Why Africa Should Resist the Power of Big Sugar to Undermine Public Health

Photo by Guillén Pérez | Coca Cola crates in Morocco | Flickr CC license
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GUEST AUTHOR: Rob Moodie, Professor of Public Health, University of Melbourne | Follow him on Twitter: @ARobM

This article originally appeared on The Conversation. It appears here by permission under a Creative Commons License.


Sugar by Moyan Brenn from Flickr (Creative Commons License)

The South African government has decided to tax sugary drinks to help cut excess sugar consumption, which is contributing to a burgeoning epidemic of obesity, diabetes and cardiovascular disease. This follows the lead of Mexico and the US city of Berkeley, where results have been very positive.

In Mexico, research predicts a win-win outcome: it may greatly decrease disease and death from diabetes and cardiovascular disease while reducing health care costs.

What can be expected in South Africa is overwrought and highly emotive opposition from the sugary drink industry. The tax has been described as “murderous” and “highly discriminatory”.

This opposition to an effective measure to protect and improve the public’s health occurs in the context of a seven-decade battle between public health (David) and unhealthy industries (Goliaths). During that time the tobacco, junk food, sugar-sweetened beverage and alcohol industries have become the drivers of the major non-communicable diseases (cancers, lung disease, diabetes and cardiovascular diseases) that now dominate the global health landscape.

The junk food, sugary drink and alcohol industries claim to be part of the solution. The solution requires them to help improve their consumers’ health by decreasing advertising to children, reducing levels of salt, fat and sugar in their products, and labelling food honestly and clearly. These are all measures they are convinced are in conflict with their responsibility to make money for their shareholders.

How can these industries be part of the solution in these circumstances? Expecting them to support effective health measures is like expecting the Springboks to support the Wallabies.

Why industry is not part of the solution

In 2008, as chair of Australia’s Preventative Health Task Force, I did think they might be part of the solution. Our task was to recommend ways to reduce the burden of death and disease due to obesity, tobacco and alcohol.

Big Tobacco was denied any influence on our work and the results have been spectacularly effective: plain packaging, annual increases in tobacco taxes and one of the lowest rates of smoking in the world.

On the other hand, Big Food and Big Alcohol were allowed to be “in the room”. Over the past eight years I have seen them undermine, obstruct and fight tooth and nail every potentially effective policy to diminish death and disease related to overconsumption of their products. I no longer believe they can be part of the solution.

How do these industries oppose the protection and improvement of people’s health? They use a sophisticated long-term approach of tracking, monitoring and attacking key researchers and advocates, attacking and undermining the science of public health and clinicians, influencing bureaucratic and political decision-makers, creating industry front groups, donating to political parties, sponsoring sporting and cultural groups and funding research that is much more likely to produce results that support their own arguments.

They are particularly adept at promoting self-regulation. With this tactic – called regulatory capture – they introduce a form of self-regulation, such as an industry code of practice.

These approaches have been found to be “relatively vague and permissive”, ineffective, and to result in relatively small measurable effects. And, of course, they are non-binding and impossible to enforce.

A prime example of this occurred in 2009, when the Australian Food and Grocery Council and the Quick Service Restaurant Industry introduced “responsible marketing” self-regulation. Both voluntary initiatives promised not to advertise unhealthy food products to children under 12.

At face value this looked like a great initiative. In reality it had no proven effect. Ingeniously designed, these promises encompassed only children’s viewing times – which is not actually when children watch most of their TV.

Photo by Geraint Rowland | The Streets of Bamako (Always Coca Cola) | Flickr CC license
Photo by Geraint Rowland | The Streets of Bamako (Always Coca Cola) | Flickr CC license

The industry initiative “captured” any potential for public regulation and resulted in years of continued saturation advertising of junk food and sugary drinks to Australian children. It was a brilliant, but very unhealthy, tactical ploy by the junk food industry. Beware of the industry association bearing gifts.

A related concern is the global consolidation of transnational corporations. An example is the recent merger between the two largest beer producers, AB InBev and SABMiller.

The capacity of these corporate Goliaths to undermine the public’s health and to influence or control health policy is becoming stronger with each merger and takeover. In Africa particularly, governments are susceptible given that their economies are often much smaller than the corporations they are dealing with.

A way to provide healthy sponsorship

Using taxes to diminish the consumption of unhealthy products has been highly successful. The Victorian Health Promotion Foundation started this 30 years ago using a dedicated tax on tobacco. This was used to replace sport and arts sponsorships that tobacco companies had provided.

Sponsorship by Quit – an organisation dedicated to helping people give up cigarette smoking – replaced harmful tobacco sponsorship in sport. A sugary drinks tax in South Africa can be used in this way to replace sponsorship by promoters of unhealthy drinks.

Industry will resist a sugar tax as fiercely as Big Tobacco fought plain packaging to stop effective measures being widely adopted.

The sugary drinks industry in South Africa will claim the new tax will wipe out jobs and slash profits. We know, however, from experience in Australia and elsewhere that these industries know how to protect profits. When cigarette taxes are increased, tobacco companies cynically increase their prices – and then blame the government.

The sugary drinks industry will throw everything into stopping the sugar tax in South Africa, just as they tried in Mexico and Berkeley. They do not want sugar taxes spreading across the world. It’s the same motive that drove Big Tobacco to fight so hard against plain packaging in Australia.

The introduction of a tax in South Africa might provoke the ire of the sugary drinks industry, but it will decrease death and disease among the poorest, while providing much-needed finances to improve health and sponsor healthy sports. It’s worth the ire!

The Conversation

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92 Comments

  1. Next they’ll tax pizza and other higher caloric foods, then certain sports, even sun exposure, a known carcinogen. Where’s the line drawn? We’re not the government’s or food activists’ pets.

    • Enough panic. Stop hyperventilating and change your diaper.

      With the exception of the Danish fat tax, that’s not what we’ve seen. The science on the health impact of sugar and sugar sweetened beverages is pretty robust and a soda tax makes sense precisely because it’s an easy item to draw a line around with a minimum of taxonomic haggling over definitions.

      Conservatives and libertarians engaged in the same kind of hyperventilating and soiling their diapers when tobacco taxes were passed and they didn’t lead to a spate of unjustified sin taxes. Not everything is a slippery slope and a tax isn’t ban. It’s an attempt to nudge behavior in the direction of public health and raise money to pay for the social costs.

      But you can stop bleating about imaginary threats to your dried out, wizzened concept of freedom.

      • The science on the health impact of sugar and sugar sweetened beverages is pretty robust
        True, but people make choices. What if everyone switches to fruit juices, the same sugar content. or milkshakes even more calories, sugar free energy drinks far worse.

        Yes Mexico implemented a Sugar tax and now they have claimed “the fattest large country in the World” title from the US. yet at the same time Obesity in the US has peaked and is now trending down.

        In my humble opinion Education works far better than than a tax, or you could do both.

        • Fruit juices are not packed with sodium to up the palatability and milkshakes aren’t pure liquid, so they are filling. For those reasons, neither short circuit our the way our endocrine system works towards energy balance. Just about any substitution will result in public health benefits.

          Yes, the tax should accompany education, but education in general and especially by itself is a piss poor public health intervention. In a sense, a sugar tax is a form of education. Even sugar tax campaigns that fail result in a decrease in SSB consumption.

          ” Yes Mexico implemented a Sugar tax and now they have claimed “the
          fattest large country in the World” title from the US. yet at the same
          time Obesity in the US has peaked and is now trending down.”
          C’mon, you’re smarter than that. Now you’re just throwing sand.

          http://www.latimes.com/science/sciencenow/la-sci-sn-soda-tax-mexico-20161102-story.html

          In 2014, it adopted a 10% excise tax on the sale of sugary drinks.

          The beverage producers claimed that soda taxes would do
          little to reduce consumption. But market surveys show that Mexicans
          reduced their purchases of sugar-sweetened beverages by an average of 6% in 2014 per household.

          And by December 2014, that drop in purchases was at 12%.

          World health officials want super-size tax on soda and sugary drinks, but are countries ready to swallow that?

          If Mexicans sustain this pattern of consuming fewer sweetened beverages,
          the model developed by researchers predicts that over 10 years, the 10%
          excise tax could prevent 189,300 new cases of Type 2 diabetes, 20,400
          strokes and heart attacks, and 18,900 deaths among adults 35 to 94 years
          old.

          • Fruit juices are not packed with sodium

            I thought we were discussing sugar content not sodium? Plus most fruit juices have more sodium than most sodas.

            milkshakes aren’t pure liquid

            Well once they melt they are liquids, but they do contain far more fats and some other nutrition that are not in a soda. Milkshakes do contain about 4x more calories and far more sugar per ml than a soda though.

            general and especially by itself is a piss poor public health intervention.

            Yet further down you say this ” Even sugar tax campaigns that fail result in a decrease in SSB consumption.” To me this seems like the perfect solution. Threaten to tax without implementing the tax. It looks like a win win, lowers consumption and educates without the bureaucracy.

            C’mon, you’re smarter than that. Now you’re just throwing sand.
            No, my argument is “implementing a sugar tax on SSBs does nothing to lower overall sugar consumption and it may make obesity even worse”. SSB are not the only way humans can get cheap empty calories from sugars. Choices will be made and can be even worse for health overall.

            I am on your side, I want less obesity and diabetes, but I want to implement programs that actually work. Not a program that may make the problem even worse by targeting only one source of sugar in people’s diet instead of all of them. If all added sugar is bad it should all be targeted.

            If Mexicans sustain this pattern of consuming fewer sweetened beverages,
            the model developed by researchers predicts

            Model, Really? Does this model take into account that people have free will and will make choices to consume other sweets? Seems like an epic fail, considering Mexicans are getting fatter.

          • 1. We are discussing sugar content. I’m not debating the direct health effects of sodium, I’m addressing the fact that in soft drinks, added sodium is used to boost palatability to the point of short circuiting our satieity signaling. I don’t know where you are getting the idea that fruit juices have as much or more sodium than sodas. That’s false, unless you have extraordinary evidence.

            2. OK. I was referring to the effect of fat on satieity. I didn’t parse myself carefully enough, but my point stands. A milkshake has a different effect on satieity signalling than a Big Gulp Coke.

            3. Again. C’mon. It takes a few years for interventions to gain purchase and reverse trends – which we saw in the US as interventions took a few years to reverse our obesity trend. Nor does it make an intervention a failure if it doesn’t reverse a trend, but it reduces the rate of growth relative to the counter factual. As somebody who has argued with enough anti-GMO idiots, you should be able to think counter factually by instinct by now.

            https://uploads.disquscdn.com/images/849b612d41b1de32d6fcb98f233d5024b7b512c1cac8ac0e406e47de22f4d0b5.png

          • While sugar tax campaigns usually have an effect on consumption, it’s short lived – the tax has a long term effect, both as an economic incentive, and as a pedagogic device.

          • Yep, and the dunce cap, the hickory switch and the wooden ruler wielded by a pissed off nun were all fine, effective pedagogic devices in their day. Thank goodness education hasn’t lost its golden touch. When all else fails, get back to your roots, eh?

          • I don’t know where you are getting the idea that fruit juices have as much or more sodium than sodas.

            Well I have to admit that my research was just going to the local gas station grabbing my favorite soda and comparing the label to some random fruit juice I found there. Some had way more, some about the same and some less/no sodium. I do remember that it was the blended fruit juices and coconut water that had more sodium. So yes my research was piss poor. I should not have said most, some is more accurate.

            A milkshake has a different effect on satieity signalling than a Big Gulp Coke.

            Thank god, they have 4x more calories and even more sugar. Can you even imagine how fat people would be if there were 99 cent Big Gulp milk shakes? Or would people be just as fat,,Hmmm.

            C’mon. It takes a few years for interventions to gain purchase and reverse trends

            I would like to see evidence for this. Tobacco and alcohol taxes seem to work fairly quickly. If you have time or the inclination I would like to see some of this evidence, (not models). Thanks

            which we saw in the US as interventions took a few years to reverse our obesity trend.

            Well I believe it is more of an exercise trend than a food choice trend. It seems just from personal observation, that the middle class and wealthy are getting thinner and the poor are about the same or fatter.

            This is another reason I think a soda tax will not work and may make the problem worse. To the middle class a soda tax means nothing to them, the kids will still get the big gulp, but to the poor, it may force them into making even far worse choices or just make them poorer.

            I can’t see a way that the poor will win with this tax. Will they change behaviour, probably, but will those choices be healthier or have less sugar/total calories, most likely not.

            This is why I think that education will work far better, unless you want to tax all added sugar. But then once again the poor will just switch to other forms of empty carbs or just become poorer.

            As somebody who has argued with enough anti-GMO idiots, you should be able to think counter factually by instinct by now.

            Well it is easy to debate Anti-GMOers, they are idiots after all. Much more difficult to debate intelligent people. Like you.

            Hey do you want some whipped cream for your cherry pick? Have a bottle of Pepsi in my hand right now, only 18 mg of sodium according to the label. The tropicana pure orange in my fridge says 12 mg. Maybe the water makes a difference?

          • ::::: Despite this progress, interventions which have relied primarily on
            communication and education have mostly failed to achieve
            substantial and sustainable results in terms of
            behaviour change, and have made little impact in terms of closing the
            gap
            in health status between different social and
            economic groups in society.
            Despite this progress, interventions which have relied primarily on
            communication and education have mostly failed to achieve
            substantial and sustainable results in terms of
            behaviour change, and have made little impact in terms of closing the
            gap
            in health status between different social and
            economic groups in society.

            http://heapro.oxfordjournals.org/content/15/3/259.full

          • So then, obesity and diabetes are simply diseases of deficiency…a deficiency of taxes. And nothing more.

            Got it. Seems a little too oversimplified and kinda prone to abuse, but OK, whatever you say, Cap’n.

          • You’re like a one man straw man factory. You should think of going into the straw man business, you’d have a bright future.

          • Yeah, I tend to get that way whenever a salesman drops around to sell me some incredibly simple cure-all for some hideously complicated set of problems. I used to trust and accept the miracle at face value but I only ended up asking the difficult questions after the big disappointment of being horns-waggled. So nowadays I simply ask the incredulous questions right up front. I like to think it has helped me dodge some bullets. You tell me.

          • “incredibly simple cure-all”

            See. You’re doing it again. Nobody is saying that a soda tax is a cure-all. Pretending that somebody is, is creating a straw man argument for you to knock down.

            Get over yourself. You aren’t asking any incredulous questions up front, I don’t think you’ve asked any questions so far, you’ve just spewed your gut level intuitions about a policy intervention that rubs you the wrong way.

            I don’t particularly like the idea of a soda tax, it’s outside of my preferred policy framework, but the obesity and diabetes epidemic is a major challenge and there aren’t a lot of effective tools in the toolbox, so you go with what works.

          • Well now, you’re becoming a little agitated, so let’s review the discussion to this point Marc.

            You’ve held up the spectre of the obesity epidemic and increased diagnosis of diabetes as a widespread phenomenon, one aching to be resolved, a pressing repair project, if you will.

            You’ve ruled out education as devoid of impact on said epidemic, dismissed it out of hand from the “tool kit”

            When asked about it you’ve ruled out physical exercise as devoid of impact on said epidemic, likewise tossed that from the “tool kit”

            But still you advocate for a silver bullet. Food taxes are that silver bullet, you assure us…because “there aren’t a lot of effective tools in the toolbox, so you go with what works”. That’s great, except we are merely hypothesizing food taxation (a soda tax, in this instance) will “work” to resolve the obesity/diabetes situation in impoverished populations. So far there are a couple of studies confirming taxation can have a chilling effect on product sales (wow, truthiness confirmed here, eh?), but no solid data demonstrating incidence or prevalence of obesity and diabetes decline in response to food taxation. OK, the pat excuse is, of course, ‘it’s too soon to tell’…and that’s correct, some preliminary experiments probably need to be completed before turning revenue agents loose in every supermarket and corner store.

            Funny thing about tool kits — when the only tool you choose to keep in the kit is a hammer, every repair job begins to look like a nail. The great thing, though, about a hammer is when at first it doesn’t have the desired effect, one can simply hammer harder and harder. Usually the repair project is ruined but the satisfaction of taking your frustration out on it with the hammer is sooo gratifying. I am reluctant to let you work on any sophisticated machinery and I trust you now understand why.

          • I don’t particularly like the idea of a soda tax, it’s outside of my preferred policy

            Well what is your preferred policy to tackle this issue?

          • The things I like: clear simple regulations, universal programs, avoidance of rent seeking, etc are pretty toothless on this issue. One of the big drivers is income and poverty, so sure … I’d like to tackle that. I like the idea of a UBI, but I’m not going to go around acting like a UBI would solve everything or that a UBI is currently in the cards.

            What we are left with FROM A POLICY perspective, as opposed to a CULTURAL perspective is:
            • Soda Tax
            • Soda vending out of public schools
            • School lunch reform
            • Ban on marketing to children
            • White listing the SNAP basket of goods

            All of these things are more prescriptive than I prefer and it’s all pretty weak sauce other than real, fully funded school lunch reform. It’s a flow chart. Can this be fixed with A? No? How about B? No? C? No. You finally get to X,Y,Z.

            I also don’t see much downside to a soda tax. If it only shaves off a few percent off the incidence of obesity and diabetes, but funds either cooking classes or education or Medicaid coverage of diabetes care – that’s still a win.

            It’s just not a problem that’s amenable to policy intervention, even as it has major impacts on public healthcare expenditures and lowers quality of life and productivity for citizens. So, we’re stuck with jerry rigging something from second rate tools.

            But the experience with tobacco taxes is pretty hopeful.

            http://content.healthaffairs.org/content/31/1/199.full.htmlFor

            ::::: Adam Smith wrote in The Wealth of Nations, “Sugar, rum, and tobacco are commodities which are nowhere necessaries of life, [but] which are…objects of almost universal consumption, and which are therefore extremely proper subjects of taxation.” If the tobacco tax history is any
            parallel, the current discussion of taxes on sugar-sweetened
            beverages could represent an early development in the broadened use of
            taxes to promote health and decrease health care costs.

            In addition to generating substantial revenue, which can be used to fund health services or other infrastructure, the proposed penny-per-ounce excise tax on sugar-sweetened beverages is predicted to greatly reduce the adverse health and cost burdens of obesity, diabetes, and cardiovascular diseases among US adults.

          • Well, I could get behind a tightening up of SNAP-eligible purchases. But it would have to be science-based. OK to leave out soda and chips, but most cookies and such are just as HZ says; “OK in moderation”. One big class of foods to be excluded from SNAP would have to be organic and any other systemically over-priced fad foods. So, as HZ queries; who would decide what’s “junk” and what isn’t? Do I hear the eager fidgeting of our old friend the closet tin pot dictator stirring to rapt attention?

            But the whole SNAP discussion infers that obesity and diabetes afflict only the poor. We know that’s not true and we can safely say SNAP reform to cure those diseases is a bigoted notion at its core. There would be some well-deserved blowback from such a move.

            I simply cannot get behind any incursion into food taxation. Food is too basic a human need to be made vulnerable to tax and spend political gauchos. Crack that door open and it’s just too damned easy for revenue agents to get carried away — the hammer in the toolkit analogy — tax ’em ’till they’re satisfied.

            Anyway, I cringe when I hear folks like you, Marc, casually state that a food tax would have no down side because it would generate revenue that could be pissed away on other feel good regulatory adventures. Noteworthy also is your suggestion that a slice of these wonderful new tax revenues could be spent on education — heh, so there might be hope for education, after all? Where would we be today if all the tax-based funding that has been thrown at failed public health education around nutrition for a generation or longer had been invested in capable educators and effective teaching programs, instead of wasted on pop-science feel good food fads and the standard bureaucratic overhead? On their watch the obesity epidemic flourished, and that is inexcusable. These hopeless assclowns are precisely the ones I would NOT want heading up a revamped public health nutrition effort.

          • most cookies

            And they are mostly treats for kids, and who want to ostracize poor peoples kids. That seems kind of mean.

            One big class of foods to be excluded from SNAP would have to be organic and any other systemically over-priced fad foods.

            Yes 100% of all the virtue signal foods should be banned, Organic, Fair trade, free range, it is just a waste of money. Plus fancy bottled water, if you are poor there is no need for fancy french water. i would ban fancy water before lobster. I really don’t like any bans but these make sense for the taxpayer.

          • No. There’s no hope for education and you explain in part, why. You’re in favor of fairy tales, but fairy tales aren’t what we end up with.

            I don’t believe in fairy tales. I believe in evidence. And I believe that people respond to incentives.

          • Well, Marc, like you my impulse is to think of failed (but generously remunerated and incentivized) public health educators like Marion Nestle, who make a lucrative career of twisting public health science to promote pop-science urban myths and to sell cheesy books. That nightmare apparition dominates our experience with public health education to the point we assume all is hopeless. It’s that dreadful truthiness vice again, eh? But, when giving fair consideration and looking around a bit there appear to have been a few minor successes since the early days of pump handle epidemiology…

            http://www.healthyamericans.org/assets/files/Examplesbystate1009.pdf

            I would readily admit these are too few and too far between for all the resources we throw at the charade that has come to be accepted as “public health education”. That’s why I’m in favor of cleaning house, tossing out all the quack public health educators and re-installing qualified science-based trainees with a genuine interest in effective public health education, free from the sort of base self-aggrandizing distractions so typical of the old Marion Nestle prototypes.

            By the way Marc, it is a matter of public record that failed public health educator Marion Nestle is rabidly supportive of food taxation and micromanaging food marketing by imposing and enforcing stringent arbitrary regulations. So too Kathleen Merrigan of ridiculous “know your farmer” fame, who panders to foodie elites and would delight in seizing power to pick winners and losers. Tin pot dictators at heart, and little more. They’ve spoiled it for everyone.

          • clear simple regulations

            Yes, somple regulations are far better than confusing, complicated ones, but not as good as no regulations.

            universal programs
            Universal programs are horrible. if beekeepers cant make universal programs work for bees, how could they possibly work for humans?

            avoidance of rent seeking,

            I hate rent seeking.

            • Soda Tax

            Making poor people poorer is not going to help, in my opinion without a lot of education and the education must come first.

            • Soda vending out of public schools

            The studies that you provided says that it doesn’t work.

            • School lunch reform

            As a Canadian this is another thing that I don’t understand. You give the poor a “Free food card” and they cant make lunch for their kids? WTF? No wonder poor people are fat, they cant even get their asses of the couch to make a sandwich for the kids.

            • Ban on marketing to children
            Good luck with that, the number one marketer of kids foods are kids. You do know that they they can speak and they talk to each other.

            fully funded school lunch reform.
            Scrap school lunches and use the money for education. If parents cant feed their kids a simple lunch take them away.

          • Well, that’s just putting ideology before evidence.

            Not really ideology. All I was trying to say is that if the world was perfect and all people were perfect, no regulations would be needed. i am fully aware that this is not true and regulations are needed, so simple ones would be best.

          • Exactly; the “ideal” is anarchy, which is what we evolved from.

            In a sense, all of human history has been an exercise in trying to get as far away from that as possible!

          • http://fafdl.org/blog/2015/06/08/incentivizing-work-in-snap-with-vegetables/

            I’ve long thought that the basket of goods covered by SNAP (Supplemental Nutrition Assistance Program, formerly known as food stamps) should whitelisted. That is, SNAP should pay for foods that provide sustenance. It should not pay for things like soda and cookies. Another reform would be to forgo the whitelist for recipients but require a mandatory basket of goods for participating retailers must carry and keep in inventory. Using the already existing WIC package would be a simple way to do this. Another popular idea would be to simply exclude sugary beverages.

            Whitelisting SNAP would accomplish a number of important things:

            • It would end a large indirect federal subsidy to junk food manufacturers
            • It would increase the indirect federal subsidy to non-junk food producers
            • It would improve the eating habits of a substantial number of
            Americans by increasing fruit and vegetable consumption that is too low
            and decreasing sugar consumption that far to high. There is a reasonable
            expectation that this would lower medical costs. Those are medical
            costs which are most likely being picked up by the taxpayer.
            • It would serve as a strong public health message that diet matters and that junk food is not just empty calories
            • It would nearly end the problem of food deserts over night. If
            corner stores needed to carrying a certain basket of goods to certify
            for SNAP, store in low income neighborhoods would start stocking fresh
            produce and whole grain bread and cereal over night. Problem solved.
            I’ve worked with corner stores to achieve WIC status. They respond to
            incentives and WIC participation changes their product mix for the
            better.
            • It would insulate SNAP politically. A program that only pays for
            nutritious food is much harder to attack politically and would be less
            vulnerable to budget cuts.

          • Well I am a Canadian so I don’t really understand SNAP and why you even have it. I do sort of understand how it works. People get a card and then can buy food with it, but only food, right?

            It should not pay for things like soda and cookies.

            Well I don’t like banning stuff, and there could be a good reason for buying sodas (kids party, mix for adult party, treat for well behaved kids) and there is nothing wrong with cookies, in moderation. Now if there was a limit on the amount of sugary snacks that you could buy with the Free Food card, I would be all for that. Kind of like ration cards back in the olden days, save them up and have a party.

            equire a mandatory basket of goods for participating retailers must carry and keep in inventory.

            Well this is an excellent idea, but it needs quite a bit of education to go along with this plan. It will not do the poor any good to have a fridge full of kale and eggplant if they don’t know what to do with it.

            • It would end a large indirect federal subsidy to junk food manufacturers

            Most likely a very good idea, as long as it doesn’t make my Captain Crunch berry cereal more expensive. The only problem I see with this is “What is Junk Food” and who gets to decide what is Junk?
            Is a TV dinner junk food, frozen pizza, chocolate milk?

            • It would improve the eating habits of a substantial number of

            You are not going to be able to force people to make better food choices without major problems, unless you teach them why it is better for them and the family.

            • It would nearly end the problem of food deserts over night.

            This might have the opposite effect, if the rules are too strict it might force the small stores out of business.

            • It would insulate SNAP politically. A program that only pays for
            nutritious food is much harder to attack politically and would be less
            vulnerable to budget cuts.

            I don’t even know why you have this program, seems Kooky to me.

          • Coke – 45 grams sodium

            Snapple Apple Juice – 10 mg
            OJ – 2 mg

            You are still failing to grasp the difference satiety signalling has on consumption in your comparision of shakes and soda calorie counts. People get FULL from drinking a shake and stop taking in more energy. That just isn’t the case for soda, which is why a people will drink multiple sodas throughout a day, but not multiple shakes.

            :::::: The prevailing evidence suggests that weight gain arises
            because compensation at subsequent meals for energy consumed in the form of a liquid could be less complete than that for energy consumed in the form of a solid, most likely because of the low satiety of liquid foods. For example, DiMeglio and Mattes showed that consumption of 1180 kJ soda/d resulted in significantly greater weight gain than did consumption of an isocaloric solid carbohydrate load. Others have reported similar findings.

            Many studies have shown a connection between consumption of
            sugar-sweetened beverages and total energy intake, which supports the
            notion that, when persons increase liquid carbohydrate consumption, they do not concomitantly reduce their solid food consumption. For example, Schulze et al reported that women who increased their intake of sugar-sweetened beverages also increased their total caloric consumption by an average of 358 kcal/d and that most of the excess calories were contributed by soda.

            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210834/

          • Coke – 45 grams sodium

            Are you sure it is grams? I have consumed lots of soft drinks in the states and they don’t taste salty. 45mg I think you meant.

            Well I grabbed a Pepsi bottle from the back of my brothers truck.
            Pepsi per 355ml serving
            calories 150
            sodium 15mg

            OJ container from the recycling bin
            Co-op branded pure not from concentrate OJ with pulp per 250 ml serving

            calories 120
            sodium 12 mg

            You are still failing to grasp the difference satiety signalling has on consumption in your comparision of shakes and soda calorie counts
            Yes I get it, you stop after drinking one milkshake. But they contain about 1000 calories plus 500mg of sodium and fat. The vast majority of people would also stop drinking soda if they drank a 1/2 gallon of it at once.

            multiple sodas throughout a day, but not multiple shakes.

            What I am trying to say is multiple sodas are equivalent to one milkshake. If you just changed 1 soda to one milkshake per day and everything else was the same the average person would gain 1-3 lbs per week, eat an extra slice of pizza and the same will happen.

            For example, DiMeglio and Mattes showed that consumption of 1180 kJ soda/d resulted in significantly greater weight gain than did consumption of an isocaloric solid carbohydrate load

            well that makes sense, solids have to be digested, not so much for liquids.

            total caloric consumption by an average of 358 kcal/d and that most of the excess calories were contributed by soda.

            So, if you tax soda, they can get the same calories from somewhere else. They can go to walmart and buy Kool aide and dump a crap pile of sugar in it and get even more calories.

            Well the study that you provided mostly shows that Women gain weight from drinking sodas, so should we only tax them?

          • :::::: Using econometric models of repeated cross-sectional data on diabetes
            and nutritional components of food from 175 countries, we found that
            every 150 kcal/person/day increase in sugar availability (about one can
            of soda/day) was associated with increased diabetes prevalence by 1.1%
            (p <0.001) after testing for potential selection biases and
            controlling for other food types (including fibers, meats, fruits, oils,
            cereals), total calories, overweight and obesity, period-effects, and
            several socioeconomic variables such as aging, urbanization and income.
            No other food types yielded significant individual associations with
            diabetes prevalence after controlling for obesity and other confounders.
            The impact of sugar on diabetes was independent of sedentary behavior
            and alcohol use, and the effect was modified but not confounded by
            obesity or overweight.

            http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0057873

          • increased diabetes prevalence by 1.1% (p <0.001) after testing for potential selection biases and controlling for other food types

            1.1 %? You want to add a tax with unknown effects to combat a 1.1% increase?
            What will the tax do to the poor?
            Do you really want to make poor people poorer to lower diabetes by 1%?
            Are there any studies that link being poor with diabetes?

          • Yes, diabetes is more prevalent among poor people. The regressive nature of a sugar tax is a feature, not a bug.

            :::: During the first year of Mexico’s soda tax, purchases of sugar-sweetened beverages “went down on average about six percent,
            relative to what we think it would have been otherwise,” Ng says. (Her calculations took into account a preexisting downward trend in soda purchases in Mexico.) The decline accelerated as the year went on, reaching 12 percent by December.

            . . . In the first year of the tax, it was the poorest people who cut back on soda the most, averaging a 9 percent decline and peaking at 17 percent in December.

            . . . Mexico’s data answers another question Wang has been wondering about: Once consumers reduce their soda consumption, “what else do they drink?” Ng’s analysis hints at an answer, showing a four percent increase in purchases of bottled water over 2014. “That’s a good shift,” Wang says.

            https://www.wired.com/2015/07/mexicos-soda-tax-working-us-learn/

          • Yes, diabetes is more prevalent among poor people. The regressive nature of a sugar tax is a feature, not a bug.

            So if diabetes is linked to being poor, how is a tax which will make people poorer going to help? Shouldn’t you have a plan that would make the poor wealthier, lowering the risk of diabetes and making their lives more enjoyable? This is something that Education can do and taxes cannot.

            Ng’s analysis hints at an answer, showing a four percent increase in purchases of bottled water over 2014. “That’s a good shift,” Wang says.

            Why would this be a good shift? Maybe they are taking it home to make Kool-aid cause tap water in Mexico tastes like crap. A good shift would be a lower rate of diabetes and less obesity.

          • ::::: Within this new phase of aetiological thinking, however, there has continued to be less clarity about the role of ‘low levels of physical activity’. In this commentary we challenge the theoretical basis for considering reduced energy expenditure in activity as a cause of the obesity epidemic and summarize the empirical data to support that contention.

            From both perspectives – physiological theory as well as observational data and trials as set out below – energy expenditure in activity appears to be playing no role in either causing or moderating the obesity epidemic, suggesting that current guidelines need to be reformulated.

            http://ije.oxfordjournals.org/content/42/6/1831.full?ijkey=ccde00f9b58dd772fda633993b0aa9b9de55e67a&keytype2=tf_ipsecsha

          • Wow, and I thought my kids, when they were pre-teen and teenagers, had the market cornered on excuses for avoiding physical activity. Heh, today’s self-styled nutrition scientists have perfected not only the science but the art of glorifying the righteous couch potato. Never walk when you can ride, eh? And if you can’t ride, don’t trouble yourself to go.

            So, if we enthusiastically educate folks to believe physical exertion of any kind is a wasted effort and if we also indoctrinate them in an attitude of entitlement demanding instant gratification and canonizing self-indulgence, might these same human organisms be placed at undue risk of growing fat and diabetic? Well, no, not if we also tax the bejeezus out of ’em.

            Heh, yeah, it’s a complete mystery why “education” has failed to stem the obesity epidemic and all that comes with it.

            Interesting historical footnote: Heard just this past week that the term “obesity epidemic” was coined as part of the sales blitz for a diet drug; fen-phen. At that time the spectre of an obesity crisis was held up as justification for the drugging of America. Now the term has been co-opted by foodie cultists to justify their overbearing meddling. What could possibly go wrong with any of that?

          • I try to follow the evidence, not the truthiness. There are lots of good reasons to exercise, but the evidence on the link between exercise and weight regulation isn’t that strong.

            That’s why you see lots of fat farmers and construction workers and fit, slim investment bankers.

            http://well.blogs.nytimes.com/2014/11/12/exercising-but-gaining-weight/

            ::::: Then each woman began a supervised exercise program designed to be vigorous but manageable by most people, said Glenn Gaesser, a professor of nutrition and health promotion at Arizona State and senior author of the study. The women walked on treadmills at the laboratory three times per week for 30 minutes at a pace that represented about 80 percent of their maximum endurance. They continued the program for 12 weeks, with the scientists repeating the original fitness and other tests every month during that time.

            http://onlinelibrary.wiley.com/doi/10.1046/j.1467-789x.2000.00016.x/full

            ::::: Based on observational studies, it seemed that an actual increase in
            energy expenditure of physical activity of approximately 6300–8400
            kJ/week (1500–2000 kcal/week) is associated with improved weight
            maintenance. This is more than was prescribed in most randomized trials,
            and certainly more than the participants actually achieved. Adherence
            to a prescribed exercise programme remains a big challenge. Before new
            methods to improve exercise adherence are found, the role of prescribed
            physical activity in prevention of weight gain remains modest.

            At the end of 12 weeks, the women were all significantly more aerobically fit than they had been at the start. But many were fatter. Almost 70 percent of the women had added at least some fat mass during the program, and several had gained as much as 10 pounds, most of which was from fat, not added muscle.

            https://www.sciencedaily.com/releases/2009/01/090106091143.htm

            :::::

            Physical activity has many proven benefits. It strengthens bones and
            muscles, improves mental health and mood, lowers blood pressure,
            improves cholesterol levels and reduces the risk of cardiovascular
            disease, diabetes, breast cancer and colon cancer.

            But Loyola research suggests that weight control might not be among
            the main benefits. People burn more calories when they exercise. But
            they compensate by eating more, said Richard Cooper, Ph.D., co-author of
            the study and chairman of the Department of Preventive Medicine and
            Epidemiology.

            “We would love to say that physical activity has a positive effect on
            weight control, but that does not appear to be the case,” Cooper said.

          • Great work! All that is great news for pre-diabetic folk — just chill out, no cause to risk breaking a sweat, ever!

            Now show us the studies confirming poverty and taxation, taken together, inevitably result in svelt profiles and health eternal.

          • “All that is great news for pre-diabetic folk — just chill out, no cause to risk breaking a sweat, ever!”

            Nobody is saying that. Enough with converting everything into a strawman argument.

          • he women walked on treadmills at the laboratory three times per week for 30 minutes at a pace that represented about 80 percent of their maximum endurance.

            Well that is not a weight loss exercise regime, that is just a bit of cardio. No wonder they didnt lose any weight. Even if these women were huge, 300+lbs, walking for 30 min only burns about 150-250 calories. Looks to me like this study was designed to fail. To lose weight you have to stress your major muscle groups, walking does not do this. They could have done 30 min of beginner Yoga and burned 4x more calories in the 30 min plus burned more all through the day while the muscles recovered. Walking shouldn’t even be considered exercise. Give them 30 min 3 times per week weight training, and 3 times per week of HIIT plus one day of rest/stretching/or Yoga for 12 weeks and they will lose massive weight, every time.

            People burn more calories when they exercise. But
            they compensate by eating more, said Richard Cooper, Ph.D., coauthor ofthe study

            But he wasn’t exercising them. Going for a stroll is not excercise.

          • Good catch HZ! I took Marc at his word that they exercised the subjects in his studies but I guess “exercise” probably means one thing to farmers like you and I, and something entirely different to sedentary folk who detest physical exertion and routinely avoid it at all cost. Heck, having to get up off the futon to get more donuts would seem like an insufferable physical hardship to some of those good folks. Dragging the empty soda bottles to the curb probably counts as a major outing, akin to scaling the Matterhorn.

            Heh, about all that little bit of weekly strolling accomplished was to massage some gas out of the system, shift some lingering intestinal contents southward clearing the decks for another big feed. Just enough to goose up an appetite. It’s about the same idea as walking through the dairy barn several times each day and getting the cows up so they will feel like stepping up to the feedbunk and packing away more chow.

          • Sorry man, but one study does nothing to counter the years of data about exercise.

            Granted, it is easier to lose weight with diet, but exercise leads you to a fuller, healthier weight that is sustainable. Muscles require more calories for respiration. Diet may get you there, but exercise will keep you there.

            Really, more investment bankers are thin than farmers? That is an observation that is very shallow. There are many, many farmers that have different modes of farming. Some are on tractors all day, and that is it. Do you really have hard numbers to back that statement up–how many farmers do you know versus investment bankers?

          • I know a lot of farmers. Investment bankers less so, but when I lived in Manhattan my observations were fairly data rich. Go into any hospital and observe the weight of CNAs who are on their feet all day, changing beds, moving patients, etc with doctors who are far less physically active. A day observing healthcare workers by income and class will go a long way to dispel both the idea that a lack of physical activity and an information deficit is are serious variables from a public health perspective.

            It’s not one study. I’ve posted more in this thread and there’s plenty more where that comes from.

            As to your observation about the the biology of exercise, muscle, and weight regulation, that’s all true, but we are talking epidemiology and public health policy. On those fronts, the role of physical activity and the obesity epidemic and interventions that work are more based on people’s moral intuitions than data.

          • weight of CNAs who are on their feet all day, changing beds, moving patients

            Standing and walking are not active, just like twirling around on a swivel chair and typing are not exercises. You have to break out in a bit of a sweat at min for it to be exercise. Unless these CNAs are pulling patients up the stairs it makes no difference. Existing and doing everyday activities will not lead to any extra calories being burned. Shoveling your stupid stuck tractor out of a snowbank, now that is activity that leads to weight loss.

          • Then you have to be clear whether you are talking about “exercise” or “sedentary behavior” and “physical activity” as the variable supposedly at the heart of this. The evidence that we were engaged in more exercise in the 50s, 60s and 70s is even thinner than the idea that sedentary lifestyles are to blame.

            The question is what broke our homeostatic system of weight regulation? There really isn’t a model where physical activity can do that at the population level. The gluttony and sloth model would predict that the denizens of Versailles would be very fat, but there is no evidence having people dress you and carry you around in sedan chairs resulted in an obesity epidemic.

          • The evidence that we were engaged in more exercise in the 50s, 60s and 70s is even thinner than the idea that sedentary lifestyles are to blame.

            Really? No one or very few people today actually have to do any physical work, (work=breaking a sweat) machines do it all. If you are a bricklayer, you don’t have to lift any bricks/mud far, a machine brings them to you. Dig a hole for a tree, bobcat or mini excavator, Mop a shopping center floor, ride a floor cleaning machine. concrete placer, a pump truck puts the concrete where you want it, house framer, lift trucks put all the lumber where you want it. Car assembly plant, robots do all the real work, need a newspaper, you don’t even have to put your slippers on anymore, no one is packing around heavy assed newspapers. Work in a warehouse, electric pallet jacks move everything. Secretary, no more packing heavy files, it is just a mouse click now. Housewife, they don’t even have to go to shop anymore, click and it is delivered. Food prep is a phone call away. Clean the floor, that is what a roomba is for. In the 50s, 60s and 70s, the poor were the ones doing all the physical work. Today it is machines.

            Other than for recreation, very few people have to break a sweat anymore, including a lot of farmers.

            Millions of labor (work) saving devices have appeared since the 1970 and it all adds up to fatter people.

            There really isn’t a model where physical activity can do that at the population level.

            Well then there is something wrong with the model/s in my opinion.

            The gluttony and sloth model would predict

            It would also predict that the wealthiest and middle class today would be the fattest, but that is not the case. The wealthy and middle class can afford Yoga, ice time, spin classes, nutritionists, personal trainers, the poor cannot.

            the denizens of Versailles

            Just like the wealthy today, they could afford recreation, dances, horseback riding, hunting excursions, etc. The poor and the middle class during this time were to busy sweating for a living to have time for that.

            A new model suggestion. Less sweat=fatter people

          • Yep, even farming has become less physical. Electric-over-hydraulics, especially with emerging electronics is awesome in the field!

            One other important consideration regarding apparent class differences in obesity rates — activity levels.

            Most banking and business types keep a pretty hectic schedule, perhaps including hitting the gym or fitness machine. But a big change is how all that busy activity during a long day leaves little time for eating, snacking, sipping beverages and, it seems lately it’s not stylish to be seen eating or drinking while working or walking around. Back in the day it was very, very different. The pace was a little more casual, the “break room” (a mandatory social gathering and gossiping place) was kept well stocked with cookies and such, every business or training meeting featured coffee (with sugar & creamers), donuts — the good kind with sugar frosting and jelly in the middle. Frequently attending seminars or conferences where lunch was always, always served…and plenty of sweet snacks, hot coffee and cold sodas before, during and after the proceedings. Anyway, you get the drift.

            Also contrast the situation for the impoverished. Some keep plenty busy juggling multiple part time jobs, but few of those jobs encourage 45 minutes before work in the on-site fitness room. And for the poor a hectic pace probably only means neglecting personal and family stuff…like eating right. Easier to grab a coffee w/ cream & sugar along with a couple of donuts for breakfast while driving to the first job. Then hit a drive thru on the way to the second job and the third, maybe again on the way back home if the joints are still open. Heck, I’ve done this myself. when running around on errands. And I’m not blaming fast food joints here — if weren’t for them many of us might well have starved at times.

            For the non-working poor boredom has to contribute to overeating the really appealing “junk food” stuff. Haven’t you ever wondered where all those shelves and shelves of chips and snacks disappear to? Quite a few of them vanish into a niece and nephew of mine when they are around here, unless someone can entertain those kids and distract them away from gnashing. Physical activity in the form of merely getting outside and moving around, even if they didn’t run or work or break a sweat, would do ’em a world of good simply by interrupting the voracious intake of snack foods. The little turds are a little too paunchy for their own good. Taxing them would be a poor substitute for interesting them in activities other than loafing around and snacking.

          • How does your model square with:

            1961-63 Trinidad West Indies

            A team of nutritionist from the US reports that malnutrition is a serious problem on the island, but so is obesity. Nearly a third of the women older than twenty five are obese. The average caloric intake among these women is estimated a fewer than 2000 calories a day.

            1963 Chile

            Obesity is described as “the main nutritional problem of Chilean adults.” 22% of military personnel and 32 % of white collar workers are obese. Among factory workers, 35% of males and 39% of females are obese.

            1964-65 Johannesburg South Africa

            Researchers from the South African Institute for Medical Research study urban Bantu “pensioners” older than 60 – “the most indigent of the elderly Bantu,” which means the poorest members of an exceedingly poor population. The women in this population average 165 pounds. 30% of them are “severely overweight.” The average weight of “poor white'” women is also reported to be 165 pounds.

            1969 Ghana
            25% of the women and 7% of the men attending medical outpatient clinics in Accra are obese, including half of all women in their 40s. “It may be reasonably concluded that severe obesity is common in women aged 30 to 60,” writes an associate professor at the University of Ghana Medical School, and it is “fairly common knowledge that many market women in the coastal towns of West Africa are fat.”

            1970 Lagos Nigeria
            5% of men are obese, as are nearly 30% of the women. Of women between 55 and 65, 40% are “grossly obese.”

          • How does your model square with:

            :::::: EFFECTS OF EXERCISE TRAINING WITHOUT DIETARY INTERVENTION:
            Results of studies of exercise training alone, with no caloric restriction, are mixed: decreases, increases, and no changes in body weight and body composition have been observed.
            http://dx.doi.org.sci-hub.cc/10.1016/S0025-7125(16)30700-3

            === Does physical activity prevent weight gain–a systematic review. (2000) ===

            ::::: Prospective studies with physical activity measured at baseline, and
            randomized weight reduction interventions, gave inconsistent results regarding the effects of increased physical activity on weight change.
            The weighted mean weight regain in randomized studies with or without
            exercise training was 0.28 and 0.33 kg/month, respectively. Based on
            observational studies, it seemed that an actual increase in energy
            expenditure of physical activity of approximately 6300-8400 kJ/week
            (1500-2000 kcal/week) is associated with improved weight maintenance.
            This is more than was prescribed in most randomized trials, and
            certainly more than the participants actually achieved.

            https://www.ncbi.nlm.nih.gov/pubmed/12119991

          • http://dx.doi.org.sci-hub.cc/1

            This study disproves your theory. There was only one study in this review that involved actual exercise, and they lost a significant amount of weight.

            Leon and coworkers31 observed a significant loss of weight (Fig. 6) with no change in lean body mass in six young obese men who underwent 12 weeks of vigorous exercise
            training (90 minutes, 5 times per week, expending up to 1100 kcal per session),
            with no dietary intervention.

            And 1100 kcal in 90 min is barely vigorous (slow jog or very fast walk on flat ground)

            physical activity of approximately 6300-8400 kJ/week

            That is not even exercise if spread over a week. You would burn more calories per week looking for a lost sock for a half an hour 5x per week.

            I am starting to see a pattern here, no exercise no weight loss.

          • “And 1100 kcal in 90 min is barely vigorous…”

            I dunno about that. That’s 733 cal/hr. A 200 lb. person walking 3.5 mph is only going to burn half that. Depends on what you call, “vigorous”, though.

            It’s a lot easier to not eat that Snickers bar than it is to eat it and exercise it off, that I do know.

          • Well a slow jog (12 min mile pace) burns about 800 cal/hour, so not all that vigorous. It would be like an hour and a half game of touch football, something most young men should be able to do.

            Walking is insanely efficient for the human body, it really doesn’t burn anything at all, shouldn’t even be counted as exercise.

          • I don’t think your numbers are accurate.

            Walking 3.5 mph burns maybe 300 cal/hr, but you’re saying that jogging 5 mph (1.4 times faster) burns 2.7 times more calories?

            That doesn’t make sense.

          • Walking 3.5 mph burns maybe 300 cal/hr
            Well most likely about 400 or more, these guys were big.

            Walking you don’t leave the ground so it is a very efficient movement (like a pendulum), jogging and running you have to lift yourself off the ground and propel yourself forward using more muscle. Running is jumping forward using alternate legs, walking is not falling on your face using alternate legs.
            So yea, you burn about 2x more calories jog/running than walking but only gain a bit of speed.
            Plus these guys were big 100KG on average

          • It’s a lot easier to not eat that Snickers bar than it is to eat it and exercise it off, that I do know.
            Nah, slap on the skates and practice your quick starts and power strides and stops for 3 sets of 5 min with a one min break in between and snickers is gone,plus a bit more. Or you could just recreational skate with the grandkid for 40 min or so.

          • No population ever exercised at the levels you are defining as rigorous. So it can’t be the case that stopping something that nobody was doing can be causal in the obesity epidemic. And we’ve established that you don’t have any idea what my hypothesis is.

            1. That study doesn’t disprove my hypothesis, because my hypothesis ISN’T that rigorous exercise can’t result in weight loss. What I’m asserting is that an increase in sedentary behavior in adults is not a causal variable in the obesity epidemic and that at the level of public health, admonitions to Eat Less, Move More are pointless and ineffective because they are based on a faulty model and admonitions are piss poor public health interventions.

            2. 1100 kcal per 90 mins is 733 kcal per hour. About the equivalent of a 160 pound person running a 8.5 minute mile pace for an hour. That’s fairly rigorous.
            http://calorielab.com/burned/?mo=se&gr=12&ti=Running&wt=150&un=lb&kg=68

            3. The research shows that increasing activity doesn’t result in weight loss or improved weight regulation until you get to the point of really vigorous exercise at least an hour a day 5-7 days a week.

          • No population ever exercised at the levels you are defining as rigorous.
            It was most likely more back in the old days. Hmmm would I rather an hour and a half of calisthenics, or dig ditches for 10 hours, chop down trees by hand for 10 hours, lay railroad tracks and pound spikes by hand for 10 hours, drag giant slabs of rock across the desert so a King can have a pyramid for 10 hours per day, build a great wall with just a basket for 10 hours a day, plow a field by hand for 10 hours, hike across a continent carrying my body armour and weapon just to fight some barbarians. Even just rigging up a large set of draft horses for the daily duties would most likely burn more calories. Survival was tough back in the day, it involved a hell of alot of work.

            So it can’t be the case that stopping something that nobody was doing can be causal in the obesity epidemic.
            But they were exercising. They called it work back in the old days.

            And we’ve established that you don’t have any idea what my hypothesis is.

            I know what it is…Your hypothesis is that the lazy bastards today are not fat because they don’t do anything but lay on the couch and watch youtube cat videos, it is because of sodas. You say it way better, more sciencey. Your really good at the science, a but it is a bit dry.

            2. 1100 kcal per 90 mins is 733 kcal per hour. About the equivalent of a 160 pound person running a 8.5 minute mile pace for an hour. That’s fairly rigorous.

            Well they were about 100 kg so it equivalent to about a 12 min mile. or the same as them playing touch football for an hour and and a half, not all that vigorous. If they played hockey for an hour and a half they would burn 2x that amount. These were young men, they should be doing this anyway. this should be part of being a normal young man, playing for an hour and a half a few times a week. They should want to do these activities, it is a great excuse to drink beer after and socialize with real people.

            really vigorous exercise at least an hour a day 5-7 days a week.

            In all seriousness, the point I am trying to make is that it is not vigorous exercise. Plus using modern exercise techniques, you can reduce the 1 hour to 20 min 3 times a week.

          • OH FERFUCKSAKE SAKE. How many calories have you burned moving the goalposts back and forth to avoid admitting your model doesn’t square with the data or the observations. You can’t even agree with yourself for three comments in a row.

            Lot’s of populations that weren’t serfs or slaves have maintained a healthy weight without working engaging in work that burned 1000 calories an hour.

            One minute you are denying that poor populations in developing countries during the 50s, 60s and 70s had to work hard enough to maintain a healthy weight, despite factory work, washing clothes by hand, etc. The next you are asserting that 18th Century French aristocrats were getting in an hour or more a day of vigorous exercise in the form of dancing quadrilles. And then denying that burning over 700 calories is rigorous for an obese person – which is really fucking rich when you consider that an obese person’s resting metabolic rate is generally LOWER than a healthy person’s – so the delta between resting and 700 calories and hour is GREATER, not less.

            I don’t think I’ve ever seen such pretzeling and motivated logic to maintain an opinion that you don’t even have, you don’t know what you believe, you just know what you don’t want to believe.

            On this topic you are a textbook Anti. You’ll disagree with yourself in three different ways as long as you don’t have square up with the evidence.

          • Marc, with this rant you have exposed yourself as the “textbook Anti”.

            Pause, take a breath and do a self-check here. You are so obsessed with your idea of food taxation that you’re off in the weeds splitting hairs over what constitutes “physical activity” relative to metabolic outcomes.

            You’ve claimed in your profile and other writings (and I’ve taken you at face value) that you are a recovered liberal elite foodie True Believer. That claim caused me to respect you for being open minded and being able to grow intellectually. Now it is apparent you only think you’ve outgrown the altie ideology…or your claims were fabricated to trick me into trusting you and accepting you as a level-headed and open-minded dude so I would drop my guard and let you fuck with my mind.

            Let’s take the high road here and politely suggest you have another small hurdle here to overcome on your way to becoming a rational even-handed policy wonk. Hey, Rome wasn’t built in a day Marc. Ya gotta keep workin’ at it, buddy.

          • OH FERFUCKSAKE SAKE.

            I am sensing a bit of frustration here.

            Lot’s of populations that weren’t serfs or slaves have maintained a healthy weight without working engaging in work that burned 1000 calories an hour.

            I never said that they had to. If you are a healthy weight all you have to do to maintain that weight is to stay active a few times a week for a half an hour or so. . (active = heart rate at least 50% above resting).

            If you are obese or overweight you have to amp it up to lose weight. You will have to push your body as close as you can to safely get to max heart rate (age dependant) for at least a half hour 3x per week. Weight training every off day and once every 7th day rest or low activity stretching.
            This is the modern way of doing it, or you could get a job as a 18th century ditch digger or a lumberjack. Both these methods will result in significant weight loss, both are not easy. No one said that losing weight was easy.
            If you just restrict calories, you will still be out of shape, just thinner, and in my opinion it is even harder.

            One minute you are denying that poor populations in developing countries during the 50s, 60s and 70s

            Never said that. Overweight people have always been with us, i have seen a Buddha statue. What I was trying to say is because of labour saving devices there are far more overweight people today. Every time someone pours diesel fuel into a mini excavator, someone is getting a bit chunkier. Humans evolved to do stuff, we are not designed to sit on a couch all day and eat. That is why in the 60s, women were much more overweight than men. Men did most of the hard labor.

            The next you are asserting that 18th Century French aristocrats were getting in an hour or more a day of vigorous exercise

            I never said any such thing. I said because they were wealthy they could afford recreation. And at the time recreation involved being active, dancing, horseback ridding, hunting (same as hiking). And if they were not obese in the first place these activities would keep their weight down.

            And then denying that burning over 700 calories is rigorous for an obese person

            Once again, that is not what I said. I said for young men in the study 700 calories is just barely rigorous. These are young men (I am assuming 20-35 Don’t know the scientific definition of young men)and for them 700 is barely rigorous. At 25 a young man has lung/heart capacity to burn far more, 1000+, obese or not. A 50 year old woman, not so much.

            which is really fucking rich when you consider that an obese person’s resting metabolic rate is generally LOWER than a healthy person’s –

            Yes and that is why they need activity to boost the metabolic rate. Increase the RMR and you burn more calories by just being alive.

            On this topic you are a textbook Anti.

            I have been fairly consistent, More activity = less weight gain.

            And like I said earlier there is most likely a link between sugar/fast food consumption and weight gain, this I get.

            But without education on the benefits an active lifestyle you could ban sodas and all processed sugar and the problem will continue. The difference between someone that is totally sedentary and someone that is active is over 20% of base calories burned, or about 200 calories per day. 18lbs per year.

            I don’t understand why both of our models cannot work? The are not mutually exclusive.

          • While you can speculate and moralize all you want an honest review of the evidence doesn’t support your moralizing.

            While there is evidence that lower activity levels among kids predicts weight gain and persistent weight problems into adulthood, the evidence that sedentary behavior is causal among adults is thin to non-existent. The change among kids and the persistence into adulthood squares more with my endocrinological model than with your morality play.

            Here is how the 2015 Scientific Advisory Report on the US Dietary Guidelines characterized the state of the evidence on adults, sedentary behavior and weight regulation:

            • Moderate evidence from prospective studies suggests no association between sedentary behavior in adulthood and change in body weight, body composition, or incidence of overweight or obesity in adulthood.

            • Insufficient evidence exists to address the association between sedentary behavior and dietary intake in adults.

            [PDF] https://health.gov/dietaryguidelines/2015-scientific-report/PDFs/08-Part-D-Chapter-3.pdf

          • OK, your observations mean nothing. I know people that work as nurses or CNAs, my experience has been similar to yours–with one cageat, age. Young nurses are generally thinner and the older ones are heavier. Which mirrors the American population in general.

            Everyone in Manhattan seems to be thinner than those of us in less populated areas. This backed up by data that says that city dwellers are generally closer to their ideal weights than the suburbanites.

            You aren’t talking science, here. You need to look at more factors than you are.

          • That don’t mean nothing, because I’m using observation correctly in relation to science. While observation can’t validate a hypothesis, it can be used to invalidate one.

            Nevertheless, honest reviews of the science have shown the effects of exercise and physical activity to be scant, to non-existent until you get to very high levels of exercise, which also tends to invalidate the idea that a change in physical activity has been a major driver of weight gain at the population level. There just weren’t that many people who were getting 5 or more hours per week of rigorous exercise that stopped at the beginning of the 80s.

            :::::: EFFECTS OF EXERCISE TRAINING WITHOUT DIETARY INTERVENTION:
            Results of studies of exercise training alone, with no caloric restriction, are mixed: decreases, increases, and no changes in body weight and body composition have been observed.
            http://dx.doi.org.sci-hub.cc/10.1016/S0025-7125(16)30700-3

            === Does physical activity prevent weight gain–a systematic review. (2000) ===

            ::::: Prospective studies with physical activity measured at baseline, and
            randomized weight reduction interventions, gave inconsistent results regarding the effects of increased physical activity on weight change.
            The weighted mean weight regain in randomized studies with or without
            exercise training was 0.28 and 0.33 kg/month, respectively. Based on
            observational studies, it seemed that an actual increase in energy
            expenditure of physical activity of approximately 6300-8400 kJ/week
            (1500-2000 kcal/week) is associated with improved weight maintenance.
            This is more than was prescribed in most randomized trials, and
            certainly more than the participants actually achieved.

            https://www.ncbi.nlm.nih.gov/pubmed/12119991

          • I don’t have time to read all of the papers you posted. But regardless, the statement that your anecdotal evidence is somehow equal to the scientific method tells me that you are ill equipped for this conversation.

          • Here is how the 2015 Scientific Advisory Report on the US Dietary
            Guidelines characterized the state of the evidence on adults, sedentary
            behavior and weight regulation:

            • Moderate evidence from
            prospective studies suggests no association between sedentary behavior
            in adulthood and change in body weight, body composition, or incidence
            of overweight or obesity in adulthood.

            • Insufficient evidence exists to address the association between sedentary behavior and dietary intake in adults.

            [PDF] https://health.gov/dietaryguidelines/2015-scientific-report/PDFs/08-Part-D-Chapter-3.pdf

          • I agree that policy changes should be evidence-based. But isn’t it pretty clear that the average American’s weight has been increasing over the years?

            I may be asking a question that’s already been asked and answered in this thread, if so I apologize. We have an 11 year-old girl that’s a competitive athlete, and she can eat an entire box of Kraft Mac & Cheese and not gain an ounce. I don’t think another 11 year-old girl that does a lot of gaming can do the same.

          • It’s more than clear that the average American’s weight increased significantly since the 70s, though it seemed plateau about a decade ago.

            1. Kids are a bit different than adults. Their endocrinology is more malleable to the effects of diet composition and the impact of exercise on metabolism.

            2. As to your 11 year old, if we are talking about individuals whose activity levels lie outside of normal ranges, then the observations aren’t that useful for public health or epidemiology. You also have to ask if you are getting the causality backwards. Maybe she is drawn to athletics because her metabolism partitions energy into activity rather than fat storage.

            3. What people really have trouble wrapping their heads around is that humans have a homeostatic system of weight regulation, just like we keep our bodies at a constant temperature, we normally maintain weight and energy balance limbically, not through arithmetic in our pre-frontal cortex. 40 years ago, people who worked desk jobs didn’t have half the problem maintaining a healthy weight that people who work physical, blue collar jobs have today. And it’s not because the people who worked desk jobs in the 60s and 70s were training for half marathons. Half marathons didn’t even exist.

            So, you have ask yourself which variables could have broken that system of homeostatic weight regulation at the population level that squares with the data and our observations. The only changes that are consistent across time and populations that correlate with obesity epidemics are increases in the consumption of refined sugar, oils and carbohydrate. And the evidence on sugar is the strongest of the three. In fact it seems to be the linchpin that causes the other two to become problematic.

          • This makes a lot of sense, but I still believe that activity has something to do with it. I think we need far better studies on exercise and weight gain.

            Why didnt you say this in the first place? Could have saved me a ton of typing. 🙂

          • Nope Marc, truthiness has you in it’s evil clutches with your assertion desk workers of 40 years ago tended to be slender and fit. No way Jose. I was around 40 years ago and at that time I had extensive contact with your fabled desk workers, even stooped to being one for a couple years myself (I gained 15 pounds in about 18 months). Desk workers were virtually all doughy, paunchy and heavy. Bankers and insurance men (and especially politicians) of that day were stereotypically recognizable by their “fat cat” physique. It was the look of success and prosperity. The women working at those desk jobs, well, they all had “spreading hips”. Us redneck farm boys took sport in remarking among ourselves how this one or that one was about 2 axe handles broad across the beam. Slothful fat bastards could even be found on town road crews — they were always the ones driving the roller or dump trucks…the guys raking the asphalt mix or shoveling the crushed stone around tended to be slender. Many of the latter were spring steel and leather but, man they could eat and drink!. I guess you had to be there. And don’t tell me people with higher metabolic rates are just genetically destined to fill manual labor tasks…unless you can cherrypick a study demonstrating that.

          • Granted, it is easier to lose weight with diet, but exercise leads you to a fuller, healthier weight that is sustainable.

            I think it is easier to lose weight by exercising than dieting, for me anyway. A couple of years ago I broke my leg badly and was unable to much. I gained 50lbs in 8 months from being inactive, and I was so out of shape. It is amazing how many calories that you can burn by just being active all the time.
            Once my leg recovered, I amped up my activity and did real exercise and dropped that 50 lbs in about 4 1/2 months. I love carbs and pizza far too much to go on a diet.

          • “…education in general and especially by itself is a piss poor public health intervention…”

            Oh, c’mon now, seriously? Education is pointless? Regulation, taxation, then perhaps censorship, maybe incarceration in correctional camps for the truly incorrigible..oppression, not education, is the ideal public health intervention — of failed educators and tin pot dictators. Why do I always come away from these sanctimonious “what to eat” screeds with the sense I’ve just been propagandized by yet another aspiring el presidente of some banana republic somewhere?

          • I’m a progressive. I’d LOVE to believe that education is an effective public health intervention.

            But I’m also an evidence and metrics based guy. First and foremost. The evidence on education by itself in public health interventions is piss poor.

            Feel free to provide evidence otherwise.

          • Obviously public health educators of all types (including sanctimonious unofficial preachers of the foodie gospel) are piss poor teachers. What makes you think they will make better regulators and enforcers?

            Those who can…..do

            Those who can’t…..teach

            Those who can’t teach…..regulate

            In proselytizing progressives there seems always to be lurking a little tin pot dictator yearning to set themselves up in charge…to pick winners and losers, to do the most good for the most deserving, you see. The rest of us, the silent majority, naturally resist that and for very, very good reasons.

          • I kind of agree. It seems like more like “I hate big soda so they must be taxed” than a health initiative. If added sugar is the problem, target all added sugar in processed products. That would be fair, but this tax is not about being fair is it.

          • Actually, you could tax sugar at the wholesale level and the people would never even know why the prices went up. It would just be added to the cost of the product. This seems to me the fairest thing to do–and easiest to regulate.

            Why should I, as a consumer, pay more for one product that is identical to another product plus the amount of CO2? That doesn’t make sense. Why are we not taxing sugar found in cupcakes, deli meats, etc? At least when I am drinking a soda I know there is sugar added, I shouldn’t have to check and see if sugar has been added to my meat for crying out loud.

          • Fair, yes, but to the poor it would make most food more expensive, and they may make even worse food choices. Defeating the whole purpose of the tax.

            I am all for less fat people, but I want a program that actually works. Not one that makes the poorest people even poorer, that may force them to make even worse food choices.

          • To be fair, I’m a physicist, and I can’t afford to either “do” or “teach” at the current salary level in my field (i.e. less than I made delivering pizza).

            Regulation, on the other hand, actually pays a decent wage, because it’s working for the government and not asshole corporate types.

            As for “progressives,” the ones trying to pick winners and losers are not actually in that group; they may claim to be (e.g. Nancy Pelosi, Hillary Clinton, Harry Reid, Charles Schumer), but they are actually part of what is now being called the Regressive Left (although they aren’t actually “Left,” either….).

            You haven’t been offered an honest-to-goodness progressive in 44 years (George McGovern), and he was sabotaged by his own (Democratic) party, who then instituted the Superdelegate system to make sure that it never happened again (see this year’s Democratic primary).

          • See, right there with the “asshole corporate types”, that’s what I’m talking about and a real nice example of some of what we of the silent majority fear — the regulator who instinctively dislikes or even despises the regulated. I’m not a “corporate type” (familiar with a few, though) but I am an entrepreneurial type. We have regulators and enforcers coming at us from all sides, too many of whom snub us or resent us or simply despise us. And they’re the ones who can jam us up even more thoroughly if they choose any damned time they choose…and they never let us forget that little fact of life around here. Even with all that, entrepreneurship is the only way to go. Those of us who “do” might make OK teachers, but we would make the worst bureaucratic regulators ’cause we’re always looking for ways to make permanent improvements in a system instead of sniffing out ways to choke selected elements into stagnation and decline.

          • the regulator who instinctively dislikes or even …despises the regulated

            I don’t “hate” them; I do distrust them, though, and for good reason!

            Don’t get me wrong: I’m all for successful businesses making money and prospering, I’m just opposed to them doing so by screwing over their customers and employees.

            entrepreneurship is the only way to go

            I tried that; ran my own computer and network services company for 3 years. “Regulation” wasn’t even on my list of problems.

            Getting corporations to pay in a timely manner, and finding employees with initiative are the two issues that drove me out of business.

            we would make the worst bureaucratic regulators…

            Yes, but not for the reason you cite:

            The problem is that you look at things from the business perspective; that’s fine, if you’re in business, but not if your job is to prevent business from, say, dumping toxic waste out into a river that we get drinking water from.

            No, it is none of my concern if my actions drive a business, or even an entire industry, into “stagnation and decline.” If that is the result, then they are obviously doing something wrong, and need to go find a new way of doing it or change to a different industry.

            Are there bad regulations? Absolutely! But they have been created largely by anti-government politicians whose goal is to discredit the entire notion of regulation. That’s not a legitimate argument.

          • Yep, the prevailing attitude is one of mutual distrust. Would an attitude of mutual respect perhaps be more productive?

            Of course industries (including agriculture) sometimes pollute…because humans consume the fruits of industry, and mere mortal humans pollute. Sorta goes with the whole quality of life/standard of living notion American families like to embrace.

            What businesses do you regulate and inspect whose mission statement and reason for being is to dump toxic waste in rivers? Sure, we sometimes spill things accidentally and we could always benefit by creating fewer by-products and wasting less in our processes (accidents and waste are a loss to us and we actually work to avoid those, even on the farm — any practical help anyone can offer is sincerely appreciated, too). I’ve never become acquainted with a farmer, entrepreneur or industrialist whose stated driving ambition was to injure employees and pollute the environment. Have you? Seriously? It’s not much of a business model. In fact, I’ve only ever encountered dedicated people doing the best they can to produce stuff in the quantity, quality and price demanded by consumers. Obviously you and I move in different circles and have diametrically opposed views of how things get done and why. You are welcome to distrust me, just keep it realistic is all I ask of you, OK?

          • Yea, the guy who fucked up our economy by choosing to trust businesses to act responsibly rather than regulate them appropriately.

            After 20 years of disaster, he finally admitted that he was wrong… not that anyone was listening. Certainly, the same regulations (or lack thereof) are still in place.

          • OK, right. So, an adversarial relationship we have between regulators and the regulated, and adversarial it shall remain. Don’t look now, but Greenspan’s long gone and the silent majority has elected a new administration that promises to bite back at the worst of the regulators. I hope you’re not employed at EPA or DOE. That adversarial sh!t is a double-edged sword ;>)

          • Greenspan’s long gone

            Yet his economic policy remains….

            a new administration that promises to bite back at the worst of the regulators

            Did he promise you a pony, too?

            I hope you’re not employed at EPA or DOE

            Nope.

            That adversarial sh!t is a double-edged sword

            Sure, but the alternative is a sword with no edge at all!

          • “…a sword with no edge at all…” yep, that would be a bludgeon…and food taxation could be fashioned into a very effective bludgeon, I suspect. And I’m sure it’s not just me, I’m sure that observation is not lost on the aspiring tin pot dictators in the peanut gallery, either.

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