By Jonathan Purtle

Tuesday marked the first day of public hearings on New York Mayor Michael Bloomberg’s proposal to restrict the size of sugary beverages (primarily soda) sold at most food service establishments to 16 ounces. The proposal—which is likely to reduce caloric intake, according to letter from researchers that was published Monday in the New England Journal of Medicine—is the most recent policy initiative intended to stem the tide of the nation’s obesity epidemic.

There are lots of hurdles to be overcome before it goes on the books. Among them are the usual opponents of regulatory efforts to protect the public’s health – an industry with pockets deep enough to spend millions of dollars lobbying elected officials at all levels and still have plenty left over to fund lawsuits, and members of the public who seem to view any sort of meddling as an unwarranted infringement upon their individual liberties even though all of us end up sharing the medical bills for their decisions. A century’s worth of successful public health efforts aimed at preventing tobacco use (taxes, restrictions on availability, bans on advertising) provide some guidance for fighting these battles, but proponents of sugary beverage regulation are currently lacking an important weapon that proponents of tobacco regulation acquired in 1964—a report from the Surgeon General.

Ever since the landmark Surgeon General’s Report on Smoking and Health in 1964, reports of the Surgeon General have played a major role in shaping the public health agenda. They synthesize research, underscore urgency, and outline strategies to address the problem. In the absence of such a report, research on emerging health issues often remains fragmented, creating a “million little pieces effect” that isn’t compelling to policy makers and doesn’t stand up to harsh industry opposition. Reports of the Surgeon General have focused on issues such as smoking, violence, physical activity, and HIV/AIDS.

Last week, nearly 100 health and medical organizations from across the country called on the Surgeon General to produce a report on the health effects of soda and sugary beverage consumption. The request was organized by the Center for Science in the Public Interest and was made in the form of a letter to Kathleen Sebelius, the secretary of the U.S. Department of Health and Human Services.

"Soda and other sugary drinks are the only food or beverage that has been directly linked to obesity, a major contributor to coronary heart disease, stroke, type 2 diabetes, and some cancers and a cause of psychosocial problems," the letter says. "Yet, each year, the average American drinks about 40 gallons of sugary drinks, all with little, if any, nutritional benefit."

The letter's signatories include the American Diabetes Association, American Heart Association, Yale Rudd Center for Food Policy and Obesity, and health departments from across the country. Among them was the Philadelphia Department of Public Health.

"Given the city's activities to make the public aware of the harms of consuming large amounts of sugary drinks and to decrease sugary drink consumption," Philadelphia health commissioner Donald Schwarz explained via e-mail, "we believe that a scientifically-rigorous report documenting the current state of information on these issues is warranted and will help policymakers understand the importance of taking action."

Mayor Nutter's proposed soda tax has been twice denied by Philadelphia City Council despite the nation’s obesity crisis, which happens to be even worse here. Similar proposals have failed in municipalities across 30 states.

The letter to Secretary Sebelius notes that a report from the Surgeon General, Vice Admiral Regina M. Benjamin, could be just what is needed to transform these well-intentioned, and empirically grounded, proposals into policies that will help keep people healthy.“ Much as the 1964 Surgeon General’s Report on Smoking and Health focused national attention on the harms of tobacco use, Americans now need a wake-up call with regard to the impact of sugary drink consumption on the health, economy, and national security of our country,” states the letter.

Sebelius has yet to respond to the letter, according to Center for Science in the Public Interest. Maybe they should have sent it to Michelle Obama.

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