Amid an epidemic of obesity among children, Baltimore officials want to warn consumers away from sugary drinks sold in the city.
Legislation introduced Monday by Councilman Nick Mosby would require business that sell or advertise sugar-sweetened sodas, energy drinks, sports drinks, juices, coffees and teas to post signs warning consumers that they contribute to tooth decay, obesity and diabetes.
Mosby, who is running in the Democratic primary for mayor, and City Health Commissioner Dr. Leana Wen announced the effort earlier Monday.
"The science is clear: The biggest contributor to childhood obesity is sugary drinks," Wen said. "Childhood obesity will lead to adult diseases that kill, and we must do everything we can to protect the health of our children."
Such warnings reflect a new approach by local lawmakers looking for ways to get people to consume fewer calories. Former New York Mayor Michael Bloomberg's proposal to ban jumbo-sized sodas in New York was overturned in court, and taxes on sweetened drinks elsewhere have failed.
Mosby and Wen are looking to follow the example of San Francisco, the first U.S. jurisdiction to require warnings in advertising.
The Baltimore bill also calls for warnings on restaurant menus and in stores, in part so children buying drinks will see them, Mosby said.
Trade associations repesenting producers, distributors, retailers and restaurants in Maryland said the warnings would be ineffective and alarming to customers, while saddling businesses with extra costs.
But Wen said they would be a simple way to educate the public, and especially children. One in three school-age children in Baltimore is overweight or obese, she said, and one in four children drinks one or more sodas every day.
A 20-ounce Coke contains 65 grams of sugar, according to its label. Pepsi has 69 grams. A Snapple lemon tea has 45 grams. An 11.5-ounce illy cafe latte has 23 grams.
The American Heart Association recommends children consume no more than 20 to 32 grams of added sugar per day.
The signs would say: "Warning: drinking beverages with added sugar contributes to tooth decay, obesity and diabetes. This message is from the Batimore City Health Department."
Mosby said children and even their parents don't realize the harm.
"It's a quick warning that these drinks aren't something that kids should be drinking every day," he said.
The bill's prospects aren't yet clear. Mayor Stephanie Rawlings-Blake is "not planning to take an active role," spokesman Howard Libit said, but will "wait to see what comes out of the hearing and legislative process."
Councilmen Ed Reisinger and Carl Stokes said they want more information.
"I want to be at the hearing and hear exactly what the purpose is, and what the cost may be to the consumer as well as the businesses," said Stokes, who is also running in the Democratic primary for mayor. "We have to see what impact it truly will have."
Councilwoman Mary Pat Clarke expressed enthusiastic support. She said she wanted to co-sponsor the bill.
"There is direct evidence that says these drinks are at the root of the reason so many of our children are overweight," Clarke said. "Gee whiz, let's put up some warning signs to remind people when they are shopping: 'This is an outcome.'"
Research has linked sugar-sweetened beverages to weight gain. A recent study conducted by researchers at Tufts University in Boston and published in the journal Circulation suggested that consumption of sugary drinks leads to an estimated 184,000 adult deaths annually from diabetes, heart disease and cancer.
Public health advocates say warnings work to educate and deter consumers. Victoria Brown, a senior program officer at the Robert Wood Johnson Foundation, said labels on tobacco products have helped reduce consumption.
"Sugar-sweetened beverages are the largest single source of added sugar in the American diet," she said. "Health warning labels are proven to raise awareness of health risks."
Other cities and states have had varying success with health-related legislation. After Bloomberg's ban on large sodas was overturned, New York State is now considering warning labels on packaging. A similar bill in California was defeated, and San Francisco's ad warnings face a legal challenge.
Legislation in Congress to tax sugar and high-fructose corn syrup failed to advance last year.
Howard County Executive Allan Kittleman vetoed legislation last year that would require most food and drinks in county vending machines to meet caloric, fat and sugar guidelines, but the County Council overrode the veto. More than two dozen other cities and states have similar laws.
The Maryland Retailers Assocation said warnings in Baltimore would stick businesses with costs and pose competitive disadvantages. The Restaurant Association of Maryland said the legislation would "unjustifably alarm customers about ingredients that have long been generally recognized as safe by" the U.S. Food and Drug Administration.
The Maryland-Delaware-D.C. Beverage Association, which represents the nonalcoholic beverage industry, said consumers already can get nutritional information on packaging, and makers and sellers of sweetened beverages have responded voluntarily to consumer demand for more choices of low-calorie drinks and smaller containers.
"This proposal will not help consumers, nor will it impact public health," said Ellen Valentino, executive vice president of the association. "Instead it would frighten consumers by providing misleading labeling about products that are safe and can be easily enjoyed as part of a balanced diet."
Baltimore Sun reporter Yvonne Wenger contributed to this article.