Policy Changes Can Prevent Kids from Consuming Sugary Drinks

Dr. Sara Bleich, Professor of Public Health Policy at the Harvard T.H. Chan School of Public Health in the Department of Health Policy and Management, shares insights from her research related to kids’ consumption of sugary drinks. Dr. Bleich has devoted her career to preventing obesity, hoping to help today’s kids grow into healthy adults.   

“I’m particularly interested in children because little kids who have obesity are likely to have obesity as adults. It’s very hard to stop that trajectory once it starts. Anything that we can do to help kids grow up at a healthy weight is an investment that’s well worth making.”

— Dr. Sara Bleich, Professor of Public Health Policy, Harvard T.H. Chan School of Public Health, Department of Health Policy and Management

These days, many parents and their children know that sugary drinks, including fruit juices, sports drinks, and soda pop, are not good for them and should be avoided. But few know it better than Dr. Sara Bleich and her family. Bleich, an obesity prevention researcher, knows just how bad sugary drinks are for kids; the data are so concerning that she allows her two young children to consume sugary drinks only at parties. 

Dr. Bleich explains that, when her children go to parties, they are allowed to choose either a sugary beverage or a piece of cake. To make her point, Bleich shared a story about being at a child’s birthday party where someone said to her: “Your daughter is so funny . . . I offered her juice and she said, ‘can I see the cake first?”

Early Prevention Is Key

Dr. Bleich is passionate about her children’s health, and her passion extends to the health of all children. She has devoted her career to preventing obesity, hoping to help today’s kids grow into healthy adults. “I’m particularly interested in children,” Bleich said, “because little kids who have obesity are likely to have obesity as adults. It’s very hard to stop that trajectory once it starts.” 

In fact, research suggests that if current trends continue, a majority (57.3 percent) of today’s children (ages 2-19) will be obese by the time they are 35. “The numbers are just scary,” said Bleich. “Anything that we can do to help kids grow up at a healthy weight is an investment that’s well worth making.”

Why We Focus on Sugary Drinks

Science links obesity to chronic diseases, such as diabetes, heart disease, and cancer, which are the leading causes of death and disability in the United States. Further, sugary drinks, which contribute half of all added sugar to the diets of children ages two and older, have been found to promote weight gain in children and adults

Fortunately, overall rates of sugary drink consumption are going down, but progress has been uneven: it’s declined a lot less among children and teens from families with low incomes compared to their peers from more affluent families. There also are differences in sugary drink consumption by race and ethnicity: Black and Latino children, who are at higher risk for obesity, consistently have the highest intake levels of sugary drinks. These data are particularly concerning now, given that COVID-19 disproportionately affects low-income communities and communities of color, as well as people with obesity or other health complications.

Bottom line: even with consumption declining, too many children and teens, especially those most vulnerable to health disparities, are still drinking too many sugary beverages. In response, Dr. Bleich recommends policy changes that encourage children and families to buy and drink fewer sugary beverages. 

According to Bleich, the public knows sugary drinks are not healthy and is okay with limiting children’s access to them. “That public attitude greases the wheels for policy work actually happening,” said Bleich.

“If you’re working on policy relevant issues, it’s important to look for the low-hanging fruit. To me, sugary beverages have always felt like a low-hanging fruit because they’re easy to isolate, easy to understand, and relatively easier to craft policy around.” 

Changing Labels Can Change Kids’ Habits

Bleich and her research colleagues did a study that found placing easily understandable calorie information on sugary drinks labels–particularly explaining how much physical activity it would take to burn off the calories in just one drink–reduced calorie intake from sugary drinks among Black teens from low-income families. 

Graphic showing activity to burn 250 calories

According to Bleich, “We told them a bottle of soda was 250 calories. We also said that’s equivalent to 15 minutes of running or five miles of walking. By making the calories more meaningful, we saw calories from purchased sugary beverages go down, the number of sugary beverage purchases go down, some kids didn’t buy a drink at all, and there was a persistent effect on those outcomes afterwards.”

The study generated a lot of interest among public health advocates and researchers, and additional studies looking at similar questions. “That was one of the first times I felt I was asking questions where the answers mattered a lot in the real-world, and I wanted to do more of it,” Bleich said.

Benefits of Taxing Sugary Drinks

In recent years, Bleich and her colleagues focused on the effect of taxes on sugary beverage purchases since taxes change the food environment rather than focusing on individual behavior change.

“We know from mountains of literature on tobacco that, if you increase tobacco prices, people smoke less. And now we have growing evidence about beverage taxes that tells us if we increase the prices of sugary drinks, people buy fewer of them.”

Three years after Berkeley’s sugary drink beverage tax was implemented, which was the first in the country, evidence suggests that consumption has decreased.

Bleich herself has studied the effects of a sugary drink tax. Her research on Philadelphia’s 1.5 cent per ounce sales tax on sugary drinks showed that the volume of taxed beverages sold dropped by about 40 percent, and the drops appear larger among those with low education. Bleich believes that is very encouraging from an equity perspective because this is also a population who is at higher risk for obesity and for many diet-related diseases. 

Both Berkeley and Philadelphia put the tax revenue toward efforts to improve public health. In Berkeley, a school-based gardening and cooking program, a public education campaign, health screenings and dental care. Philadelphia uses the revenue to fund universal pre-Kindergarten education for children, community schools, and green spaces.

Creating Opportunity from Crisis

Dr. Bleich believes we have an opportunity right now to implement a national tax on sugary drinks. She points out, for example, how the COVID-19 pandemic is affecting some children’s access to food options.

“When kids are in school, particularly those who get a lot of their meals and beverages there, they are somewhat protected from unhealthy influences. The longer the pandemic goes on, the longer kids have exposure to sugary drinks outside of school. I think there probably was, and will continue to be, an uptake of sugary beverages over this period.”

Bleich shared: “If I were queen for a day, I would use the unfortunate COVID-19 crisis, which has created enormous resource gaps for government, to pass a national tax on sugary drinks and use that revenue toward improving the public’s health.”

Published on October 14, 2020

special report

Sugary Drinks Harm Kids’ Health

Reducing or eliminating consumption of sugary drinks is critical for helping kids grow up healthy. This feature highlights the latest data and trends on sugary drink consumption and facts about how sugary drinks impact kids’ health.

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Preventing Childhood Obesity: What Will it Take?

A conversation between Dr. Richard Besser, RWJF president and CEO, and Jamie Bussel, senior program officer

On October 14, 2020, the Robert Wood Johnson Foundation released State of Childhood Obesity: Prioritizing Children’s Health During the Pandemic. In this video, Dr. Besser and Jamie Bussel talk about childhood obesity, COVID-19, income disparities, and what the country needs to do to address these interwoven challenges. Watch the video and read the lightly edited transcript that follows.

Jamie Bussel: Today, we’re really excited to be releasing our second annual report, State of Childhood Obesity: Prioritizing Children’s Health During the Pandemic. And I’m thrilled to have our President and CEO, Dr. Rich Besser, here with me to discuss the report. Hi, Rich.

Rich Besser: Hey, Jamie, it’s great to see you remotely and to have a chance to talk about the report. What are the data showing us?

Jamie Bussel: The newest data are from a survey of children between the ages of 10 and 17 and what it shows us is that 15% of kids in this age range have obesity. That’s a number that’s remained pretty consistent over the last couple of years. In addition, we continue to see stark and deep disparities across race and income. And interestingly, and not surprisingly, a lot of the disparities that we’re seeing are also being mimicked by the kinds of disparities that we’re seeing with the COVID epidemic. So, I’d love Rich to sort of hear from your perspective, how you’re thinking about that. Kind of the intersection or almost the reinforcing of one issue, one crisis, with the other.

Rich Besser: What you’re saying in terms of the obesity data in America and the disparities and what we’ve been seeing over time really resonates with what’s taking place around COVID. Because while obesity hits every racial and ethnic group and every income group, it doesn’t hit each group equally. And that’s what we’re seeing with COVID. And when you think about why that is, there are a number of different factors. Some have to do with exposure but so much has to do with opportunities to make healthy choices. If you live in communities where the jobs that are available to you require face-to-face interaction and are lower paying jobs then the likelihood is that you’re going to have to go to work if you want to put food on the table and want to pay the rent.

So that increases the risk. The overlap between groups that are being hit hardest for COVID and the disparities that you’re laying out for obesity show there are real parallels there. And it calls out the importance of not just lifting up these disparities, but framing it around opportunities. Who has opportunities for healthy eating and for healthy activities and for the types of behaviors that will reduce the risk for obesity?

Jamie Bussel: So Rich, on that, because I think this conversation could be a bit gloomy, but I’m definitely a person that sees the glass half-full and so I’d love to chat a little bit about what gives you hope and optimism. I know for me, and there are some incredible stories embedded in the new report that really lift up extraordinary people, extraordinary leaders on the front lines doing things that are transformative for people, for kids, for families, without actually the supportive policies or big resources and investments. So I think for me those are incredible beacons of hope.

Rich Besser: There are a number of things that give me hope. I get hope from the humanitarian outpouring that we’ve seen during COVID. You know, in response to hunger, people stepping up and providing more support for food banks and other ways of getting food out to people. And that’s terrific. What I want to see though, longer term, is the support for the policies that, if put in place, will mean that in the next crisis, or everyday for so many Americans, we won’t need so many food banks because we will have jobs that pay a living wage so people can buy healthy food. We will break down the barriers that keep our communities so segregated that prevent people from having opportunity. And I think that we are at a moment in our history where because of this crisis, because of the pandemic of coronavirus, and the devastation from this economic downturn and the spreading and rising and the inspirational movement for racial justice that we can see policy changes that truly change the nature of our communities. We can make our communities really communities of opportunity and not communities that lead to the health consequences that we’re talking about today.

Jamie Bussel: Rich, I love that idea, the notion of communities of opportunities. Maybe I’ll just close by saying that I think our Foundation’s commitment to preventing childhood obesity is really a commitment to ensuring that every child in this country, every family, has a fair and just opportunity to live the best, healthiest life possible.

I remain incredibly hopeful and I’m thrilled that you took some time out today to chat with me about the forthcoming report.

Rich Besser: Well said Jamie. Thanks for sharing all that you’re doing around childhood obesity and around this report. I hope you are well and stay well. Great talking to you.

Jamie Bussel: Thank you. You too. Thanks, Rich.

Building a More Equitable San Antonio

San Antonio Mayor, Ron Nirenberg, explains how changing policies is helping more children have the opportunity to grow up healthy in his city.

No matter what corner of San Antonio you visit—from the playgrounds at Hardberger Park to the toddler garden at the Witte Museum—you’ll find similar infrastructure and services or a plan for addressing the inequities that exist. That’s because Mayor Ron Nirenberg is focused on building a more equitable city where everyone benefits and children can thrive. 

Mayor Nirenberg is committed to helping children grow up healthy and purposeful about allocating resources where they’re needed most. He leans on his Department of Public Health to tell him “what he doesn’t want to know about the health of his city,” so he can draft policies that address those challenges. For example, the city is working to ensure that new sidewalks are built wide enough to encourage people to walk on them, and building them in the historically under-resourced neighborhoods that never had sidewalks before. 

“My hope for the children of San Antonio is that no matter where they are born in this community, they will grow up knowing that they can achieve anything that they want to. And that they will live a healthy life and be able to accomplish their dreams here in our city. We’re on our way to building that city. “

Mayor of San Antonio, Texas, Ron Nirenberg

Mayor Nirenberg recognizes the challenges of addressing childhood obesity in a city that was built more than 300 years ago and historically has struggled with intractable generational poverty and wide socioeconomic gaps. But he’s seeing results and remains hopeful about the future. 

Published on October 10, 2019

Young boy holding a plant.

Stories and Expert Perspectives

Hear from experts about the impact of policies and programs in their communities, read interviews with researchers about data releases, and learn how some communities are taking action to help more children grow up healthy, including from places that have measured a decline in childhood obesity rates.

See More Stories

The Power of Community Partnerships

Dr. Renee Boynton-Jarrett talks about the importance of listening to and partnering with the members of her community to build and support a culture of health.

When a mother brought her 13-year-old daughter to the health clinic with concerns about her dramatic weight gain, Dr. Renee Boynton- Jarrett wasn’t quick to prescribe a solution. Instead, she pulled out a growth chart to help the mother pinpoint when her daughter’s health began to change. After Dr. Boynton-Jarrett asked a couple of questions, the mother realized her daughter’s weight gain began one month after her father was incarcerated. From there and together, they created a plan to address it. 

“Everything around how a child grows and develops, what their ultimate life chances are, and chance for health and well-being, is intricately and inextricably connected to their family and community environments. If we present opportunities for people to own what health and well-being look like in their communities, they will take that opportunity and transform lives. ”

Dr. Renee Boynton-Jarrett,
Pediatrician and Social Epidemiologist at Boston Medical Center

This exemplifies Dr. Boynton-Jarrett’s approach to care, serving as a listener and facilitator. It illustrates what she believes to be true: that we cannot continue to address childhood obesity reactively. Rather we must address its root causes: severe inequities that plague our underserved communities and leave families without access to healthy affordable foods, safe neighborhoods, safe streets, and opportunities for physical activity. 

Renee believes that the answers for addressing childhood obesity lie within individuals and communities themselves. Together with local partners, she’s helping more families have access to healthy foods. There are healthy food trucks, nutrition and cooking classes for expectant mothers, and gardens both in the community and at the hospital itself for neighborhood parents. 

Published on October 10, 2019

Young boy holding a plant.

Stories and Expert Perspectives

Hear from experts about the impact of policies and programs in their communities, read interviews with researchers about data releases, and learn how some communities are taking action to help more children grow up healthy, including from places that have measured a decline in childhood obesity rates.

See More Stories