Eating healthfully in America is hard. We have to contend with constant sugary and oily temptations, while pervasive ads coax us to eat these items day in and out.
The public health community generally agrees that regulations and taxes could help remind us of the potential health toll of the unhealthiest items — like beverages high in sugar — and keep us from consuming too much of them.
Lately, the idea of affixing a health warning label to sugary beverages also has been getting traction. So far, no city or state has been able to pass such a measure. But several are trying. California, New York and Baltimore all have legislation in the works requiring these labels on sugary drinks.
Until now, the effectiveness of such a label has been presumptive, drawing from the large body of research showing that warning labels on tobacco and alcohol products work.
But research appearing in the journal Pediatrics Thursday suggests that a warning label on sugary beverages might indeed deter people from buying the products.
The study was an online survey of about 2,400 parents from diverse backgrounds who were asked to choose a beverage for their child from an imaginary vending machine. The participants were randomly assigned one of six possible beverages: one with no label, one with a calorie label and four with different variations on a text warning label. The criteria for the (imaginary) beverages were drawn from proposed California legislation: any sweetened nonalcoholic drink with added sweeteners with 75 or more calories per 12 fluid ounces.
According to the researchers, led by Christina Roberto, assistant professor of medical ethics at the University of Pennsylvania, significantly fewer parents in the study chose sugar-sweetened beverages if there was a warning label on it: just 40 percent, versus 60 percent who chose one with no label, and 53 percent who chose one with a calorie label.
"We were surprised that the warning labels had as big an impact as they did," Roberto tells us. "I think the study shows us that calorie labels aren't terribly effective, and warning labels might have a bigger impact." The impact was actually two-fold: The labels educated consumers about the health harms of drinking sugary beverages and influenced their purchasing behavior as a result.
But while promising, the study offers only a vague idea of how warning labels might work in the real world, if a city like Baltimore or a state like California were to implement them. Roberto says she suspects the effect wouldn't be as strong. "We certainly need more data to know for sure," she says.
On Monday, a Baltimore councilman introduced legislation that would require businesses "that sell or advertise sugar-sweetened sodas, energy drinks, sports drinks, juices, coffees and teas to post signs warning consumers that they contribute to tooth decay, obesity and diabetes," the Baltimore Sun reported.
Leana Wen is the city's health commissioner, and she's hearing a lot of support from physicians and parents in Baltimore for the proposed policy. "Parents are telling us they would like information to level the playing field. They want to have accurate information for themselves and their children," says Wen. "The evidence tells us that [other kinds of] warning labels on tobacco and alcohol products do have an effect on parents and consumer choices."
But, Wen says, the beverage industry has been pushing back hard in Baltimore, lobbying legislators to reject the warning label policy and "frightening our small businesses, telling them they're going to be hurt by this and lose business."
It's not clear whether the bill will make it out of committee. But Roberto says that her study revealed that support for such policies might be broad. Some 73 percent of the participants said they were in favor of a policy requiring a warning label on sugar-sweetened beverages.