In 2015, the city of San Francisco passed an ordinance requiring advertisers of sugar sweetened beverages (SSB) to include a warning that SSB contributes to obesity, diabetes and tooth decay. The American Beverage Association (ABA) sued for a temporary injunction to block this law on the merits, saying that the scientific evidence for this warning is not that good. The judge denied that preliminary injunction to block implementation of the ordinance citing in part case law that was decided when we were fighting the cigarette industry. Then the ABA asked for reprieve while they argue in court. That was denied also because the judge felt that they were not likely to succeed in the case. Then the ABA asked for a stay while they argued about the size of the warning and that was finally granted for however long it takes the Ninth Circuit to resolve that issue. (1)
The loudest and most influential voice for this battle against sugar and sugar sweetened beverages is our old friend Dr. David Ludwig at Harvard. In a recent editorial (2) he reminds us of that “massive public health failure” that was the recommendation, launched 40 years ago, that we eat a low fat, and consequently high carbohydrate, diet. Since then “the prevalence of obesity and diabetes increased several-fold, even as the proportion of fat in the US diet decreased by 25%,” though we still recommend you eat less saturated fats (3) and less trans fats. Dr Ludwig says that the residual problems of the low-fat diet still haunt us. Many people still believe that fat is bad and many foods are still advertised as “low-fat.”
Dr. Ludwig should learn from history himself and be careful about the evidence for this new bandwagon. The American consumption of sugar and sugar sweetened beverages has already gone down a lot in the last several years at the same time that obesity has not stopped going up, as we have said in prior fat science columns.
1. Schilling D, Jacobson MF. Science and public health on trial. Warning notices on advertisements for sugary drinks. JAMA October 18, 2016; 316:1545-6.
2. Ludwig DS. Lowering the bar on the low fat diet. Published online September 28, 2016. http://app.jamanetwork.com/#page=issuesContainer
3. Frank AP, Clegg DJ. Dietary guidelines for Americans – eat less saturated fats. JAMA 2016;315:1919-20.
John DiTraglia M.D. is a Pediatrician in Portsmouth. He can be reached by e-mail- firstname.lastname@example.org or phone-354-6605.
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