Welcome to my Sunday obsession. Since early March, I’ve heard many debates on The Soda War: is the banning of sodas greater than 16 oz an effective way to fight obesity? Here I will present a few of the issues in this debate and the great difficulty I’ve experienced in finding primary sources of information.
I listened last week to a Slate’s Table To Farm episode that debated about whether banning of extra-large sodas is an effective way to limit calorie intake and obesity. They had two guests on the show representing both sides of the debate. I personally found the anti-soda ban argument a bit weak—this guest said that policies are unfair because they are targeting low income people’s pleasure foods; you don’t see anyone limiting the intake of brie, chips, beer or wine, for example, which are also not particularly healthy. The failing of this argument is that one product is sold as a single serving (extra-large sodas) versus products that are meant to be multiple servings (though I suppose people do eat a whole bag of chips in a sitting)—but it’s not like you go to the movie theatre to buy a large wheel of cheese for yourself.
Their debate has stayed on my mind, so I started to look for good sources of information. After doing a preliminary Google search for “public health news,” I was lead to American Public Health Association’s website. At first glance, I was impressed by the breadth of topics covered: click on the “Topics” tab, you will see the broad range of public health news topics they are reporting on (Child Health, Environment, Funding, Health Reform, HIV, Nutrition, etc).
Once I got into the articles, however, I was disappointed by the lack of primary sources. On the “soda ban” page, it said in the first paragraph, “New research shows that prompting beverage makers to sell sodas in smaller packages and bundle them as a single unit actually encourages consumers to buy more soda — and gulp down more calories — than they would have consumed without the ban.”
It went to on to list how this topic was being portrayed in a couple of city newspapers, but it failed to cite the original paper it was talking about. I would like to see the article showing how it can encourage more soda drinking. It did have links to the Jon Stewart show and his mention of this topic (or rather heckling). Why not cite the original source so we can decide for ourselves if the research is good?
In trying to track down the original study, I discovered that many media sources had been referencing this study and using it as concrete evidence against the soda bans, ie “Study shows that limiting size makes us want to gulp more.” However, most of the articles I read, including a New York Times article, did not provide links to this study. Also, I could not find the original study on Pubmed (I searched for “Brent Wilson” “Limiting Sugary Drinks” “Wilson soda”). I could not easily find it by going to PLOS website. I finally found a link to it here (KPBS, affiliated with San Diego State University).
The author of the study is Brent Wilson, a psychology doctoral student at University of California San Diego. How many people were studied? 100 college students. Aren’t you glad that policy makers (and media sources and the public) are relying on this one study (by a student with undergraduate student participants) to make public health decisions? I haven’t personally decided yet what is the most effective way to fight obesity. But I won’t be making my decision based on this single, small study by a student.
Another part of this debate has to do with the ‘anti-Bloomberg laws.’ According to the New York Times, the State of Mississippi has passed a law mandating that any policy that restricts food or drink must be passed at the state level. This means that cities or counties cannot form their own policies on a large range of nutrition issues: limits to soda size, salt content, shortening in cookies, toys in fast-food meals for children, how a menu is written or just about any other daily dining experience. However, this has had an unexpected backlash. Local governments are upset, not because they wanted to ban large-sized drinks, but they see this as a limit on their local authority to decide what is right for their region. Others are upset, like restaurant owners, because they want the choice to be up to them. Because restaurants and other vendors are driven by consumer demand, more and more restaurants are taking up healthier options already, not because the government demands it of them, but because consumers want these options. Restaurants should therefore be able to cater to the demands of the consumers. The ironic part of this, is that Mississippi, according to NPR, has the highest rate of obesity in the country (1 in 3). So if restaurants are catering to consumers, should we be focusing our efforts on educating these consumers and influencing them to want healthy options?
The biggest lesson from my weekend reading is that the major news providers seem to have a couple of pieces of knowledge that they are all reporting. They lack real evidence and, worse, make it difficult to track down the ‘real’ evidence they present. It took me a lot of motivation and time to track down the primary sources. There has to be a better way to access information that is cited in the top media sources. I want to be able to look at these primary sources, see what real evidence is out there for or against of proposed public health intervention, and decide for myself. If I had not taken the time to hunt the original sources down, I could easily have made important decisions based on very flimsy evidence.
What about you? What public health interventions do you think we should be focusing on to fight obesity? Policies? Education? And where can we go for reliable public health information on this?