Addressing the Obesity Epidemic and Sugar-Sweetened Beverages

Roberta R. Friedman, ScMDirector of Public Policy

Yale Rudd Center for Food Policy and ObesityHospitals for a Healthy Environment in RI Conference

April 2, 2010

The Rudd Center

• Strategic Science– Economics – Food Marketing to Youth – Law, Nutrition & Obesity – Public Policy– Schools, Families & Communities – Weight Bias & Stigma– Food & Addiction

2

Today

• Science• Mechanisms• Inconsistencies in literature

Definition

Added Sugars

• Sugar induces all of the diseases associated with metabolic syndrome, including:– Hypertension– High triglycerides and insulin resistance– Diabetes

Lustig, Nature, 2012

Sources of added sugars, NHANES 2007-08

Sources of added sugars, NHANES 2007-08

Sources of added sugars, NHANES 2007-08

Lustig, Nature, 2012

Empty Calories

250 calories 16 tsps sugar

16 oz 32 oz 44 oz 52 oz 64 oz

48 Teaspoons Sugar

Portion Sizes

Intake

Average US intake = 45 gallons/yr

Average US child = 193 calories/day

Andreyeva, 2011; Smith, 2010

Wang et al. Pediatrics, 2008

Marketing

Health Outcomes

• Wt gain/obesity• Type 2 diabetes• Cardiovascular disease

• Diet Quality• Dental caries• Osteoporosis• Gout

No credible evidence of benefit

Obesity

• Children– Every additional serving of per day increased risk

by 60%– More likely to be overweight and obese later in

life

• Adults– 1 or more SSB/day = 27% more likely to be

overweight

Clear association of intake w. increased calories, body wt., risk of diabetes

AJPH, 2007

Recent large studies show relationship between long-term weight gain, type 2

diabetes, CVD

Phys & Behav, 2010

Cardiovascular Disease

• Link to – Higher blood pressure– Adolescents’ risk of CVD and type 2– Waist circumference– High LDL cholesterol– Low HDL– Hypertension

Other Concerns

• Deterioration in dietary quality – lower intakes of calcium, fiber, micronutrients, other protective

compounds

• Dental caries– consistent observational and laboratory data

• Osteoporosis – displacement of calcium-containing foods, effects of phosphoric

acid, other components

Mechanism

• Sugar in liquid form less filling than in solid

• We don’t compensate for extra liquid calories by eating fewer calories from solid food

Mourao, IJO, 2007; DeCastro Physio Behav, 1993; Harnack, JADA 1999

…studies funded by the food industry reported significantly smaller effects than

did non–industry-funded studies.

AJPH, 2007

Industry funding increased likelihood of finding favorable to the sponsor by 4 to 8-fold

Lesser, et al., PLoS, 2007

Thank you! Roberta.Friedman@yale.edu

www.yaleruddcenter.org

www.yaleruddcenter.org/ssbtax