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
