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Colorado State University A Feasibility Study

Decreasing Soda and Sweetened-Beverages Intake Among Fort Collins Residents

May 1st, 2015

Sarah Haynes skhaynes@rams.colostate.edu

(970) 556 3049

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Table  of  Contents  Executive Summary .........................................................................................................................2

Introduction ......................................................................................................................................4

Purpose .........................................................................................................................................4

Historical Background ..................................................................................................................5

Criteria .............................................................................................................................................6

Method of Analysis ..........................................................................................................................7

Criteria Evaluation Results ..............................................................................................................8

Conclusion .....................................................................................................................................12

Recommendations ..........................................................................................................................13

References ......................................................................................................................................14

Glossary ........................................................................................................................................15

Appendix A ....................................................................................................................................15

Appendix B ....................................................................................................................................17

Appendix C ....................................................................................................................................17  

List  of  Figures    Figure 1.1 Survey Results ................................................................................................................8

Figure 2.1 Trends 2000–2010 in global revenue and profit. .................................................... 10-11

Executive Summary: This report determines if it is feasible to decrease the amount of soda and sweetened-

beverage intake among Fort Collins residents. Soda consumption is detrimental to the health of

individuals and with an ever-increasing obesity epidemic, action must be taken in order to ensure

longevity of health for the residents of Fort Collins. Cost/benefit, community acceptance and

legal aspects will serve as the criteria to identify the best method of decreasing soda and

sweetened-beverage consumption.

George Gianopoulos, a Kitchen Manager at the popular restaurant, Texas Roadhouse,

explains the cost and benefits of the soda market at his restaurant and gives his opinion on

decreasing soda consumption and what the monetary benefits would be for his restaurant. From

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the interview, it was found that Texas Roadhouse profits immensely from the purchase of sodas;

furthermore, by prohibiting free refills and instead charging per refill, profits would increase

even more. Potentially making the decrease of soda consumption still profitable for venders.

A survey was used to identify the public’s opinions regarding the possibility of soda

restrictions and overall thoughts of soda and personal consumption. Survey participants were

mainly female in their late teens and early twenties. It was found that this population of Fort

Collins generally has a low intake of soda and that they would dislike the government putting

limitations on the quantities of soda consumed.

Research done evaluating the possible soda restriction laws in New York and studies

done eliminating soda from being sold in Texas schools show that the decrease of soda

consumption will not be as easily regulated as thought (Taber, 2014). The law banning the sale

of soda in containers larger than sixteen ounces in New York did not pass final rulings and in

Texas, though kids could not buy soda at school, they still report drinking it on a weekly basis.

In addition, the Obesity Action Coalition, a program that looks at reducing obesity rates,

promotes the new idea of taxing soda companies, thus raising the price of sugary drinks for

consumers. Though it has not been implemented yet, it is the most promising method of

regulation in Fort Collins because and residents still have the choice and availability of sugary

drinks; however, the increased prices will deter the purchasing of sodas and sweetened beverages.

Along with taxing soda companies, survey results find that education is how most people

change a behavior. Colleen Burke, a Nutrition professor agrees that by educating consumers on

their beverage choices and the affects they may have on the body can help to discourage the

purchase of sweetened-beverages and instead increase consumption of water, herbal teas, and

low fat milk.

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This study determines that it would be feasible to increase education regarding soda and

obesity in order to help Fort Collins residents make healthier choices along with increasing soda

prices to help deter soda consumption. It also finds that government limiting the amount of soda

bought or where is it bought would not be feasible. Fort Collins residents want the right to make

their own choices and do not believe government should impede on them.

Introduction:

Purpose:

The purpose of this report is to determine the feasibility of decreasing soda and

sweetened beverage consumption in Fort Collins, Colorado. This will be beneficial in the efforts

to reduce obesity rates and health concerns related to obesity. As a small city, Fort Collins can

make sure to evade this epidemic by educating residents of the adverse health affects soda has

and by limiting the consumption. Across the country, efforts have been made to decrease soda

consumption by education, limitations of soda sales within schools and restricting the size of

containers sold.

To date, New York is the only State that has attempted legal restrictions to reduce soda

consumption. There have also been studies conducted that have researched the results of

reducing the sale of soda at schools in Texas. This particular feasibility study is the first of its

kind as it looks at community acceptance and attitude towards the reduction of soda sales and

includes perspectives from a Restaurant Manager and a local CSU Nutrition Professor. It also

focuses on the reduction of soda consumption for a single town and is not focused solely on

schools.

Historical Background:

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Obesity as a whole is beginning to take its toll on the health of Americans. For the last

few decades, there has been a shift of focus to concentrate more on reducing obesity incidents in

both adults and children. One leading factor to help control this health issue is modifying diet,

which includes controlling the consumption of sugary, high-calorie beverages (Nutrition for

Everyone, 2012). According to Harvard’s School of Public Health, sugary drinks are one of the

leading causes of obesity; therefore, reducing the consumption of these beverages will aide in

preventing and decreasing obesity rates (Obesity Causes, 2012). With constant advertisements

from big companies such as Pepsi and Coca Cola, the accessibility including free refills in many

restaurants and food places as well as large portion sized containers all contribute to higher rates

of obesity.

Many people do not understand the reasons behind why soda and sweetened-beverages

are unhealthy. These beverages have increasingly become more and more of a staple in the

American diet starting in the 1950s. Back then the single serving size of a soda was six point five

ounces and has now risen to forty-two ounces now making up a significant percentage of daily

calorie consumption. Calories from sugary drinks are usually in addition to normal eating habits.

Typical daily caloric needs are based on a 2,000-calorie diet. When one consumes a 20-ounce

soda, the additional 240 calories are not accounted for in the rest of the diet and thus a person

goes from 2,000 to 2,240 calories per day, with just one drink. With an increase in calories,

weight will increase as well contributing to the obesity epidemic. Moreover, about half of the

people in the United States drink at least one soda per day and 5% get at least 567 extra calories

per day from these beverages (Obesity Causes, 2012). A longitudinal study done with 120,000

men and women over the course of 20 years, found that those increasing intake by one sugary

drink per day, gained weight over time more than those that did not change their intake. It also

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found that those regularly consuming soda have a 26% greater risk of developing type II diabetes

and 20% of having or dying of a heart attack (Obesity Causes, 2012).

The Center for Disease Control states that about one third of all Americans are obese,

meaning just under half of the population is more susceptible to diseases such as type II diabetes,

cardio vascular disease and increased risk of stroke (Nutrition for Everyone, 2012). So far, it

has been found that obesity is one of the leading causes of death in America (Nutrition for

Everyone, 2012). Studies involving children and adults have discovered that reducing sugary

drink consumption leads to better weight control and decreased weight in those initially

overweight (Obesity Causes, 2012). Preventative actions such as decreasing sugary drink

consumption must be taken in order to decrease and slow down the obesity epidemic that is

currently sweeping America.

Criteria:

I. Community Acceptance:

This is an essential criterion because it will explain the willingness and unwillingness to

change soda consumption behavior among a community, specifically in Fort Collins. It will also

show if there will be resistance or acceptance to newly placed laws regulating sugary beverage

consumption.

II. Cost/Benefit:

This criterion outlines the potential costs and benefits to consumers and companies

selling soda and other sweetened-beverages. It is important to understand the financial aspects,

positive and negative, of trying to decrease the consumption of the multibillion-dollar soda

industry.

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III. Legal Aspects:

This criterion assesses the hypothetical laws that would be implemented in order to

reduce the consumption and purchase of soda and other sweetened beverages. These laws would

look at increasing prices of soda and sweetened-beverages, decreasing sizes of purchasable

containers and increasing taxes on soda and other sweetened beverages.

Methods of Analysis:

An interview with Colleen Burke, a CSU Food Science and Human Nutrition professor,

also helps to tie all three criteria together under one professional opinion.

I. Community Acceptance:

This criterion is established using a public survey published via Facebook in order to

assess the amount of consumption of soda and the opinions of changing laws and regulations

regarding soda consumption. The survey encompasses questions that do not hold a bias against

or for soda beverages but instead ask for opinions on the subject at hand. The survey’s main goal

is to identify what the public believes will be the most effective in changing the current

consumption rate of soda and other sugary drinks. See Appendix A for detailed survey questions.

II. Cost/Benefit:

George Gianopoulos, the Kitchen Manager at the restaurant Texas Roadhouse in Fort

Collins was interviewed to gain perspective on the cost/benefits of decreasing soda consumption.

It is important to know how regulating this industry will affect other industries and supply and

demand rates. Gianopoulos’s professional opinion assesses whether putting limitations on drink

consumption such as charging for refills would hurt or help the food industry.

III. Legal Aspects:

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Question  1  Question  2  Question  3  Question  4    Question  5  Question  6  Question  7  Question  8  Question  9   Question  10  

Num

ber  of  Responses  

Question  Number    

Survey  Results  

A  (Strongly  Disagree)   B  (Disagree)   C  (Neutral)   D  (Agree)   E  (Strongly  Agree)  

Qualitative research will be collected on proposed regulations to decrease soda

consumption by the state of New York. The ability of these laws to integrate into society will

help to determine the feasibility of integration in Fort Collins (Grynbaum, 2014). Efforts made

by limiting the sale of soda among schools, specifically in Texas, are being assessed to

understand the effectiveness of decreasing availability of soda drinks to consumers (Taber, 2014).

In addition, implementing taxes on sugary drinks and the effect on consumers and obesity rates

will influence the legal aspects criterion as well as questions from the public survey that help to

express public opinion on the principle of government ability to regulate buyer consumption.

Results:

I. Community Acceptance:

The survey results below show the question numbers and amount of participants that

choose each specific answer. This survey was written in a way to help to gather insight on

consumer opinion as well as individual soda consumption, age and gender.

Figure 1.1 Survey Results

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The most important results of the survey show that residents of Fort Collins are

apprehensive toward legally regulating the consumption of soda. Of the 42 participants, with

ages ranging from 18 to 65+, 23 responded strongly disagree or disagree to question eight of the

survey, “I think it is necessary for either the State or Federal government to help regulate soda

consumption.” This response shows that it would be difficult to implement a law reducing soda

consumption, due to the fact that many people would be against it. Also, the study gave insight to

the method most people use to change a behavior; according to the study, 31 of the participants

use education to promote changes in their own behavior, which helps to determine the best

method to decrease soda. The full study may be found in Appendix A.

II. Cost/Benefit:

According to George Gianopoulos, soda is a very popular drink choice at his restaurant,

Texas Roadhouse. The average Coke product costs $2.49 a glass with unlimited refills and each

glass is 20 ounces. Mr. Gianopoulos broke down the numbers for soda revenue on a weekly

basis from only the manufacture Coca-Cola, which is the only soda brand sold at Texas

Roadhouse (only soda not tea, was investigated). On average, Texas Roadhouse profits are

$1,962.12 per week in soda sales, on a yearly basis that is almost $94,181.76. This amounts to

788 sodas per week and 37,824 sodas per year. All of these numbers come from just one

restaurant. Gianopoulos stated that the profits from these sales were also very high because they

order five-gallon boxes of soda-syrup twice each week at the cost of $67.28 per box. In addition,

Coca-Cola has a rebate program that offers anywhere from ten to twenty percent back on

purchases made by Texas Roadhouse. This means the more soda Texas Roadhouse buys and

then sells, will lead to higher profits for the company because not only do they make money per

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drink sold, but they also get a rebate credit from Coca-Cola that makes buying more soda

cheaper.

The Kitchen Manager had a hard time estimating the exact profits his restaurant earns per

soft drink sold because Texas Roadhouse offers free, unlimited refills of soda beverages and ice

added into the glass, which has an effect on the true amount of liquid, employees are also offered

free soda when working in unlimited amounts. When asked how he would feel from a business

standpoint on regulating soda by charging for refills, Gianopoulos stated that while the profits

would be immense, he did not like selling something he didn’t believe in (Gianopoulos, 2015).

He also states charging for refills could potentially deter patrons from ordering soft drinks all

together. Which participants in the study supported when the majority answered they would not

order soda at all if they knew they would be charged for refills. Personally, Gianopoulos does not

drink soda on a regular basis because he understands its link to the obesity epidemic and does not

condone unlimited, free refills to consumers. Overall, regulated increases in cost of soda may

lead to an increase in profits for companies if consumers do not change the rate of consumption,

or it may lead to the decrease of net consumption lowering profits but increasing health.

The following table represents the profits for the two biggest soda companies, The Coca-

Cola Company (TCCC) and Pepsi Company. It helps to support Gianopoulos’s information on a

larger scale showing that these industries bring in millions of dollars every year and profits,

directly related to consumption keep rising as well (Buggy, 2007).

Global revenue and profit ($US million)

2000 2003 2005 2007 2009 2010

% Change (2000–2005)

% Change (2005–2010)

TCCC- Net revenue

17,354

21,044

23,104

28,857

30,990

35,119

33

52

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Net profit 2,177 4,347 4,872 5,981 6,906 11,859 124 143 PepsiCo- Net revenue Net profit

22,337 2,543

26,971 3,568

32,562 4,060

39,474 5,658

43,232 5,946

57,838 6,320

46 60

78 56

Figure 2.1 Trends 2000–2010 in global revenue and profit PepsiCo, PepsiCo Inc.; TCCC, The Coca-Cola

Company (Buggy, 2007).

III. Legal Aspects:

CSU professor Colleen Burke has the overall opinion that choice must be left to the

consumer. As a professor and Nutrition Counselor, she sheds light on the importance of choice

for the consumer; however, she also states that she believes it is okay for the government to help

fuel those choices by mandating that the healthier choices be made the easier and cheaper

decision than their unhealthy counterparts (Burke, 2015). Burke supports taxing soda beverages

in order to deter people from buying them, but does not think taking soda away all together, like

done in the Texas schools, is the most beneficial solution.

According to the New York Times article, “New York’s Ban on Big Sodas is Rejected by

Final Court”, the law in question which would inhibit the sale of drink containers for sodas and

sweetened beverages larger than sixteen ounces was ruled against in the highest court. Though

the Board of Health is trying to aide in lowering rates of obesity, the judge states that it

“exceeded the scope of its regulatory authority.” Meaning the government could not regulate

consumer consumption of soda. Though it is proven that soda is a leading factor in the obesity

epidemic, government regulation is too strict and unconstitutional (Grynbaum, 2014).

Texas, like New York, attempted to regulate soda consumption, this time focusing on the

younger population by banning soda sales in elementary and middle schools. Although soda and

carbonated drinks were no longer available, beverages such as sports drinks, sweetened teas and

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fruit juices were still available to students. These types of beverages are also packed with added

sugars and calories (Obesity Causes, 2012). Even though activists thought this would lower

consumption and decrease obesity rates, there was no significant data to prove reduction.

Conversely, it was reported that children continued to consume soda on a weekly basis (Taber,

2014).

Differing from directly limiting consumption of soda, the Obesity Action Coalition calls

for instating an extra tax on sugary beverages per ounce purchased. The tax would be directed at

soda companies, who would then be forced to increase the cost of these beverages to consumers.

Since soda is not a necessity of the diet (such as milk and eggs) consumers would be less like to

spend more money to buy it. Analysts predict that the cost of soda would go up anywhere from

ten to twenty percent. Moreover, soda and sweetened beverages average about 240 calories per

serving and when the price increases and consumption decreases, the net calorie intake of many

Americans will also decrease, thus leading to weight loss and lowering the rate of obesity. The

Obesity Action Coalition emphasizes taxes placed on sodas, sports drinks, energy drinks,

flavored water, fruit drinks and sweetened teas (Friedman, 2015). The increases in revenue from

these taxes will then go back into obesity prevention programs that are aimed at consumer

education. The money, according to the Obesity Action Coalition, would also be used to help

schools provide more nutritious meals and places that communities can exercise such as parks

(Friedman, 2015). In Fort Collins this money can go towards the maintenance of the many parks

and outdoor areas already in existence.

Conclusion:

Increasing cost for consumers and increasing education of the negative effects of soda

consumption are the two most feasible ways of regulation in Fort Collins, with the main goal

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being to decrease obesity rates. The results of consumer acceptance, cost/benefit analysis, and

legal aspects demonstrate difficulty in reaching consensus on how to regulate soda consumption.

Based on the survey results, many are not in favor of government regulation; furthermore,

New York and Texas attempts to regulate and decrease soda consumption fail. However, by not

banning or restricting soda sales and instead increasing cost by taxing soda companies,

consumers will be deterred and purchase less leading to a decrease of overall caloric intake. With

the tax money going to programs that provide education, such as consumption of soda is a

leading cause of obesity, which can cause cardio vascular disease, strokes, type II diabetes, and

death, consumers will be more likely to make smarter choices in the beverages they consume.

Although government regulation is not preferred by consumers, it is necessary to add these taxes

in order to preserve the quality of life for many Americans.

Recommendations:

In order to decrease obesity, it is recommended soda and other sweetened-beverage

intake must be reduced. Although the public opinion does not support regulation of consumer

choice by the government, an increase, by way of taxes, in the price consumers pay for these

beverages will result in deterring buyers overall soda purchases. When this decreases, eventually

obesity rates will as well, thus lowering mortality, and chronic disease rates.

It is recommended that educating consumers to help understand why these prices must go

up, and that the money will fuel education programs, will lead to acceptance. Education can be

provided in a multitude of settings such as the workplace, schools, healthcare facilities and

public spaces in the form of speeches, classes, posters and more. In the end, regulations and

education will be beneficial to the entire health of Americans including Fort Collins residents.

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Efforts being made to decrease obesity rates are recommended to continue being

researched and implemented. Even if new laws are not enacted, just being discussed will help to

educate and inform consumers such as the proposed law decreasing the size of soda containers in

New York. When this law was first put on the ballot, there was media frenzy and an increase in

consumer attention, when consumers become engaged and active they are more likely to increase

their knowledge about the adverse health effects of soda and therefore limit their consumption.

References: Avery, A., Bostock, L., & McCullough, F. (2015). A systematic review investigating

interventions that can help reduce consumption of sugar-sweetened beverages in children leading to changes in body fatness. Journal Of Human Nutrition & Dietetics, 2852-64. doi:10.1111/jhn.12267

Buggey, T. (2007, Summer). Storyboard for Ivan's morning routine. Diagram. Journal of

Positive Behavior Interventions, 9(3), 151. Retrieved December 14, 2007, from Academic Search Premier database.

Burke, C. (2015, April 7th). Dietitian Standpoint on Soda Intake [Personal interview]. Friedman, R. (2015). Obesity Action Coalition » A Soda Tax – Will it Change Anything?

Retrieved April 28, 2015, from http://www.obesityaction.org/educational-resources/resource-articles-2/nutrition/a-soda-tax-will-it-change-anything

Gianopoulos, G. (2015, April 8th). Restaurant Manager Standpoint on Soda Restrictions.

[Personal Interview]. Grynbaum, M. (2014, June 26). New York’s Ban on Big Sodas Is Rejected by Final Court.

Retrieved April 28, 2015, from http://www.nytimes.com/2014/06/27/nyregion/city-loses-final-appeal-on-limiting-sales-of-large-sodas.html?_r=0

Nutrition for Everyone. (2012, October 29). Retrieved April 7, 2015, from

http://www.cdc.gov/nutrition/everyone/index.html Obesity Causes. (2012, October 20). Retrieved April 9, 2015, from

http://www.hsph.harvard.edu/obesity-prevention-source/obesity-causes/ Park, S., Onufrak, S., Sherry, B., et al. (2014). The Relationship between Health-Related

Knowledge and Sugar-Sweetened Beverage Intake among US Adults. Journal of The Academy of Nutrition and Dietetics, 114(7), 1059-1066. doi:10.1016/j.jand.2013.11.003

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Taber, D.R., Chriqui, J.F., Vuillaume R., & Chaloupka, F. J. (2014). How State Taxes and Policies Targeting Soda Consumption Modify the Association between school Vending Machines and Student Dietary Behaviors: A Cross-Sectional Analysis. PLoS ONE, 9(8). n.p. doi: 10.1371/journal.pone.0098249

Glossary: (All italicized words)

Cardio Vascular Disease: A disease state in which the heart and circulatory systems function

poorly (Nutrition for Everyone, 2012).

Obesity: The condition of being grossly overweight with a BMI (Body Mass Index) of 25 or

higher (Avery, 2015).

Obesity Action Coalition: National, non-profit organization dedicated to decreasing rates of

obesity and chronic diseases related to it (Friedman, 2015).

Soda: See Sweetened Beverages

Stroke: When brain cells dies due to lack or blockage of blood flow (Nutrition for Everyone,

2012).

Sweetened Beverages: Drinks with added sugars that may be carbonated or non-carbonated

including fruit drinks, energy drinks, flavored waters and sports drinks (Friedman, 2015).

Type II Diabetes: A disease linked to obesity in which a person suffers from resistance to insulin,

a hormone that regulates many body functions (Obesity Causes, 2012).

Appendix A:

Survey on Behaviors of Soda Consumption Survey on Soda Consumption 1. Age: a. 18 to 24 b. 25 to 34 c. 35 to 64 d. 64 + 2. Gender:

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a. Female b. Male Please choose the answer that best supports your habits 3. I drink soda a. rarely (Less than 10 times per year) b. monthly c. weekly d. several times a week e. several times per day 4. If a restaurant charges for refills I will be most likely to: a. only have one drink b. continue to order as many sodas as I need to be satisfied c. Not buy soda at all d. none of the above 5. When trying to change a behavior I: a. Use education to promote change b. Will only change if the law prohibits my current behavior c. Will change my behavior if I cannot afford to continue it d. I have never tried to change a behavior 6. If I could only buy soda in 16 oz containers or less (even at restaurants) I would be: a. Happy- I don’t even like to drink more soda than that. b. Angry- Soda is my go-to drink. c. Neutral- I don’t really drink soda d. Annoyed- Now I have to spend more money to have more than one 7. I would describe my attitude toward food and drinks as a. Health conscious b. A Health Nut c. Taste matters more than health. d. Whatever I can afford, I eat/drink. Please rate your opinion on a scale of one to five for questions 8 through 10

1: Strongly Disagree 2: Disagree 3: Neutral 4: Agree 5: Strongly Agree 8. I like soda (including regular, diet, and other sweetened beverages such as fruit juice, sports drinks and energy drinks) 1 2 3 4 5 9. I think it is necessary for either the State or Federal government to help regulate soda consumption 1 2 3 4 5 10. I think soda is moderation is not harmful 1 2 3 4 5

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Appendix B:

Interview with Colleen Burke

Do you ever consume soda? • On occasion, maybe 5 to 6 times per year • In social situations, usually involving mixed alcoholic beverages • Not against soda consumption all together, it just needs to be limited. 4 cokes a day,

which may be a standard for many is way, way too much. Do you think there should be more restrictions on soda and sweetened beverage consumption, specifically in Fort Collins?

• Yes. • Luckily this place is already very health conscious, but people still need education • Making glasses smaller in restaurants

Do you think restrictions would work? What kind? • Taxes are the best in my opinion • Small price increases may be enough to deter purchasing sodas • Making the healthier choice easier and cheaper to make is very important

Do you think by decreasing soda in the United States, obesity will also decrease? • Yes • There are others things to drink besides artificially flavored beverages, flavored water

with real fruit, herbal teas, are all options

Appendix C: Interview with George Gianopoulos

How much does your restaurant profit from the sales soda type beverages?

• $1,962.12/week, $94,181.76/ year • 788 soda sold per week, excluding refills and employee use • 37,824 sodas sold per year

What is your professional opinion on the potential regulation of soda and sweetened beverages? • Incredible margins for profit, easy money

Do you think profits would increase or decrease with regulation of sodas? • Potentially both. At first an increase but later a decrease when people don’t want to pay at

all for soda If you could no longer sell sodas, would your revenue be largely affected?

• I think so; unless there was an alternative healthy beverage we could sell. It could also affect liquor sales because people like soda with alcohol such as whiskey and cokes.