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Written Testimony of the American Beverage Association to The New York Senate Finance Committee and The Assembly Ways and Means Committee

Written Testimony of the American Beverage Association to The New York Senate Finance Committee and The Assembly Ways and Means Committee

Presented by:
Maureen L. Storey, Ph.D.
Senior Vice President, Science Policy
American Beverage Association
1101 16th Street, N.W.
Washington, D.C. 20036

February 2, 2009

Mr. Chairman and Members of the Committee:

Thank you for the opportunity to provide written testimony on the lack of a scientific link
between soft drinks and obesity. Obesity is a serious issue in our society and its causes are much
broader than one single food or drink. We need to encourage more physical activity and
sensible, moderate consumption of all foods and beverages - which will balance caloric intake
with caloric expenditure.

Despite what Gov. Paterson and Commissioner Daines claim, the science is clear: the association
between sugar-sweetened soft drinks and obesity, if it exists at all, is so weak that total
abstinence from soda drinking will have no impact on public health. A peer-reviewed metaanalysis
by my former colleagues and I published in 2008 in the American Journal of Clinical
Nutrition showed virtually no association between BMI and sugar sweetened beverage
consumption.1 In our analysis, we examined the collective results of 12 studies. The current
scientific evidence shows that the relation between change in sugar-sweetened beverage
consumption and change in BMI is about 0.03, which is not statistically significant, nor is it
biologically significant. The association is so small, in fact, that totally eliminating soft drink
consumption would have no practical effect on BMI.

Governor Paterson relies heavily, if not entirely, on a study conducted by Ludwig and
his associates to impose an obesity tax on non-diet soft drinks and juice drinks without
regard to other serious limitations and failures in the Ludwig study.2 Ludwig and his
coauthors acknowledge the limitations of their study, admitting that, "[t]here are several
limitations to the interpretation of our findings." Including that it "cannot prove causality"
between soft drink consumption and obesity.

For example, this study population was 11- and 12-year old, growing children, many of whom
would be entering puberty-a period of normal "fattening" and growth. It is widely known and
accepted that BMI is an imperfect index to assess obesity in rapidly growing children, in
particular, and some adults as well. For example, with a BMI of 28.5, 6'2", 222-pound New
York Jets quarterback Brett Favre is classified as overweight.

Ludwig and his colleagues used skinfold thickness and BMI measured at the beginning and end
of this 19-month study to categorize the children either as normal-weight or obese. This
simplistic categorization reduces the precision of the study and was unnecessary since body
weight is an easily measured, continuous variable. The authors, therefore, chose not to fully
utilize the data available to them.

Another point that is seldom, if ever, acknowledged about the Ludwig study is that of the 548
Massachusetts children in this study, 150 were obese at the beginning of the study and 152 were
obese at the end of it. All lifestyle habits (diet, exercise, and sedentary behavior) and changes in
lifestyle habits related to obesity should have been analyzed to understand why some children
became normal-weight while others became obese. This was not done. While most of the
children remained in the same normal-weight or obese category at the beginning and end of the
study, there were some exceptions. For example, the authors emphasize that 37 originally
normal-weight children became obese, yet they fail to acknowledge that 35 originally obese
children became normal-weight during the 19-month study. These observations should have
been included in a fair, unbiased analysis. It therefore appears that the entire Ludwig study rests
on two additional obese children. This is hardly "proof" of a causal link between sugarsweetened
beverages and obesity.

The Ludwig study is only one among many that have been published on this topic and Governor
Patterson ignores other studies that show soft drinks are not linked to-or are very weakly
associated with-obesity in children and adults. In a commentary by Allison and Mattes
published in the Journal of the American Medical Association several days ago,3 the authors note
that some epidemiological, animal, and short-term food intakes studies support an association
between sweetened beverage consumption and others do not. The evidence, therefore, is
inconclusive. In addition, a review published by Gibson4 in 2008 concludes:

"...sugar-sweetened drinks (SSD) are by nature a source of energy but there is
little evidence from epidemiological studies that they are more obesogenic than
any other source of energy. Assertions that SSD are a disproportionate cause of
excess body weight and/or that their avoidance would be effective in preventing
weight are, in my opinion, not well substantiated by the science."

From a scientific standpoint, the totality of the scientific evidence does not support a tax on soft
drinks. There is nothing unique about the calories in sugar-sweetened drinks that uniquely
contribute to obesity in children or adults.

From an economic standpoint, taxes are always regressive affecting those who can least afford it.
A recent white paper by Gelbach and associates showed relative insensitivity to food prices
based on "healthfulness." 5 Imposing an obesity tax on certain food or subsidizing others is too
small to have an effect on health. The authors conclude that governments would have to impose
a 100% tax on unhealthful foods to realize a one percent decline in BMI.

In closing, I would like to reiterate what the science already says: that soft drinks are not a
unique contributor to obesity and to say otherwise is misleading to the people of New York
State. And a so-called "obesity tax" on beverages would have no noticeable impact on the health
of citizens.

¹ Forshee RA, Anderson PA, Storey ML. Sugar-sweetened beverages and body mass index in children and
adolescents: a meta-analysis. Am J Clin Nutr 2008; 87: 1662-1671.
² Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and
childhood obesity: a prospective, observational analysis. Lancet 2001; 357: 505-508.
³ Allison DB, Mattes RD. Nutritively sweetened beverage consumption and obesity: the need for solid evidence on
a fluid issue. JAMA 2009, 301: 318-320.
⁴ Gibson S. Sugar-sweetened soft drinks and obesity: a systematic review of the evidence from observational
studies and intervention. Nutr Res Rev 2008; 21: 134-147.
⁵ Gelbach JB, Klick J, Stratman T. Cheap Donuts Expensive Broccoli: The Effect of Relative Prices on Obesity.
March 21, 2007. http://www.law.yale.edu/documents/pdf/Intellectual_Life/JKlick_Cheap_Donuts.pdf accessed
January 8, 2009.