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I’m following the soda tax initiative in Richmond, CA with rapt attention.  Richmond, as I explained last week, is a low-income city with a lot of obesity-related chronic disease and high soda consumption.

Residents will vote on its soda tax initiative in November.  In the meantime, the American Beverage Association has gone to work to spin the science, attack critics, and fund “community coalition” groups to oppose the initiative.

Richmond requires such groups to disclose their top donors on political mailings.  The soda-industry funded “Coalition” went to court to block this requirement on First Amendment grounds.

Now, according to Robert Rogers, the terrific reporter for the Contra Costa Times who has been working on this story, a federal judge in San Francisco issued a temporary restraining order doing just that.

Complete victory for our side,” said coalition spokesman Chuck Finnie. “(Judge Charles Breyer) indicated he doesn’t think (the ordinance) applies to us because we are not engaged in independent expenditures. (Breyer) indicated a city can’t require a campaign to publish political arguments under the guise of claiming it is a disclosure.

This will be back in court on September 18.

In the meantime, “Big Soda” is expected to spend more than a million dollars in Richmond to make its efforts look like a local campaign.

Here is the Statement on Ruling on Richmond Mailer Ordinance.

And here are related Contra Costa Times stories on the soda tax initiative.

• Poll: Should Richmond add a tax to sodas and other sugared drinks?
• Actor Danny Glover comes out in support of Richmond soda tax ballot measure
• Barnidge: Voters should be prepared for a lot of taxing issues
• Big money from ‘Big Soda’ sloshes around Richmond’s controversial sugar-tax measure
• Groups take sides in Richmond soda tax debate
• El Monte joins Richmond, becomes second California city to propose soda tax

Sometimes the actions of food companies defy credulity.

Get this: The Community Coalition Against Beverage Taxes, a “grassroots” group funded by the American Beverage Association, has taken the city of Richmond, California to court to block it from requiring disclosure of funding sources in election campaigns.

In case you haven’t been following this situation, the Richmond city council got a soda tax initiative (“Measure N”) placed on the November ballot.

Richmond is a low-income, mixed-race city (80% non-white), with an 11% unemployment rate, and an average household income of $23,000 a year.  It population is largely obese and drinks a lot of sodas.

You would hardly think a city like this would get on the radar of Big Soda, but you would be oh so wrong.

For details, we have to thank Robert Rogers who writes for the local Contra Costa Times.

Mr. Rogers has been following the money.

Because California requires lobbyists to register, he has been able to get hard numbers on the relative spending of anti-tax forces and those who favor the tax.  The difference is impressive.

The city of Richmond must have suspected that something like this would happen because the city council passed an ordinance that requires special interest groups to disclose who funds them in campaign literature.  They must list their top five funders.

You might think this idea entirely appropriate to a democratic society, but the American Beverage Association (translation: Coca-Cola and PepsiCo) does not.

According to Rogers’ account on September 4, Big Soda has sued the city in federal court to stop it from insisting that campaigns disclose who funds them.

On what grounds, pray tell?

The First Amendment, of course.

The suit, filed in federal court in San Francisco on Aug. 30, seeks an order barring the city from imposing its campaign ordinance on the Community Coalition Against Beverage Taxes, a declaration that the groups’ First Amendment rights were violated and money to cover court costs.

The coalition is funded mostly by the American Beverage Association and has spent more than $350,000 locally in an effort to defeat a November ballot measure that could impose a penny-per-ounce tax on sales of all sugar-sweetened beverages in the city.

…Coalition spokesman Chuck Finnie said Tuesday that the law itself is unconstitutional and should not be applied to the anti-soda tax groups.

“The law in question is being enforced to prevent opponents of an unfair, misleading and misguided tax from being able to communicate effectively with Richmond voters,” Finnie said. “The sponsors of the Measure N tax don’t want voters to hear how the tax is going to raise grocery bills, hurt local businesses on which livelihoods depend, and the fact that city politicians would be free to spend all of the money raised by Measure N in any way they see fit and that not one penny must be used to fund anti-obesity efforts.”

In other words, revealing funding sources prevents “effective communication.”

The court will hear this suit on Friday.  Stay tuned.

In the meantime, here are the relevant documents, thanks to Robert Rogers.

• Document: Richmond’s campaign disclosure ordinance
• Document: Soda-tax opponent’s application for temporary restraining order
• Document: Soda-tax opponent’s lawsuit against Richmond campaign disclosure law

My monthly, first Sunday column in the San Francisco Chronicle:

Q: I still don’t get it. Why would a city government think that a food regulation would promote health when any one of them is so easy to evade?

A: Quick answer: because they work.

As I explained in my July discussion of Richmond’s proposed soda tax, regulations make it easier for people to eat healthfully without having to think about it. They make the default choice the healthy choice. Most people choose the default, no matter what it is.

Telling people cigarettes cause cancer hardly ever got anyone to stop. But regulations did. Taxing cigarettes, banning advertising, setting age limits for purchases, and restricting smoking in airplanes, workplaces, bars and restaurants made it easier for smokers to stop.

Economists say, obesity and its consequences cost our society $190 billion annually in health care and lost productivity, so health officials increasingly want to find equally effective strategies to discourage people from over-consuming sugary drinks and fast food.

Research backs up regulatory approaches. We know what makes us overeat: billions of dollars in advertising messages, food sold everywhere – in gas stations, vending machines, libraries and stores that sell clothing, books, office supplies, cosmetics and drugs – and huge portions of food at bargain prices.

Research also shows what sells food to kids: cartoons, celebrities, commercials on their favorite television programs, and toys in Happy Meals. This kind of marketing induces kids to want the products, pester their parents for them, and throw tantrums if parents say no. Marketing makes kids think they are supposed to eat advertised foods, and so undermines parental authority.

Public health officials look for ways to intervene, given their particular legislated mandates and authority. But much as they might like to, they can’t do much about marketing to children. Food and beverage companies invoke the First Amendment to protect their “right” to market junk foods to kids. They lobby Congress on this issue so effectively that they even managed to block the Federal Trade Commission‘s proposed nonbinding, voluntary nutrition standards for marketing food to kids.

Short of marketing restrictions, city officials are trying other options. They pass laws to require menu labeling for fast food, ban trans fats, prohibit toys in fast-food kids’ meals and restrict junk foods sold in schools. They propose taxes on sodas and caps on soda sizes.

Research demonstrating the value of regulatory approaches is now pouring in.

Studies of the effects of menu labeling show that not everyone pays attention, but those who do are more likely to reduce their calorie purchases. Menu labels certainly change my behavior. Do I really want a 600-calorie breakfast muffin? Not today, thanks.

New York City’s 2008 ban on use of hydrogenated oils containing trans fats means that New Yorkers get less trans fat with their fast food, even in low-income neighborhoods. Whether this reduction accounts for the recent decline in the city’s rates of heart disease remains to be demonstrated, but getting rid of trans fats certainly hasn’t hurt.

Canadian researchers report that kids are three times more likely to choose healthier meals if those meals come with a toy and the regular ones do not. When it comes to kids’ food choices, the meal with the toy is invariably the default.

A recent study in Pediatrics compared obesity rates in kids living in states with and without restrictions on the kinds of foods sold in schools. Guess what – the kids living in states where schools don’t sell junk food are not as overweight.

Circulation has just published an American Heart Association review of “evidence-based population approaches” to improving diets. It concludes that evidence supports the value of intense media campaigns, on-site educational programs in stores, subsidies for fruits and vegetables, taxes, school gardens, worksite wellness programs and restrictions on marketing to children.

The benefits of the approaches shown in these studies may appear small, but together they offer hope that current trends can be reversed.

Researchers also suggest other approaches, not yet tried. The Yale Rudd Center has just shown that color-coded food labels (“traffic lights”) encourage healthier food choices.

And Rand Corp. researchers propose initiatives like those that worked for alcoholic beverages: Limit the density of fast-food outlets, ban sales in places that are not food stores, insist that supermarkets put junk foods and sodas where they are hard to see, ban drive-through sales, restrict portion sizes and use warning labels.

These regulatory approaches are worth trying. If research continues to demonstrate their value, cities will have even more reason to use them. If the research becomes compelling enough, the federal government might need to act.

In the meantime, cities are leading the way, Richmond among them. Their initiatives are well worth trying, testing and supporting.

**Marion Nestle is the author of “Why Calories Count: From Science to Politics,” as well as “Food Politics” and “What to Eat,” among other books. She is a professor in the nutrition, food studies and public health department at New York University, and blogs at foodpolitics.com. E-mail: food@sfchronicle.com

The costs of obesity are personal, but also societal.

Economists love trying to figure out how to quantify such things.

The most widely used estimate for the United States is from Cawley and Meyerhoefer’s 2012 article in the Journal of Health Economics: $190 billion annually for health care and lost productivity (their 2010 working paper may be easier to access at the National Bureau of Economic Research site).

Now the Campaign to End Obesity has published its own analysis of these costs.

• $44.7 billion, for inpatient services.
• $45.2 billion, for non-inpatient services.
• $69.3 billion, for pharmaceutical services.
• $146.6 billion, across all services.

As the Campaign puts it:

the total economic cost of overweight and obesity in the United States and Canada caused by medical costs, excess mortality and disability is approximately $300 billion per year. The portion of this total due to overweight is approximately $80 billion, and approximately $220 billion is due to obesity. The portion of the total in the United States is approximately 90 percent of the total for the United States and Canada.

I don’t know what to make of such estimates.  They are always based on assumptions that may or may not be valid. 

One thing is clear: obesity is expensive, personally, economically, and politically.

That’s why it’s a good idea to support public health initiatives to make it easier for people to maintain a healthy weight.

Providing healthier food in schools, getting junk food out of schools, soda taxes, soda caps, and restrictions on marketing to kids are the kinds of ideas that are worth supporting.  

Now. 

My once-a-month (first Sunday) Q and A column in the San Francisco Chronicle deals with recent city initiatives.

Q:Why do municipalities continue to try to tell us what to eat or drink through taxes (the 1-cent soda tax on the Richmond ballot in November) or outright bans (eliminating super-size soft drinks, proposed by Mayor Michael Bloomberg in New York)?  Richmond residents could just buy their sodas in neighboring towns, and 1 cent seems hardly enough to influence anyone. New Yorkers could just buy two drinks if they want more. Isn’t this all rather silly?

A: Silly? On the contrary. These are dead-serious attempts to address the health problems caused by obesity through “environmental” change – changing the context in which we make food choices.

By now, health officials are well aware that asking individuals to take responsibility for making their own healthy food choices hasn’t got a prayer of success in the face of a marketing environment that encourages people to eat everywhere, all day long, in very large portions and at relatively low cost.

This is the default food environment, where it’s useless to tell people they need to eat less and expect them to do it. They can’t. Instead, it makes sense to try to change the food environment to make healthy choices the easy choices.

Healthy by design?

Suppose, for example, that all kids’ meals at fast-food restaurants were healthy by design and automatically provided milk or water.

You could still order a soda for your kid, but you would have to ask for it – and pay extra. If you are like most people, you won’t bother. That’s why the default matters.

Cities are trying to change the default. One change may or may not make a difference – we don’t know that yet. But changing the default might well make healthy choices easier in schools, fast-food restaurants and other institutions.

Bloomberg’s proposal in New York, to ban sodas larger than 16 ounces, is one such step. From my standpoint, 16 ounces is generous. It’s two full servings and provides about 50 grams of sugars, 200 calories and 10 percent of daily calories for someone who consumes 2,000 calories a day.

Portion sizes used to be a lot smaller. Decades ago, Coca-Cola advertised 16-ounce bottles as “big” and enough to serve three over ice.

If we could recognize that larger portions have more calories – and act on this knowledge – we might have an easier time maintaining weight. But we can’t, at least not easily.

The Richmond soda tax proposal recognizes that more than half of Richmond schoolchildren are overweight or obese. This percentage is higher than in other areas of Contra Costa County.

Even more striking, city officials estimate that two-thirds of Richmond adolescents consume more than 400 calories a day from soft drinks.

Kids who habitually drink sugary sodas tend to have worse diets, to be fatter and to display more risk factors for chronic diseases than kids who don’t.

This makes sugar-sweetened beverages an obvious target for environmental approaches to obesity prevention. Sugary sodas have calories but no nutrients. They are consumed in large amounts. They are highly correlated with obesity and health risks. They are “liquid candy.”

Sugary drinks should be once-in-a-while treats, not daily fare.

Richmond officials hope that the tax will encourage healthier choices. They deliberately set the proposed tax small so it would not unduly burden low-income residents.

One penny per ounce – 16 cents on a 16-ounce soda – may not be enough to change behavior, but it sends a clear message: It’s less expensive to drink water, and it’s healthier to reduce soda intake.

Funding programs

The Richmond proposal has one other critically important feature. It specifies that soda tax revenue will be used to fund city programs to address and reduce childhood obesity, especially in low-income areas where obesity rates are high.

These experiments are worth national attention. They may well do some good for individuals, and I can’t see how they would cause harm in any way except, perhaps, to the economic interests of soda companies.

Soda companies are taking these initiatives seriously. They are pouring millions of dollars into lobbying and community campaigns against both proposals.

Both have elicited plenty of public discussion, much of it focused on the rights of individuals versus the public health interests of government.

What I like about these initiatives is that they do not infringe on individual rights – people can buy as much soda as they want. The proposals simply try to make the default food environment slightly more conducive to healthy choices.

I’m hoping both proposals go forward. I can’t wait to see how they play out.

I have a commentary in the October 23 issue of New Scientist (UK):

World’s first fat tax: what will it achieve?

Enviably healthy Denmark is leading the way in taxing unhealthy food. Why are they doing it, and will it work

I don’t often respond to comments but this one about the political division caused by obesity is worth further discussion.

I truly resent your statement that Republicans don’t want to have an education, access to health care or access to nutritious food. Such statements not only undermine your credibility but contribute nothing to the discussion.

For the record, Republicans as just as committed to these things as the Democrats. The difference is that the Republicans don’t believe that it is the taxpayers responsibility to provide them.

If not taxpayers, who?  The writer does not say.

I thought of this question when I read the new report released by the NYC Center for Economic Opportunity. The center was established in 2006 by Mayor Bloomberg to seek evidence-based ways to reduce poverty in the city.

As the New York Times explains:

Without a flood of food stamps and tax benefits for low-income families, about 250,000 more New Yorkers would have slipped into poverty at the height of the recession…The center concluded that the poverty rate would have been three percentage points higher without federal tax programs passed in 2009 for low-income families and an aggressive city program to enroll New Yorkers who were not receiving public assistance but were eligible for food stamps, coupled with higher food stamp benefits.

Beyond personal damage, poverty is demonstrably bad for the health of cities.  Poor people do not buy much.  They cause social unrest.  They drain public resources.  Getting people out of poverty is sensible public policy and has been throughout history.

History also tells us that private charity is never adequate to meet the needs of the poor.

That’s why U.S. taxpayers support food stamp and other food assistance programs to the tune of close to $100 billion a year, as can be seen in the USDA’s budget figures.

The “aggressive city program” paid off.  At a time of economic crisis, poverty levels throughout America increased.  New York City’s did not.

Isn’t dealing with poverty a core function of government?  Isn’t some reasonable level of income equity a core feature of democratic society?

I think so, but await your opinions.

I keep telling you.   You can’t make this stuff up.  Try these for food politics–in this case, soda politics–in action.

Beverage Association gives $10 million to Children’s Hospital of Philadelphia (CHOP)

From the Philadelphia Inquirer blog (March 16):

In keeping with a controversial pledge to made last year to City Council as part of an effort to ward off Mayor Nutter’s steep tax on sugar-sweetened beverages, the soft-drink industry will donate $10 million to the Children’s Hospital of Philadelphia to fund research into and prevention of childhood obesity.

The three-year grant is funded by a new organization, the Foundation for a Healthy America, created by the American Beverage Association, the national trade group representing manufacturers and bottlers. The ABA was instrumental in lobbying Philadelphia City Council to reject Nutter’s proposal to tax sugary drinks at 2-cents per ounce as a way to cut consumption and raise money for the general fund.

In a press release Wednesday, CHOP insisted that it will “retain absolute clinical and research independence,” as the source of its funding for the research is likely to come under attack from those wary of the beverage industry’s influence. That includes funding for clinical studies to be submitted to peer-reviewed publications.

Atkins Obesity Center publishes review of effects of soft drinks on obesity

In a delicious irony, the latest review of this topic comes from the Atkins Center at Berkeley.  Yes, the Atkins Diet Atkins, the one that promotes high-fat, low-carbohydrates, and has everything to gain from proving that sugars are bad for you.

With that duly noted, set the irony aside.  The review was funded by independent agencies and organizations.  Let’s take its results at face value.

The reviewers looked at five kinds of evidence: secular trends, mechanisms, observational studies, intervention trials and meta-analyses.  All supported the idea that

The currently available evidence is extensive and consistently supports the hypothesis that sweetened beverage intake is a risk factor for the development of obesity and has made a substantive contribution to the obesity epidemic experienced in the USA in recent decades.

Sweetened beverages are an especially promising focus for efforts to prevent and reduce obesity for two reasons: (i) the evidence supporting the association between sweetened beverage intake and excess weight is stronger than for any other single type of food or beverage; and (ii) sweetened beverages provide no nutritional benefit other than energy and water.

Coca-Cola funds North Carolina School of Public Health campaign against Childhood Obesity

Isn’t that nice of them?  The apparently unironical slogan of the campaign : “Everything in moderation.”

Robert Wood Johnson Foundation report, “F as in Fat”, features piece by PepsiCo’s CEO

Melanie Warner, writing on bNET, explains that the RWJ Foundation is usually scrupulously independent but that putting Pepsi’s PR piece into its document makes no sense.

A third of the way into the report, up pops a bizarre “personal perspective” from PepsiCo’s (PEP) CEO Indra Nooyi in which she details the many ways her company is working to make America healthier. “Helping consumers by building on our portfolio of wholesome and enjoyable foods is not just good business for PepsiCo -– it’s the right thing to do for people everywhere,” Nooyi chirps in a two-page soliloquy that reads like a press release and touts everything from Pepsi’s pledge to reduce the sodium in its products by 25% by 2015 to its reduced sugar drinks like Trop50 and G2. No other food company is mentioned, just Pepsi.

[This inclusion]…also ties into the ongoing debate about what role the food industry should play in helping Americans slim down. Are food companies trusted partners who are committed to fundamental changes, or is getting people to eat healthier versions of processed food really a whole lot of Titanic deck chairs?

As the research linking soft drinks to obesity gets stronger and stronger, it is no wonder that the Beverage Association is buying off city councils, and soft drink companies are eager to position themselves as helping to solve the problem of childhood obesity, not cause it.

Do these actions remind you of any other industry’s behavior?  Cigarette companies, anyone?