Last summer, San Francisco became the first city in the nation to require businesses that sell sugary drinks to post this disclaimer: "WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay." City leaders also banned ads for sugary drinks on public property and prohibited the use of city funds to buy such beverages.
It wasn't difficult to understand why. Studies suggest the consumption of sugary drinks — from soft drinks to sweetened energy drinks, iced tea and even some milk and juice-based beverages — is a major contributor to the obesity epidemic. Researchers from Tufts University have calculated that it's responsible for 184,000 adult deaths each year, including 25,000 Americans. As the American Heart Association has observed, sugar-sweetened drinks may not be the only source of sugar in the average American diet, but they're the main source.
The question is: Have the warning signs and other measures proven to be effective and, if they have, at what cost to businesses? It's too early to tell, of course, and that's exactly why we would ask Mayor Stephanie Rawlings-Blake and the City Council to table the proposal put forth by Councilman Nick Mosby and City Health Commissioner Dr. Leana Wen to require businesses to post warnings nearly identical to those developed in San Francisco.
That's not to suggest their concerns over sugar-laden drinks are misplaced. They are not. Obesity is a serious business, particularly in the African-American community where, according to the Centers for Disease Control and Prevention age-adjusted obesity rates top out at 47.8 percent (compared to 34.9 percent of all Americans). The cost is also staggering: Annual medical costs run more than $147 billion, according to the CDC. No wonder communities from California to New York have been exploring ways to lower obesity rates and reduce consumption of high-sugar beverages.
That's why we support the city's efforts to encourage groceries in the so-called "food desert" neighborhoods, healthy school meal programs, public education campaigns that promote healthy choices in both diet and exercise and other public sector measures. When Howard County Executive Allan Kittleman last year vetoed legislation requiring vending machines in county facilities to stock healthier, less sugary fare, we expressed profound disappointment that he would deny county employees and many county residents better access to more nutritional options.
But it's one thing for government to restrict harmful behavior on its own property and another to place that burden on the private sector. Would warning labels on menus, for instance, cause restaurant patrons to make smarter choices? Maybe, maybe not. Mandated calorie counts on menus have shown mixed results at altering consumer behavior, at best. One 2012 study published in the American Journal of Public Health actually suggested patrons were drawn to menu items that claimed higher calories, not lower ones.
Tobacco warning labels have certainly proven effective at helping curb smoking, but there is, admittedly, a difference between the use of tobacco, which is unsafe, period, and the consumption of sugary drinks, which may be strongly correlated with diabetes, cardiovascular disease, tooth decay and cancer but, in limited portions and countered with otherwise healthy lifestyle choices, pose less of a threat. There is also a difference between tobacco's fierce warning required by the U.S. Food and Drug Administration on every pack of cigarettes and the blander posting mandated by this proposal.
It is also unfortunate — and frustrating to any parent — that the beverage industry still appears to be in denial about the adverse health consequences of their products, particularly on children (just check out the volume of sugary drink ads that run with TV cartoons and similar youth-oriented programming). The San Francisco measure spurred strong industry reaction — as Councilman Mosby's legislation would likely trigger as well. In such a fight, it would be far better if the costs and benefits of San Francisco's actions could be spelled out in detail and over a reasonable period of time. Baltimore business owners have taken enough of a hit this year from the slowing economy and Freddie Gray unrest to heap an unproven mandate on them now.
Perhaps Baltimore should eventually adopt such an approach, and we certainly thank Dr. Wen and Councilman Mosby for bringing attention to the issue. But it's unnecessary for Charm City to be at the vanguard of this particular public health intervention until the benefits have been proven. Just as individuals should be cautious about their dietary choices, government must wield the regulatory bludgeon with care. Costly or not, taking quick and decisive action won't lower Baltimore's obesity rates if the strategy, no matter how well-meaning, turns out to be ineffective.