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Research examines impact of soda taxes on oral health

Mary Otto
Mary Otto

By Mary Otto

Is there a soda tax debate coming to your community? The potential for such taxes address problems with obesity, diabetes and cardiovascular disease are important angles to explore, but don’t forget the oral health aspect of the soda tax story.

In the Nov. 4 elections, Berkeley, Calif., voters approved, by a wide margin, Measure D, which places a 1-cent per ounce tax on sugar-sweetened beverages. The measure was strongly opposed by the American Beverage Association but won support from a wide range of health groups, including local dental organizations.

The outcome of the vote gave Berkeley the distinction of being first city in the country to approve such a “sin” tax, Forbes contributor Robert W. Wood observed in a blog published Nov. 8 on the magazine’s website. “The beverage industry reportedly spent about $2.3 million in Berkeley and failed to stop the measure. More money was thrown at San Francisco, where a soda tax was defeated,” Wood reported. “Some say famously liberal Berkeley is low hanging fruit. Yet it is still seen as a pivotal victory that could mean more soda taxes to come in more mainstream cities.”

In a Nov. 10 story on the vote, (not yet posted online,) billionaire Michael Bloomberg has announced he is willing to help to other cities who want to follow Berkeley’s example, reported Politico’s Helena Bottemiller Evich, who has followed the soda tax battle for months. As mayor of New York, Bloomberg  mounted a campaign to ban large-sized sodas. His mandate was eventually struck down in court. But Bloomberg adviser Howard Wolfson told Politico that the former mayor is ready to financially back other municipalities who want to put a soda tax on the ballot.

“We are going to look aggressively to partner with local leadership because we see an enormous, dam-breaking opportunity … to see the success in Berkeley replicated in other places,” Wolfson told Bottemiller Evich.

Research on effects of 'sugar taxes'

In his column, Wood, who writes about taxes and litigation for Forbes, examined the potential of a sugar tax to address growing problems with diabetes and obesity and cited research on the issue, including a 2012 Health Affairs study that garnered attention during the debate over New York’s ban on big sodas.

In that paper, “A Penny-Per-Ounce Tax On Sugar-Sweetened Beverages Would Cut Health And Cost Burdens Of Diabetes," authors Y. Claire Wang and colleagues took aim at sugar-sweetened beverages as contributors to the nation’s obesity and diabetes epidemics and examined the potential impact on health and health spending of a nationwide penny-per-ounce excise tax on such drinks.

They concluded the tax would reduce consumption of these beverages by 15 percent among adults ages 25 to 64, helping to prevent of thousands of adverse health events and save billions in medical costs.

Sweetened drinks and tooth decay

The authors of the Health Affairs study did not focus upon the potential impact of the soda tax on the burden of tooth decay. But a Robert Wood Johnson Foundation research synthesis includes tooth decay among the many adverse health consequences of the increased consumption of sugar-sweetened beverages over recent decades. The paper also examines the effectiveness of interventions in lowering health risks. The foundation’s Bridging the Gap project researches and monitors state level beverage taxes.

Likewise, the Rudd Center or Food Policy and Obesity at Yale University has included oral health in its work on the soda tax question. Rudd researchers have concluded that a penny per ounce tax would result in an 8 to 12.6 percent decrease in the consumption of sugar-sweetened beverages.

“Children ages 4 to 8 should consume no more than 15 grams of added sugar per day according to Choosemyplate.gov and the American Heart Association,” the Rudd researchers have pointed out. “Given that there are at least 15 grams of sugar per serving in two-thirds of the drinks marketed to children, these drinks contribute to excess sugar consumption.”

Image: Rex Sorgatz via flickr.

And while the authors of a major new study recently published in BMC Public Health do not discuss soda taxes, they highlight the cumulative impact of sugar consumption upon the oral health of adults. The authors of the paper “A Reappraisal of the Quantitative Relationship Between Sugar Intake and Dental Caries: the Need for New Criteria for Developing Goals for Sugar Intake” studied the global epidemic of tooth decay. Noting that oral conditions affect 3.9 billion people worldwide with untreated tooth decay in permanent teeth representing the most prevalent problem, they make a case for a drastic reduction of dietary sugars worldwide.

“The findings from this study indicate that the current approaches to controlling dental caries are failing to prevent high levels of caries in adults in all countries and this relates to the current high level of sugar intake across the globe,” wrote the authors.

Guidelines on sugar consumption

They criticized the long standing guidelines set out by the World Health Organization that determine sugar consumption should account for 10 percent of daily energy intake, or roughly 50 grams per day. Instead, they recommend  “a new and radical policy of progressive sugar reduction” with recommended  levels downgraded to three to five percent of  daily energy intake.

In fact, the WHO did reduce those guidelines earlier this year, finding that only five percent of a person’s daily caloric intake should come from sugar, Charlotte Alter reported for TIME.

“WHO experts said that dropping recommended daily sugar amount to five percent would help fight cavities and obesity, but admits that it’s a tough goal to meet,” Alter reported. “We should aim for five percent if we can,” WHO nutrition direction Dr. Francesco Brana said in a news conference, “but 10 percent is more realistic,” Alter wrote.