Courtesy of http://www.urbanoyster.com
Yes, we are back on obesity again, but how can we ignore it when it is only becoming worse and worse in this country. I recently read that 1/3 of all Americans born after the year 2000 will develop diabetes, especially type II diabetes, at some point in their lives (Manning, 2003)! Not only is diabetes devastating by itself, but it can also lead to vascular diseases and other complications of the kidneys and eyes. Diabetes is also a major cause of heart disease and limb amputation (Manning, 2003). I am all too well orientated with diabetes as it is rather prevalent on my mother’s side of the family. My grandfather suffered greatly, from both the pain and the duration of his diabetes, and it eventually took his life. In the last ten years of his life he became legally blind, losing his ability to do what he loved most, driving cars. He also lost the ability to liberally do his next favorite activity, eating…After all, he was Italian! During the last ten years of his life, he also lost the functioning of his kidneys, thereby requiring him to seek hours of dialysis every other day for the rest of his life…An activity which he truly hated…Finally, months before his death, his physician recommended amputating both of his legs below the knee, as he had lost almost all sensation in his lower legs….However, for the sake of my grandfather’s personal dignity, my grandmother demanded that he keep his legs….All this horror, but while his body was shutting down on him, he never lost his clear mind and psychological abilities…What a truly horrible way for a person to die….
This is one of the many reasons why I am a big believer in prevention. With obesity on the rise, this is going to lead to even greater numbers of diabetic Americans. So, if we want to promote the prevention of obesity in this country, where do we start? How about our children! Who has the greatest degree of responsibility in this manner? Their parents! Unfortunately, many parents out there don’t understand themselves how to maintain their health thereby preventing future health episodes. This is one of the many reasons why I am a great supporter of local public health agencies and the different programs that they host helping people learn about healthy eating and cooking strategies.
Courtesy of http://www.health.state.nm.us
However, this blog isn’t about what parents need to do. Rather, I would like to talk about health policy in our schools. A major source of obesity in this country is the consumption of soft drinks. So, should schools ban the sale of soft drinks? It is an interesting question as California has already stepped to the plate and done this. In 2003, California banned the sale of soft drinks in all public elementary and middle schools. Later, in 2005, California banned the sale of soft drinks in all public high schools, while also passing legislation on the nutritional requirements of vending machine products and the amount of fruits and vegetables required in school meal planning (Daily News Central, 2005). According to Governor Arnold Schwarzenegger and officials, “over the past decade, Californians have gained 360 million pounds… obesity threatens to surpass tobacco as the leading cause of preventable death in California… it causes more than $20 billion in health-related costs each year” in California alone (Daily News Central, 2005).
Click Here to See an Interesting Video Concerning Soft Drinks in Alabama Schools
So, do laws like these actually help? It’s hard to say, as researchers seem divided on the ban’s effectiveness. However, one thing is not being debated, and that’s the excess sugar and calories found in soft drinks and its relation to obesity. In fact, policy efforts to curb soft drink availability in schools has taken place in at least 30 different countries around the world, as obesity is becoming a world-wide pandemic (Hawkes, 2010). One of the reasons why policy makers are targeting soft drinks in schools is because school time is the one main time when children are away from parents making their own independent decisions, leaving them to the shrewd marketing techniques of the soft drink companies. In fact, it must be noted that soft drink companies have purposely been targeting schools because they have an easy and unprotected target in children, and because of this over 85% of American high schools have soft drink vending machines (Hawkes, 2010). So what’s stopping us from banning soft drinks in schools?
While there is clear evidence that soft drinks are nothing but empty calories and excessive sugar, studies have found soft drink bans in schools are not as effective as first thought. A recent cross-sectional study by Fernandes (2008) looked at the relationship between school bans on soft drinks and overall soft drink consumption by American fifth graders. Thus, in this study the exposure would be attending an elementary school that has banned soft drinks, while the disease or outcome would be the overall decrease in consumption of soft drinks. Over 10,000 fifth graders from 2,300 elementary schools were used for this study. The study found that of the over 10,000 fifth graders that attended an elementary that did not ban soft drinks, about 26% of them purchased and consumed soft drinks at school, with a significant percentage of those fifth graders being low-income and black, non-Hispanic individuals (Fernandes, 2008). Overall, the study found that by banning soft drinks in elementary schools, there was a significant reduction in soft drink consumption of only 4% (Fernandes, 2008). While this reduction in soft drink consumption is relatively low, this is only one study, and every study has its own limitations. For example, in this study, the fifth graders themselves were interviewed, along with the possible presence of recall bias. Fernandes (2008) also warns that the results of this study should not be applied to middle and high school students, as elementary students tend to have less free time and less pocket money relative to middle and high school students. Finally, Fernandes (2008) concluded that additional research is needed on this topic, and emphasized the importance of schools on the personal health of its students.
Click Here to Hear More About the Above Study
This policy debate is interesting to me because my high school banned the sale of soft drinks halfway through my years there. When I was younger, I used to love soft drinks, especially Dr. Pepper and Root Beer. Today, I am totally abstinent of soft drinks, with the only exception being sprite or 7-up when my stomach is upset. When they removed the soft drink vending machines from my high school, they replaced them with milk vending machines. These vending machines contained skimmed, 1%, 2%, chocolate and even strawberry milk products. Being someone who is lactose intolerant, I found this rather amusing. While I wasn’t offended of this change, in fact I was a supporter of it, I wished they had installed fruit juice vending machines also, since I couldn’t drink the milk. Nonetheless, in the end, I think it was a good move on the part of my high school.
Do you support schools banning the sale of soft drinks? Or is it a waste of time?
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Daily News Central. (2005, September 16). Schwarzenegger Bans Soft Drinks in California High Schools. Daily News Central.
Fernandes, M. M. (2008). The Effect of Soft Drink Availability in Elementary Schools on Consumption. Journal of the AMERICAN DIETETIC ASSOCIATION , 108, 1445-1452.
Hawkes, C. (2010). The Worldwide Battle Against Soft Drinks in Schools. American Journal of Preventive Medicine , 38 (4), 457-461.
Manning, A. (2003, June 16). 1/3 of Americans Born in 2000 will get Diabetes- Type 2 Diabetes is on the Rise. USA TODAY.
Epidemiology...it's everywhere! 