New York Mayor Michael Bloomberg proposed this week a first-of-its-kind ban on the sale of large-sized sodas and other sugary beverages at restaurants and other outlets, but don't look to Baltimore to immediately follow suit.
Though studies say such restrictions, as well as higher prices and education, can curb consumption, some local leaders plan to let New York be the test lab for now.
Baltimore Mayor Stephanie Rawlings-Blakewill remain focused on a controversial plan to increase the tax from 2 to 5 cents on sugary drinks and alcohol. It was meant to generate millions in public school construction funds, but was formulated with health effects in mind, said Ryan O'Doherty, her spokesman.
"The mayor's proposal encourages healthy choices because the tax completely exempts milk and dairy substitute containers and beverage containers with at least 10 percent juice contents," he said.
But he added, "Congratulations to Mayor Bloomberg for standing-up to the big, powerful beverage industry on behalf of city youth."
New York plans the ban as early as March on soda, sports drinks, sweetened teas and other sugary beverages larger than 16 ounces sold in fast food restaurants, concession stands and delis, according to media reports. It would not apply to diet soda, dairy products or alcohol, or drinks sold in groceries or convenience stores.
It was immediately denounced by industry.
"New Yorkers elected Bloomberg as their mayor, not their mother," J. Justin Wilson, senior research analyst at the Center for Consumer Freedom, an industry-backed group, said in a statement. "He seems to be on a never-ending crusade to demonize and regulate anything and everything that tastes good."
Bloomberg has already targeted trans fats and salt and forced restaurants to display calories counts on menus, some actions that Baltimore has emulated.
Dr. Oxiris Barbot, Baltimore's health commissioner, said there are educational efforts underway to change behavior among city children and adults. Officials are in schools talking about good nutrition. And at recently held community meetings, residents identified obesity as a top issue to tackle, though no specific plans are formulated.
"Clearly we have a mandate from residents for more coordinated and perhaps more aggressive approaches," Barbot said about what they may consider.
On average, kids and adults get up to 15 percent of their calories daily from sugary drinks, and poor minorities at higher risk for obesity consume more, said Sara Bleich, an associate professor of health policy at Johns Hopkins' Bloomberg School of Public Health. (There's no evidence diet soda consumers are thinner or healthier than regular soda drinkers, she said.)
There are proven methods of limiting sugary beverages, the largest source of empty calories in American diets, Bleich said. She recently completed a study showing that kids told they had to run 50 minutes to burn the calories in one bottle of soda cut purchases by 50 percent.
But she said, "Giving consumers information is helpful in changing behavior but it's not ideal on its own."
She said the most effective way to curb consumption, studies show, is to "fiddle with prices." New York tried and failed to tax sugary drinks, and Baltimore's tax may not be high enough, she said. Studies show the tax would need to be closer to 10 percent for a significant impact.
People generally don't like restrictions such as the one proposed in New York, but they also can work. Someone able to buy 16 ounces of soda is likely to be as satisfied as if he got 20 ounces, without the extra calories, Bleich said. Few are likely to buy two sodas to compensate.
In the end, she said many steps are needed to tackle the obesity epidemic now costing $147 billion in health care costs annually.
That's a number not lost of Dr. Joshua M. Sharfstein, secretary of the state Department of Health and Mental Hygiene.
"There's a lot of evidence that sugary drinks like soda play a role in obesity and obesity is a big problem," he said. "It will be interesting to see how this approach plays out in New York. … I think the important message is people should limit their intake of sugary beverages."