Question 3 - John
After reading the supplemental article, what are your initial thoughts on labeling SSBs with Health Warning Labels? Do you feel that this is a necessary practice to start and do you feel that the results of this study would translate to the real world application?
posted by Unknown @ 3:10 PM
26 comments
26 Comments:
My initial thoughts are about how people still start smoking despite all of the knowledge and warnings out there. This is not to say such warnings aren’t effective in some ways. It just needs to be understood that additional supporting strategies will likely be needed. I certainly don’t think having such labels would do any harm from a health stand point. For a real world perspective, I think the SSB over-consumption issue is ingrained in much of our societies life and habits. We won’t “fix” it overnight. It will take a lot of different strategies chipping away at it from all different angles to finally resolve the prominence of SSBs in American diets. Such warnings could be another tool for us to use as we try to start chipping away. Awareness raising that a problem exists is the first step to finding a solution.
As Gina mentioned I think that putting health-warning labels on SSBs wont fix the problem of over-consumption overnight. However, I don’t see the harm in including them on the product. Some people simply do not have the education we have on SSBs and having a warning label could potentially help them make better choices. With that being said, I think if these labels were going to be implemented on SSBs it is important to educate the public on why they were put on there. It is also important to educate the public on why they are just now being put on and haven’t years before, explaining that our beverage choices are impacting our health. I recently saw that one of the mornings shows aired a YouTube video where someone melted all the sugar in different sugar sweetened beverages. There was a lot of buzz going around about it and I am sure it affected people’s choices the next time they went to buy the beverage that was displayed in the video. Finding ways to grab the public’s attention and getting across the point of why they should care are two important steps to take. As Gina also mentioned you will always have the ones who still will over-consume but my hopes would be with media attention, education, and other strategies to lower SSBs consumption the rates of those over-consuming would decrease.
I guess the first question that came to my mind was: how do we decide what to consider a SSB and what is excluded? Obviously I think of the typical SSBs such as soda and Gatorade, but do we also consider other beverages that have lesser amounts of sugar in them? Perhaps there is an official definition of SSBs that could be used.
Gina makes a valid point about the surgeon general warnings on tobacco products not preventing all people from smoking. However, is there research to show that since the implementation of these labels there has been a decline in use of tobacco products? I guess I am not sure, but I would venture to guess that there has been a decline in tobacco use, whether that is related to these labels or not, I am not certain. I would say that the labeling certainly would not hurt. As Moriah mentions, some people don’t have the education or even think twice about the foods they are eating or beverages they are drinking. Perhaps they do not realize that drinks like Gatorade are loaded with sugar. I certainly think that labeling SSBs with Health Warnings might be a step in the right direction.
I do not think putting a warning on SSBs would be beneficial and it would actually make our jobs as future dietitians more challenging. We always try to encourage moderation rather than restriction, but by putting a warning label on SSBs I think we would be encouraging restriction rather than moderation. We really need to get the idea of “bad/ banned foods” out of people’s heads. Maybe putting a “seal of approval” on products that are low in sugar would be more beneficial and positive. Taking a more positive approach might encourage companies to manipulate their beverages for the better in order to get this “seal of approval.”
I agree with Moriah that education would be crucial. However, education is expensive and time consuming (all important factors to consider). Amanda also makes a great point about how we would distinguish what sugar sweetened beverages are. Companies would begin manipulating their drinks with crazy, processed ingredients to meet certain sugar criteria to be able to avoid the warning label and then a whole other problem might be created where people would be putting other harmful products into their bodies besides sugar.
I think that labeling SSBs would be effective. As others have said, I do not think it would solve the fix the problem of overconsumption of SSBs, but I think it would increase awareness of people's choices and may sway them into making more healthful beverage choices.
I really like what Carly said about steering away from labeling foods as "bad" and trying to concentrate on labeling foods as "good." Pointing out healthy choices seems like it would be more apt to encourage people to choose healthier choices regularly and increase their confidence that they are doing the right things. This creates a more positive spin overall on people's relationship with food which seems more likely to illicit long-term healthy changes.
Amanda also brought up the important question of what is a SSB? What would be included? This makes me fear that aspiring for low sugar in beverages would lead to increased drive to create more artificial products. What first came to mind was the creation of trans fats in margarines when low-fat diets became the big thing. We do not want to make our beverages more processed than they already are. I think that taxing SSBs would be an effective strategy, as that has seen to be the most effective way to reduce the prevalence of smoking, but that also brings into question what is an SSB?
Gina makes a good point that warning labels on cigarette boxes don't stop people from smoking, however, overall smoking in the whole U.S. population likely has decreased. This supplemental study has shown how the warning labels made a difference in a person's decision about SSBs. Therefore, I think we should start making them a requirement on SSBs. A lot of product labels are designed in a way for consumers to mistaken them as a "healthy" beverage option. For example, sugar-sweetened tea with "real sugar", sure it is more "natural" but it is also providing a lot more calories than artificially sweetened drinks. Some consumers may not be aware of that, and some are. But I think it's important to make it obvious to consumers whom are misinformed and may be affected by the warning labels.
I really enjoyed the concept of labelling SSBs with a health warning label. I feel that this concept could be feasible after more research has been conducted. California, in my option, seems to be the most progressive state when it comes to health-related laws. It would take more research and several focus groups to determine the actual level of feasibility of the label changes. I feel that the biggest hurdle to overcome would be the backlash from consumers. Several new labelling acts have recently been enacted or are currently in-progress, and the general consumers seem to have mixed reactions to these changes. For example, chain restaurants are required to provide nutrition information on their menus. While it may be shocking to see the caloric values for a drink from Starbucks, I am curious to see how impactful this information is to the consumer who has already made up his/her mind that they intend to purchase a drink (regardless of caloric value).
Justine makes an interesting point that the awareness of SSBs may result in the creation of more artificial products. I would argue that this is already an issue. Artificially sweetened drinks are not classified as SSBs, but are they any healthier for the general population? I agree with Vivian's observation that labelling something as "natural" or "sweetened with honey" tends to lead the consumer to perceive the drink as healthier, even though it has high caloric content. I believe that this is lends support to the addition of limiting added sugars in the 2015 Dietary Guidelines and the requirement of labels for added sugars on the new Nutrition Facts panels.
I like this idea of having warning labels on SSBs. Food companies use different marketing strategies (while often times misleading) such as low trans-fat, no high fructose corn syrup, etc. to get consumers to buy their products. While I don't think having these warning labels will initially change the amount of SSBs purchased/consumed, I think it would be something that would change over time. Just as companies stear consumers to buy certain products because the are perceived as 'healthier,' these warning labels may also have the same effect on consumers to stay away from purchasing certain products.
Along with what Vivian pointed out, it is important to let consumers be aware of any misleading information on labels, and help make it obvious to them if what they have is actually a better choice. These labels, along with grocery store dietitians would be helpful for these confused customers.
My initial thought about labeling SSBs with a warning sign is that it may grab attention; however, I do not think it would have real work application. I have previously heard about labeling foods similar to traffic lights with color coding nutrient values with red, yellow, and green. Color draws attention to the consumer; however, it places a very black and white approach to food choices which I do no necessarily agree with. In regards to translating to real world application, I do not think the warning labels on SSBs would ever pass legislation to meet the consumer because of the large SSB industry that would push against this policy. Unfortunately, large companies such as Coke and Pepsi have a lot of pull in governmental policy and I see a slim chance warning labels would be mandated.
In comment to Holly's post-- I agree. History has shown that providing the consumer with more information about food and beverage choices has has little impact on consumer behavior. Consumers often know what they want, and a label isn't going to change that. The only benefit I have noticed from this labeling act is that the food industry has bettered their products and attempted to reduce added sugars, saturated fat, etc. in response to having to list nutrition information. Perhaps the SSB industry would follow suit if warning labels needed to be posted on their product by reducing the amount of added sugar to make their product look more appealing than competitors.
My background knowledge on the warning labels prior to reading this article was limited. After investigating, I am opposed to the addition of such warning labels. I do not think that significant benefits would come from such labels. The logistics and policies that would be necessary to get such labels on SSBs alone would be daunting and likely faced with significant opposition from the beverage industry. If these business and political obstacles could be overcome and warnings were present on SSB, I believe that this information would be lost in the already complicated product label. Beverage labels are already overloaded with nutritional information, branding, and other information about the company. A warning label could easily get lost among the other information. Another reason that I believe the labels would be ineffective is because of customer habits and brand loyalty. Consumers that repeatedly purchase an item like Cherry Pepsi are not likely to look closely at a label on a product. When their home supply runs out, they will simply pick up another pack at the store. The continuous exposure to the same product and its inclusion in regular consumption patterns would not likely be influenced by a label change. I also believe that putting such labels on SSB could be a slippery slope to similar warning labels on other unhealthy food items like candy. Where will the line be drawn for what foods need a warning label for their potential to contribute to chronic diseases? Any source of empty calories and added sugars have potential to cause weight gain, diabetes, and other poor health outcomes. I believe that the nutrition facts labels are adequate sources of information, and that focus should be on educating consumers on how to interpret the information to make healthy choices.
Through the news media, over the last several years, I have heard a number of stories about the attempts of various state and city governments to combat the obesity epidemic through SSB regulation, either size limits or warning labels. Yet, for all the conjecture, I had limited evidence knowledge behind SSB warning labels. The Roberto et al. (2016) study was able to demonstrate that warning labels can be an effective tool in educating individuals about SSB and labeling has the potential to decrease consumption of SSB. Thus, I view the warning label as another tool to educate individuals about beverage choices. The label is not there to prevent you from choosing a SSB but it is there to remind you that there are healthier less sugar filled drink choices available. If you have a can of coke today perhaps tomorrow you will reach for a bottle of water or glass of low-fat milk.
Great point Amanda. Where do we draw the line? Being from the swamps of Florida (where Gatorade was invented at University of Florida), the beverage, though very high in sugar, definitely has it's place in hydration for active people, in hot climates especially. Individuals who are losing a lot of fluids and electrolytes and/or need quick fuel replacement in the midst of an activity greatly benefit from inclusion of sport beverages like Gatorade. Then you have people who reach for a Gatorade because they just walked up two flights of stairs and feel like they have exerted themselves because they have just begun to glisten (that point right before you start to sweat, but you don't actually sweat). With such conditional/contextual appropriateness, I foresee a lot of companies legally battling to the death to not have a label on their beverage stating it's potentially bad for your health. That point would definitely need to be hashed out before any labeling requirement was proposed. Regardless, lobbying would be insane, and the money (that would be spent on lobbying) might be better spent on requiring food/beverage companies to allot funding to nutrition education programs. I feel like the companies may prefer that option to a warning label requirement about the damaging health effects of their SSB.
I have never really been on the bandwagon for Health Warning Labels whether it apply to beverages, foods, or food establishments. As many of our philosophies for foods go, we want to PROMOTE positive options to draw attention to healthier choices. By adding warning labels to SSBs, we may be creating undesired attention towards these products. I find this idea to be extremely unrealistic and not something that would efficiently be implemented.
I feel that this goes into the argument of what is considered "healthy" and is not a can of worms that I feel needs to be opened. Individual perceptions are greatly variable, and up and coming research is frequently modifying which nutrient intake levels are adequate or of concern. I tend to focus on the non-diet approach with a focus on food as a whole as opposed to specific nutrients or "bad foods."
I was very intrigued by the video Moriah mentioned that demonstrated the amount of sugar in various beverage options by melting down the sugar content in each option. I think more of these attention-grabbing experiments would be much more effective and thought provoking that a label suggesting a product is "off limits."
Initially I assumed that adding health labels could be beneficial in decreasing SSB consumption. Especially since the study found that adding the Health Warning Labels lead to individuals choosing less SSBs. I’m not sure if the labels would help for the long term though and believe that educational promos on SSBs would also have to be put in place- similar to anti-smoking campaigns.
I am not a fan of health warning labels on foods. Perhaps, it would catch people's attention and make them think twice about consuming their SSB drink. At first, it might decrease consumption, but ultimately I feel like it would have very little impact in the long run. I also don’t like labeling foods good or bad, as several of you pointed out. It creates misconceptions and people aren’t getting the full story. We need to educate the population on sugar consumption overall. If we start putting labels on SSB, shouldn’t we put health warning labels on ice cream and cookies, too? SSB are a major factor of increased sugar intake in our population, but there are other sources that are contributing to this issue. To combat the problem, I think education on sugar intake and moderation is key.
Kirsten, you bring up a good point with consumer habits and brand loyalty. People have their habits, and I agree that a simple label will not change their ways. Someone who has had a can of Pepsi in their lunch everyday for 20 years may look at the label, but they most likely won't change their ways. Generally people don't change their habits until their health is on line. I think education is important, and a label is just barely addressing the issue.
This is an interesting proposal putting health warning labels on SSBs. Like Gina, my thoughts are the people who still smoke despite the knowledge and warnings out there. I am not sure that a health warning label would stop people from drinking SSBs. So I question the effectiveness that this would have especially since it would cost a lot of money to have companies change their labels to include the health warning. My next big concern is labeling what is included and what is excluded for SSBs. Just like Amanda mentioned, there is too much gray area. I also think that it would make people choose diet drinks is still not as good of an option as water. When some people are told not to have a certain food or drink, that is usually all they crave and they may drink more SSBs than they did before. We are better off labeling beverage choices as "RD approved", so taking a more positive approach would be more beneficial in my opinion.
I do not feel it is necessary to display consequential health warning on sugary food labels. Even as large portions of the consumer public may not realize the significant long term effects of poor diet choices on chronic health conditions the addition of a label will not alter this gap. As expressed in prior posts other warning labels such as cigarette labels are ignored by consumers despite clearly stating the significant risk to long term health. The mentality which supports this avoidance behavior is 'a little won't kill me,' in continuance of this mentality consumption of high sugar food options or their saturated and trans fat counterparts are not likely to change as a result of labels due to the continued lag in cause and effect, action and disease. In application chronic health labels on high sugar food options is not feasible to enact for a legislative committee at a federal level due to the power of food business lobbyists. Significant differentiation would be required to distinguish sugary beverages in terms of brand, and sugar content limits to be a direct cause of listed chronic diseases over other contributes such as cookies, cakes, and baking sugar. A burden of proof and legal precedent which supported health warning on tobacco products is not found for surgar sweetened beverages.
The addition of a warning label for SSB will not stop consumers from drinking the products entirely. I do feel that some may veer from SSB but the majority of the population that does drink SSB (adolescents, teens, and young adults) will still continue this behavior. The label may have them rethink their purchase or choice but the warning probably won’t significantly change the consumption of SSB in the majority of the population. Look at cigarette labels and the salt-shaker-high-sodium warning label being placed on food items, both of these products are still being used by consumers. With this said, a SSB warning label may only decrease the behavior slightly but I do not believe it will harm anything, other than costs to companies to place labels on products.
Gina and Moriah have both mentioned the use of informing individuals and getting the population more attuned with the effects of SSB. I cannot agree more since I believe that by educating people on SSB we can have the individual make an education decision to not consume or not to consume as much of SSBs. If the individual is the main person who purchases such products for family or friends, education and solid facts may sway that person from buying SSB, thus reducing the amount of SSB consumed.
- Kelly Berg
I 100% support labeling SSB with a health warning. While I agree with Kelly and others who have said it will not stop all consumers from drinking it at all, there is also a large population of people who try to choose healthier products but lack the education to do so. I have had more than a dozen diabetic patients come to me excited to tell me they cut out all soda from their diet and when I asked what they are drinking now they will tell me gatorade, kool-aid, sweet tea, etc.
I agree with Amanda's point of the challenge of deciphering what exactly defines a sugar sweetened beverage. Drinking even 100% juice can easily be taken too far by a lot of people, yet I do not think it's necessary to label these as "bad" either. Diet soda is another questionable drink choice. I have worked with some RDs who strongly encourage diet soda for patients as a sweet drink and then other dietitians who strongly advise against all soda, whether diet or regular.
I think including a health warning label would definitely catch some eyes and spark national conversation but I don't necessarily know if it would be effective in deterring people from consuming excessive levels of SSBs.
Like Gina and Viv mentioned, the first thing that came to mind was the health warning on cigarette boxes. Effective, may be to an extent, do a good portion of people still excessively smoke cigarettes? Yes. Another example is the health warning on alcohol bottles that applies to pregnant women. Informative yes, do all people abide by the warning? Unfortunately not. I also think that in general the type of person who abides by health warning labels on packages might not be the type of person who is consuming excess SSBs to the point where it is harming their health (just an opinion though, who knows).
I think the way to approach decreasing national SSB consumption is through innovation, not regulations. What is the "next big thing" that we as dietitians can contribute to that will replace the popularity of SSBs? I suppose that is the million dollar question!
There are a lot of great points being made about this topic. I particularly agree with Rachel's comment about being able to distinguish the negative health effects of SSB from other items like cakes, etc. Her point was very well stated and acknowledges the fact that there are many contributors to chronic diseases, including various kinds of high sugar items. There is not enough evidence to indicate that SSB specifically cause these diseases, which is a reason why the label is likely to receive immense push-back from the beverage industry as they are likely going to feel targeted by such labeling. I also agree with much of what Jenn said about focusing our resources on promoting positive choices, rather than labeling potentially disease -causing food products. A "choose this" mentality is likely going to be more effective for healthy food choices than a "don't eat that" mentality. Labels and nutrition education focused on what NOT to eat can make consumers feel overwhelmed, guilty, or restricted, and ultimately discouraged.
Carly brought up a great point about how warning labels could change our views on moderation vs restriction and “bad” vs “good” foods; leading companies to manipulate their products to avoid the “bad” seal/label. Moriah also brought up a good point about education. Regardless of warning labels we, as future RDs, need to work on educating people about SSB, so they have the power to make their own informed decisions and limit the unintended effects of warning labels.
Carly, I also feel your emblem of approval or endorsement for nutrient dense low added sugar foods holds the greater impact for consumer health. Public knowledge exists that SSB are poor nutrition choices. The lack in education stems more from the benefits of better choices. However, product packaging is becoming increasingly crowded and difficult to decipher for consumers. With the introduction of an RD approved emblem, it would benefit to merge with existing nutrient emphasizing logos such as the More Matters logo or the Produce for Better Health organization.
My initial thought after becoming familiar with the study was that labeling SSB’s with Health Warning Labels is a great idea! After all, the results were fairly significant that the warning label positively influenced parent’s decisions about not choosing to purchase SSB’s for their children. But then, I thought about this concept more and my initial thoughts were challenged. If a Health Warning Label were placed on sugar sweetened beverages, where would the line be drawn? Would there need to be a health warning label on hot chocolate or sports drinks if they has similar sugar levels as other SSB’s? When I think about warning labels, I think about cigarettes and alcohol. SSB’s having warning labels seems like a bit of a stretch.
In response to Gina, I also perceive the greatest issues with giving SSB’s a warning label would be politics and lobbying. The real world application of this concept is EXTREMELY unlikely. Consider Coca-Cola for a moment. This company has an enormous influence on the global economy and is one of the largest big food corporations on the planet. Even if this Health Warning Label idea was proposed and introduced in the House, Coca-Cola would fight it to its demise.
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