Conflicting nutrition information is perplexing. What foods are best, and how much of them should we eat? There’s evidence that exposure to conflicting nutrition information leads to confusion, decreased trust in health recommendations, and less adherence to healthy behaviors – not only for the foods in question, but also more general nutrition guidelines (including those that aren’t controversial, like vegetable consumption).
Consequently, the exclusion of 100% fruit juice from Philadelphia’s city-wide sugary beverage tax is a huge problem. At best, this exclusion looks like an oversight. At worst, it’s an endorsement.
Sugary beverages of any kind aren’t healthy. They have little to no nutritional value and are the largest source of added sugar and excess calories in the American diet. Consumption is not only associated with weight gain and obesity, but also health problems like type 2 diabetes and tooth decay. Importantly, interventional studies show that reduced consumption of sugary drinks improves health outcomes.
Taxing sugary drinks – and effectively raising their prices – can (and has) reduced consumption. A soda tax in Berkeley, Calif., reduced consumption by 21% in the first year of implementation, and these reductions were sustained over the following three years. Philadelphia’s soda tax reported even stronger results. Within the first two months of the tax, sales of sweetened beverages fell by 38%, a startling decline.
But Philadelphia’s tax only applies to drinks with added sugar (including both natural and artificial sweeteners). 100% fruit juice is excluded, adding to fruit juice’s “health halo.” This “health halo” effect occurs when a food that has some healthy attributes is perceived as fully virtuous. Whole fruit provides many health benefits, including dietary fiber, potassium, and vitamin C. Fruit juice may retain some beneficial nutrients – like antioxidants or vitamins – but it shouldn’t be consumed heavily (and some claim, even much at all).
In fact, although fruit juice is widely perceived as healthier than soda, it contains just as many calories and sugar. A 12-ounce can of Coca-Cola has 140 calories and 10 teaspoons of sugar, whereas 12-ounces of apple juice has 165 calories and 9.5 teaspoons of sugar – in short, apple juice has just a half-teaspoon less sugar than a can of Coke, roughly equivalent to 2.5 Skittles. While the sugar in 100% fruit juice is naturally occurring (rather than added in), the physiological response (and health consequences) are essentially the same. The key issue is fiber: when you eat a banana, the fiber in the fruit slows down the body’s absorption of sugar (and fills you up). Remove the fiber, and the sugar hits immediately, just like a soft drink.
Soda, sport drinks, and sweet teas – artificially sweetened or not – aren’t good for you. But fruit juice – according to both popular belief and implied by the soda tax exclusion – is different. This perceived “health halo” shouldn’t be trusted; fruit juice is still packed with sugar and excess calories, which are associated with poor health outcomes, including obesity, diabetes, and even early mortality.
If we trust our legislators to put in place the Philadelphia beverage tax, we need to trust them to do it right. Talk to your local legislators and tell them that you want all sugary drinks included in the Philadelphia beverage tax. Let’s remove the confusion and set the record straight – all sugary drinks should be limited, no exceptions.