking a soda a day can increase the risk of diabetes 83 percent, as summarized by the San Francisco Chronicle.

Is Kahn sounding like an industry apologist, as the CCR interviewers later pointed out in "All Fall Down"? Indeed his points do echo that of industry rhetoric. For instance the SF Chronicle reported the response of the sugar industry to the the Brigham and Women's study:

"the[y] disputed the conclusion, arguing that the study was flawed and that it was impossible to single out one type of food or drink and blame it for the obesity crisis...A careful reading of the paper reveals that it was an unhealthy lifestyle, not consumption of a particular food or beverage, that increased the women's risk for type 2 diabetes.."

The Chronicle quoted Richard Adamson, vice president for *scientific and technical affairs* at the American Beverage Association, who cautioned:

"A careful reading of the paper reveals that it was an unhealthy lifestyle, not consumption of a particular food or beverage, that increased the women's risk for type 2 diabetes."

CCR continues, and tries to encourage Kahn to consider the idea that a tax on sugar might help people reduce their sugar intake. Kahn balks.

CCR: "Are you saying that unless we can tax all high calorie foods, we should tax no high calorie foods?...There are a handful of states that already tax soda."
KAHN: "I don't know that they do it or not. If they do, I would wonder - should I single out soda, or should I single out the donuts? If I single out the donuts, shouldn't I single out the pies, and cakes and pastries...[t]he epidemic is the result of too many calories in, fewer calories out. That is it."

While the controversy roils, New Jersey passed a comprehensive bill banning the sale of high sugar and fat content foods in schools by 2007. Connecticut has a similar bill pending governor approval and 17 states also have legislation pending. While sugar may not be the only cause, it seems that many agree that it is contributory to the extent that action can be taken against it.

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