Have a Coke and a Smile

A couple of months ago, the courts ruled against the esteemed Mayor Bloomberg of New York in re: the ban against the sale of soft drinks larger than 16oz. This ignited some interesting debates within the nutrition communication industry (and don’t kid yourself—it is an industry).

In a dialogue I had with a fellow registered dietitian about that near-extinct concept, “personal responsibility,” I stated bluntly, “Collective punishment belongs, with the fascism it strengthens—in the dustbin of history.” My colleague’s position: “The personal responsibility of each of us extends to trying to make it more difficult for others to overindulge and do harm to themselves.”

While this is an unequivocal contradiction—how can personal responsibility be extended to another who is fully capable of taking responsibility for him- or herself?—it raised a question that has been asked all too rarely in the debate on nutrition and health, especially as it relates to the obesity pandemic: Who decided that it is incumbent upon food and beverage companies to babysit the world and be responsible for the health of the individual, not to mention the entire nation? In addition to portion size, Coca Cola has been taking it on the chin by self-righteous pundits and nutrition police for its existence as a sugared beverage. It seems that food is yet another category in which we’ve become a culture of victims.

I just can’t get on board with the idea that providing health-promoting foods—not just wholesome and safe but proactively healthful, food as medicine—should be mandatory for the makers of processed foods. Don’t get me wrong: The fact that it’s the rare company that has not embraced the enhancement of American nutrition beyond the basics is a wonderful and laudable thing. But, damn it, to do so is entirely voluntary and merits respect for the doing—not punishment if not done.

Yes, America does need to eat better. Of all the health issues, obesity certainly is the 800-lb. gorilla. According to an article in Marketwire discussing a new report, Weight Management Trends in the U.S., by the research group Packaged Facts, “U.S. retail sales of the weight management products and services—including foods and beverages, meal replacements and diet aids, and commercial weight management programs—will reach $38.0 billion in 2013 and $40.9 billion in 2016,” with food and beverage products comprising nearly 80% of those dollars. CDC reports that two-thirds of adults and a third of children age 6 through 18 are overweight/obese. Nearly half of all adults admit to dieting in some fashion or at least “watching their weight.”

But the answer for individual failings is not collective punishment. Nutrition and health experts (and those like Mayor Bloomberg who are self-appointed “experts” in spite of no background in nutrition science) do more harm than good when they prescribe the same Rx to everyone, healthy or ill alike. One thing missing in virtually every media-centered debate on health and nutrition is the actual science. A salient fact that always comes as a shock is that the connection between diet and disease has multiple and complicated bridges and pathways.

It is not, “Eat sugar/fat/salt and die;” It is, “Eat a diet loaded with empty calories on a daily basis for many years and be an inactive couch potato and you have a high chance of compromising your health and cutting years off your life, moreso if you are genetically disposed toward it.”

Drinking a large Coke on occasion does not make a person obese any more than singing “O Sole Mio” in the shower now and again makes one an opera star.

I’ve encountered the argument that the ban on large sodas is similar to the restrictions on cigarettes. This is patently not true: Cigarettes will harm the greatest majority of people who smoke—those who smoke a pack a day and live to 95 are the exception, not the rule. On the other hand, even taking an obese population in the U.S. of 100 million, the percentage for whom obesity is a sole result of too many calories in soda pop consumed is negligible.

Still, let’s go wild and say that 1 in 10 obese people are obese ONLY because they consume large sodas. Even this erring on the side of cartoonish exaggeration would mean 97% of the population has to be saddled with the hassles of obtaining, and of paying higher costs for, a 24-oz. serving of soda.

Government involvement adds tax burdens and beverage makers, distributors, wholesalers and retailers are inconvenienced and penalized. Then there’s the ecological damage. Purchasing two sodas instead of one doubles the energy of production and doubles container waste. It massively increases the cost of the product. All these issues eventually negatively impact the consumer.

In the same way that no sane person would demand everyone immediately undergo chemotherapy and radiation to avoid getting cancer, the focus on helping the unwell should be effected without trying to pull the well—to pull everyone—into one giant net of intervention. The rise of low sodium-induced heart disease in the elderly via the blanket prescribing of low-sodium diets in senior living centers, and the rise of obesity through the unintended leap in total caloric intake when fat was demonized, are two perfect examples of how “health fascism” can go seriously wrong.

It is the responsibility of individuals to police their behavior. And it is the responsibility of nutrition educators to educate, not legislate—and to do so based on science, not serendipity. And then it is up to the food and beverage processors to make good, tasty, wholesome and safe foods and drinks. If they decide to include ingredients in formulation that make it easier for individuals to be more self-reliant when it comes to their health, well, great. That’s a much better approach than punishing 97 out of 100 people for no reason.