Globally, 1.7 billion people are overweight or obese and 246 million
have diabetes. Ninety percent of all diabetes cases are type 2, of which
90% are directly attributable to excess weight.1 Overweight and diabetes
account for a large percentage of healthcare costs in most countries.2
Vartanian et al’s meta-analysis found a clear association of soft drink
intake with increased calorie intake and body weight, lower intakes of
milk, calcium and other nutrients and increased risk of several medical
problems including diabetes.3 Based on the data, the authors appropriately
recommend reductions in population soft drink consumption, a task easier
said than done in today’s obesogenic environment.
Americans, for example, consume 38.3 gallons of full-calorie soft
drinks per person per year.4 This corresponds to approximately 63,000
calories, or if consumed in excess of energy requirements, 18 pounds of
weight gain per individual per year. In light of rapid globalization, the
wide reach of soft drinks accompanies technological advances that lead to
sedentary behavior, placing individuals, especially children and
adolescents, at further risk for overweight and diabetes. But
globalization can also be part of the solution.
How can we utilize powerful globalizing forces to reduce sweetened soft
drink consumption? The answer lies in structural, rather than educational,
changes.
Industry can and should be a part of the global response to obesity, but
in what role? Development of new drinks like Diet Coke Plus, Tava and 7Up
Plus are encouraging, and show that issues of obesity – and declining soda
sales due to consumer anti-fat attitudes – are beginning to be taken
seriously.5 Several reports by investment firms – Swiss Re, JP Morgan
– show that investing in health and healthier drinks and products is
profitable, and a report published by the HEAL Partnership in February
recommends ways that companies should address consumer health and obesity
issues, including strategy, governance and reformulating products.6 The
May 2006 agreement between Clinton's Alliance for a Healthier Generation
and Coca-Cola, PepsiCo and Cadbury Schweppes is a good example of
industry’s role.7 Kraft, PepsiCo and others have created healthier
products and voluntarily restricted advertising; more companies should
follow.
Governments also have an important role. Cigarette taxes and
advertising bans are known to be among the most effective ways to curb
smoking, especially among youth. Considering skyrocketing obesity rates,
and growing concern of diabetes, among children and adolescents,
governments should discourage sweetened soda consumption by adding taxes
to their sales and even subsidizing healthier beverages. Governments can
also work with industry to encourage healthier drinks/foods, for example,
by financially rewarding companies for innovation. The cost of treatment
for obesity and diabetes far outweighs the cost of prevention: innovation
costs can be viewed as minimal, even as investment.
Triumphant collaboration between public health and industry was
demonstrated in early fortification of foods with iron and folic acid in
the US. However, no successful attempts to reducing overweight have been
reported anywhere; creative win-win solutions are crucial. Media
campaigns, using cartoon characters and story formats to garner the
attention of children and celebrities to appeal to teenagers, can
encourage consumption of healthier foods and drinks. Finally, NGOs can
bolster the above efforts by working to unite all actors toward the common
goal of reducing obesity, an example of which is provided by the London-
based Oxford Health Alliance.
In light of unprecedented increases in overweight and diabetes globally,
action is urgently needed to curb trends. Potentially cost-effective and
pragmatic solutions – structural changes as opposed to educational
interventions alone – that include industry are crucial. Excess calories
from sweetened soft drinks is just one cause of the obesity epidemic, but
collaborative efforts directed at reducing soft drink consumption can
provide a focused start.
References
1. Hossain P, Kawar B, El Nahas M. Obesity and Diabetes in the
Developing World – A Growing Challenge. N Eng J Med. 2007; 356(3): 213-
215.
2. Yach D, Stuckler D, Brownell KD. Epidemiologic and economic
consequences of the global epidemics of obesity and diabetes. Nature
Medicine. 2006; 12(1):62-66.
3. Vartanian LR, Schwartz MB, Brownell KB. Effects of Soft drink
Consumption on Nutrition and Health: A Systematic Review and Meta-
Analysis. American Journal of Public Health. 2007; 97(3): 1-7.
4. American Beverage Association [homepage on the Internet].
Washington, DC: American Beverage Association; 2007 [updated 9 Mar 2007;
cited 2007 Mar 9]. What America Drinks; [1 screen]. Available from:
http://www.ameribev.org/all-about-beverage-products-manufacturing-
marketing--consumption/what-america-drinks/index.aspx
5. Martin A. Makers of Sodas Try a New Pitch: They’re Healthy. The
New York Times. 2007 Mar 7.
6. HEAL Global Partnership [homepage on the Internet]. London: IBLF;
2007 [updated 2007 Feb 8; cited 2007 Mar 7]. HEAL General Full Desc Page;
[about 3 screens]. Available from:
http://www.iblf.org/heal/general.jsp?id=123870
7. William J. Clinton Foundation: Alliance for a Healthier Generation
[homepage on the Internet]. New York: William J. Clinton Foundation; c2004
-2007 [updated 2006 May; cited 2007 Mar 7]. School Beverage Policy; [about
2 screens]. Available from: http://www.clintonfoundation.org/cf-pgm-hs-hk-
work2.htm