Air Date: Week of March 31, 2006

This Boston Public Middle School vending machine offers 100% juice, as well as yogurt drinks that contain 34g of sugar.

A recent study suggests that overweight youth who drink sugar-sweetened beverages on a daily basis leads to about one pound of weight gain in a three to four week period. Dr. David Ludwig, head of the Optimal Weight for Life clinic at Children’s Hospital-Boston speaks with Living on Earth host Steve Curwood.
 AND Sweetened beverages are being blamed for fueling the obesity epidemic in children. But many schools depend on revenue earned from the vending machines to fund extracurricular programs. Rachel Gotbaum reports.

Transcript

CURWOOD: It’s Living on Earth. I’m Steve Curwood. One out of three children in the United States is now overweight or obese, a sharp rise from earlier generations. And doctors say these kids may have shorter life spans than their parents when obesity-related diseases such as diabetes and heart disease kick in years later.

Many people link the consumption of sugary drinks to the obesity epidemic and, as a result, some schools have restricted or prohibited soft drink vending machines. We’ll visit one school that is wrestling with the pros and cons of those vending machines in a few minutes. But first, we turn to Dr. David Ludwig who’s just published the results of a preliminary study in the journal Pediatrics that shows a direct link between sugary drinks and obesity in certain children.

Dr. Ludwig heads the obesity program at Children’s Hospital-Boston. Let me ask you, why focus on soft drinks?

LUDWIG: Soft drinks are a particular concern because consumption rates have increased so dramatically in the last three decades. In the 1950s, children drank three cups of milk for every cup of soft drink. And today that ratio is reversed – three cups of soft drinks for every cup of milk. Observational studies – that is, looking at large groups of people over time and comparing changes in diet with changes in health – have suggested that soft drink consumption promotes obesity in a very dramatic fashion.

But these kinds of observational studies can’t definitively prove cause and effect. It could be that the children who are drinking more soft drinks are also doing other unhealthful lifestyle patterns that might instead be actually causing the weight gain. For that reason, it’s important to do what’s called a randomized controlled trial, and that was the basis of our current study.

CURWOOD: So what did you do for that study?

LUDWIG: We took 100 high school children in Cambridge, Massachusetts, who were drinking soft drinks at least once a day. And we randomly assigned them either to a control group, who were told to just basically keep doing what they’re doing in terms of soft drink consumption and other lifestyle patterns, and an intervention group. And the intervention group received home deliveries of non-calorie-containing beverages – that would be water, flavored waters, non-sugar-sweetened teas, and diet drinks, if they wanted – with the idea that by making these non-caloric beverages convenient and accessible we could more effectively eliminate sugar-sweetened beverages from their diets. Remember that sugar-sweetened beverages are highly advertised to kids and ubiquitously available.

CURWOOD: So, how long did you do this?

LUDWIG: So we provided these non-caloric beverages to their homes for a six month period. And we found, first off, that simply by making alternative beverages convenient and accessible to children, that they will almost totally eliminate the sugar-containing varieties from their diets. So, basically, advertising works, that the things that children find convenient and accessible are, in fact, influencing their eating habits. But perhaps most dramatically we found that among the overweight children in our study, those receiving this intervention to decrease sugar-sweetened beverages lost an extra pound per month compared to those in the control group.

CURWOOD: So you said this affected the heavy kids. What about the kids with ordinary body weight? Did this change in sugary drinks change their bodies?

LUDWIG: The effects of decreasing soft drinks increased with how heavy a child was. So among the normal weight children there was no effect. What it suggested was that those children replaced the calories from soft drinks from other parts of their diet.

CURWOOD: Now, when you talk about soft drinks and sugar, specifically what are you talking about for sugar?

LUDWIG: In our study we defined sugar-sweetened beverages as any product in which the major source of calories came from sugar. By way of comparison, a typical regular soft drink is about ten percent sugar. So that means that for 12-oz. servings they’re about ten teaspoons of sugar being consumed.

CURWOOD: What do you believe will help solve this obesity problem among our children?

LUDWIG: Obesity is caused by many, many different genetic and environmental factors, and clearly there will be no single one magic bullet to end the obesity epidemic, though our research, and that of others, suggest that sugar-sweetened beverages are playing a uniquely adverse role in promoting weight gain, especially in children.

But, in a more general sense, I think we need to take a complete re-evaluation of how we’ve structured the school lunch program, how we fund physical education classes in school and after-school recreational opportunities.

And also consider this as a family issue. Far too often, busy working parents leave their children to fend for themselves, not just for breakfast and lunch, but sometimes for dinner. At least one family meal a day can be an opportunity to, at the very least, provide an anchor for nutritional quality at that meal, and also to model healthful behavior that might extend beyond that meal throughout the day.

CURWOOD: David Ludwig heads the Optimal Weight for Life, or OWL, program at Children’s Hospital-Boston. Thanks for joining us, Dr. Ludwig.

LUDWIG: Thank you. Nice to be here.

CURWOOD: One way state legislators and school districts have begun to deal with the obesity epidemic in youth is by taking soda machines out of public schools. But many schools have become dependent on the revenue from their exclusive contracts with soft drink companies. The money goes to help pay for programs that would otherwise be unavailable to many kids. Rachel Gotbaum visited one such high school in Brocton, Massachusetts, and has our report.

[WALKING AND TALKING]

GOTBAUM: On a recent afternoon, Brockton High School’s energetic principal, Susan Sachowitz, walks the halls of one of the nine buildings on the school’s sprawling campus.

SACHOWITZ: Hi, just had gym?

BOY: Yeah, good.

GOTBAUM: Sachowitz goes downstairs to the corridor outside the girl’s locker room. That’s where one of the school’s two soda machines resides. The other one is in front of the boy’s locker room.

SACHOWITZ: This is the Coca-Cola soda machine. You can see that it has Coke, Diet Coke, Sprite. It has Fanta and one of the power drinks.

GOTBAUM: The machines are on a timer so kids can only buy soda at the end of the school day after gym class. There are other vending machines upstairs in the school’s three cafeterias. No soda is sold there. But Sachowitz is concerned that many of the other beverages offered to students still contain lots of sugar. She says she is no fan of the vending machines.

SACHOWITZ: I have very mixed feelings about it. We’re a school. The only machines we should have in the school are water machines, in my opinion. If we’re all worried about dehydrating, put water machines in.

GOTBAUM: Like many blue collar communities, Brockton is faced with a tight city budget. But the city has an exclusive contract with Coca-Cola, and the school district can make $50,000 a year in revenue from Coke’s vending machines. For Brockton High School’s principal Susan Sachowitz, the money is a big benefit.

SACHOWITZ: It has been a great help to me as a principal to have a fund that a teacher can come to me with an idea and say, ‘you know, I’d love our kids to participate in such and so, but the bus is $300,’ and I can say we’ll cover that. Because I have a fund that’s been money provided by the Coca-Cola machines.

GOTBAUM: The contract with Coke has allowed Brockton to do away with user fees for school sport teams that other schools must charge to students. Sachowitz says that has meant that poorer kids in Brockton are able to do doing something productive after school.

SACHOWITZ: When kids don’t have to pay user fees it’s going to encourage more to participate because they don’t have to make a choice about spending $100. They may not have it. If they stay here and participate, the more they stay connected to the school the more successful they will be. So I want them here.

GOTBAUM: And there are other perks. In order to obtain an exclusive contract with the city of Brockton, Coca-Cola also provides funding for kids programs and offers its own programs, such as camp Coca-Cola, free books for kids, college scholarships and even nutritional counseling for junior high school students. Still, Sachowitz says she has to constantly monitor what’s being sold in the school’s vending machines.

SACHOWITZ: One of the battles I had was over suddenly these flavored milks appeared in the machines, unbeknownst to me. I was very angry about it, I immediately got the Coca-Cola director on the phone. He said, oh it was a miscommunication and he got them out of the machine. But when I looked at them they were Milky Way milk and Snickers milk and let me tell you- it was all sugar. And here’s what was deceiving: the bottle is big, and it would say, for example, 190 calories; but when you looked at it it said per one serving, serving per container two or 2.5. Now, do you think a student is going to drink half of it and save the rest of it for tomorrow because it is unhealthy?

GOTBAUM: Sweetened beverages and sugared sodas have been blamed for fueling the obesity epidemic in children. One major study from Harvard Medical School found that every sugar-sweetened drink added to a child’s daily diet increased their chance of becoming obese by 60 percent.

Many lawmakers nationwide have taken steps to get soda out of public schools. The state of California recently banned soft drinks in all of its high schools, and ten major cities don’t allow sodas to be sold in their school districts either.

Last August, the beverage industry came up with its own guidelines and stopped selling soda in the country’s elementary schools, made soft drinks available in middle-schools only after-hours, and limited the percentage of sodas in high schools to 50 percent of the beverages sold. But for some critics that does not go far enough.

DAYNARD: The evidence is really coming in that this is rather like having a cigarette machine in schools.

GOTBAUM: Richard Daynard is a law professor at Northeastern University School of Law. Daynard spearheaded the lawsuits against the tobacco industry in the 1990s which won millions of dollars for plaintiffs across the country. He’s researching the prospect of mounting a similar action against the beverage industry.

DAYNARD: This is an industry that is doing something wrong, and the wrongness is a violation of state laws, present in most states- the consumer protection acts. What’s unfair about it is that it’s subjecting kids to a product that they now know is contributing to the ill health of children.

GOTBAUM: The beverage industry says it is being scapegoated for the obesity epidemic in kids. Kevin Keane is a senior spokesperson for the American Beverage Association.

KEANE: The critics and the trial lawyers have a tick list. Two years ago they went after the fast food companies. A couple of months ago they went after Tony the Tiger and Sponge Bob. Now, allegedly they’re going to go after the soft drink companies. Who’s next, Betty Crocker? We agree that the growth of overweight and obesity in children is a serious problem, and taking on that issue is going to take much more comprehensive ideas and programs than simply banning products.

GOTBAUM: Keane says the solution is to teach kids proper nutrition and to make sure they get enough exercise. They are already drinking less soda in school, he says, because the industry is offering alternatives.

KEANE: There’s a broad array of beverages offered in our schools, from bottled water to 100 percent juice to sports drinks to some full calorie soft drinks and some diet sodas, as well, and students are gravitating toward the bottled waters, and the sports drinks and the juices. They’re responding in a way I think parents would be happy with.

[SOUNDS OF GROUPS OF KIDS TALKING]

GOTBAUM: During lunch at Brockton high school, kids are drinking what they can buy in the cafeteria vending machines. The offerings include Minutemaid lemonade, Powerade sports drinks, bottled water and juice.

TREVON: My name is Trevon and I’m 16.

GOTBAUM: What are you eating today?

TREVON: Doritos and lemonade.

GOTBAUM: Do you drink soda?

TREVON: I don’t drink it a lot. I drink it on the weekends.

GOTBAUM: Why only on the weekends?

TREVON: ‘Cause I heard it gives you pimples.

GOTBAUM: Would you say that with the machines in less places here, the kids are drinking less soda?

TREVON: Yes, I would say that kids are drinking less soda because there’s a limited amount of machines. Because everywhere else you go there is juice and water and it is easier to get to.

GOTBAUM: Not far from where Trevon is sitting, Luisa, a 10th grader, is drinking water with her school lunch. She says she doesn’t drink soda in school anymore because she doesn’t take class near the soda machine.

LUISA: Actually, last year I did drink a lot of soda because they had a vending machine in the girl’s locker room, and I would buy my soda there.

GOTBAUM: And what happened?

LUISA: I don’t have gym this year, so I don’t have any soda.

GOTBAUM: City officials in Brocton say they are pleased with their relationship with Coca-Cola and they plan to renew their contract with the soda company when it expires in 2008. For Living on Earth, I’m Rachel Gotbaum.

 

Links

“Effects of Decreasing Sugar-Sweetened Beverage Consumption on Body Weight in Adolescents” Study, New England Journal of Medicine (PDF)

Press release on NEJM study

Dr. David Ludwig bio

American Beverage Association vending policy