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Smaller drink sizes mean better health: lessons from New York City

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…

The mayor of New York wants to restrict the serving size of sugar-sweetened drinks in the city. Aidan/Flickr

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.

It’d be good to accompany the ban with the provision of additional water drinking fountains in the city. Wisconsin Department of Natural Resources/Flickr

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% 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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4 Comments sorted by

  1. Dale Bloom

    Analyst

    Morgan Spurlock’s 2004 documentary film Super Size Me was totally engrossing, but I think his main criticism of the junk food industry was the instance of shop assistants to ask whether or not the customer wanted a larger size, for just a little extra.

    I have seen this occurring in Australia also, and it now appears obligatory for shop assistants to say “Is that all?” when a customer goes to the counter to pay for something, thereby tempting the customer to buy something more, just to please the shop assistant.

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  2. James Jenkin

    EFL Teacher Trainer

    Interesting article. It shows convincingly that soft drink is bad for you. However, is there evidence that smaller servings will make us consume less?

    In fact, Brian Wansink, whose research was used as evidence for the ban, suggests there may be unintended consequences (http://www.theatlantic.com/health/archive/2012/06/how-bloombergs-soft-drink-ban-will-backfire-on-nyc-public-health/258501/). He cites evidence which shows that when people are denied what they want, they rebel - for example, when someone is given a low-calorie meal against their will, they overeat for the rest of the day.

    Just because an intervention is well-intentioned does not mean it will work - and it may actually be counterproductive..

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  3. Margo Saunders

    Public Health Policy Researcher

    It is indeed telling that in the USA (my home country), a 'normal' serve is 500ml, and many places provide free refills. It's all about providing the consumer with 'value for money' -- hence the size of meals, where getting 'more for your money' has always been culturally important.
    Dealing with the psychological issues around food, including the 'rebellion' factor resulting from people feeling 'deprived' of what they feel they should have, is certainly important. I was therefore favourably impressed when, on visit to the USA a few years ago, I found that the cafe chain La Madeleine (http://www.lamadeleine.com/menu/bakery) is among those trying to do the right thing by offering beautifully-presented mini-tarts, mini-cheesecakes and mini-parfaits at mini-prices. This makes it possible to side-step that grouchy 'can't eat that' feeling. Worked for me.

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  4. Tim J Hawes

    Mr.

    I have to be honest, while an interesting article, I don't think you've convinced me that curtailing freedom is still worth it. I guess though, that that argument has more to do with politics than public health. Aka, how much government/bureaucratic interference are we willing to accept?

    Interesting to see that they are now considering action on 'popcorn, milkshakes, and milk-coffee beverages.'

    http://www.foxnews.com/politics/2012/06/13/new-york-now-considering-limits-on-popcorn-milk-drinks-pending-ban-on-jumbo/

    The article also points out that the sugar drink ban does not apply to convenience stores.

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