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Controlling Childhood Obesity by Fizzing Out Sodas in School

By Carol Duh-Leong
. 3 Comment(s)

Overweight and obese children are at a higher risk of developing and suffering from the costly chronic diseases that walk hand-in-hand with a lifetime of obesity. For example, children who contract Type II diabetes are more likely to be susceptible to chronic conditions throughout their lives, including earlier onset of progressive neuropathy, retinopathy leading to blindness, nephropathy leading to renal failure, and cardiovascular disease. Recent research released this spring has uncovered that type two diabetes linked to obesity takes an even worse toll on this children than originally predicted, the disease “progresses more rapidly in children than in adults and is harder to treat.”[1]

This national emergency requires a multilayered approach. Here is one small peek into Tennessee.

Three short decades ago, one in ten Tennessee children were overweight. Today, this statistic has risen to one in every three or 36.5% of children in Tennessee are either overweight or obese, establishing Tennessee as the state with the sixth highest childhood obesity rate in the country.[2]

Easy access to sugar-sweetened beverages has been a critical influence on childhood obesity. For each can of a sugar-sweetened beverage a child consumes per day, a child’s likelihood of becoming obese increases by 60%.[3] A 2004 study found that sugar-sweetened beverages are the single largest contributor of caloric intake in the United States,[4] and accounts for 10-15% of caloric intake for children and adolescents.[5] Targeting initiatives that reduce consumption of sugar-sweetened beverages is of paramount importance in the fight against childhood obesity.

The consequences of childhood obesity are alarming not only because of the disease burden linked to childhood obesity, but also because of the future devastation of how much it will cost to care for a majority obese adult population in Tennessee. As our country is struggling to control the cost of healthcare, the obesity epidemic will continue to demand higher costs. Federal studies demonstrate that obese children have a 70% chance of continuing on to become overweight adults.[6] With over 30% of the state’s population overweight or obese, Tennessee spent an estimated $1.57 billion ($355 per capita) on obesity related diseases last year - 22% more per capita than the national average. This number is projected to rise to 7.08 billion ($1,442 per capita) by 2018.[7]

There remains a pervasive belief that obesity exists because of an individual’s lack of willpower or a lack of oversight on the part of parents when considering a case of childhood obesity. This misguided conviction stands as a barrier against championing sound public policy to counter this exploding epidemic. The obesity epidemic is one that cannot be treated in a doctor’s office alone; it is the result of living in an environment where nutritious food is inaccessible due to an overabundance of non-nutritious foods through accessibility, affordability, and marketing rather than a matter of self-control.[8] Public acceptance of this model is crucial to enacting policy initiatives that address these environmental factors.

Science suggests that a minor change in diet (reduction of even 100 calories a day) will result in weight loss, making the removal of soda from the diet a concrete change that could deliver visible results in children. There are several proposals on the table that aim to minimize access to sugar-sweetened beverages in Tennessee, including a tax across all sugar sweetened beverages as well as a ban on soda machines in school.

Unfortunately, this single target is still quite complex. Many schools use the revenue from soda machines to fund school activities, making the removal of soda machines from schools a painful cut. One of the largest employers in Tennessee, Coca-Cola, maintains several bottling plants in the state. As a result of its significant investment in the state, the beverage industry has significant lobbying prowess in Nashville. Additionally, the beverage industry has invested billions of dollars to convince children that sweetened beverages are fun, athletic, sexy, popular, healthy, and even beneficial.[9] Like the tobacco industry at the start of the anti-smoking wars, the beverage industry is preparing for war.

A policy directive should consider not only impact but also feasibility of the solution. Although a tax on sugar-sweetened beverages has the potential to reach a wider population, we must consider what policy measures are politically possibly to achieve. Many state legislatures continue to discuss taxes on sugar-sweetened beverages as a reasonable method of combating the obesity epidemic (both directly from the effect on consumption and indirectly through the revenues generated), but the timing in Tennessee for such legislation remains complicated as the current recession environment is uncomfortable with new taxes. A public opinion poll revealed that a majority of Tennesseans (78 percent) opposed a special tax on snack foods.[10] A more moderate approach may be more appropriate.

Like a scalpel is a more adept tool at demonstrating a clean result than a chainsaw, a ban on soda vending machines is a more elegant and less intrusive solution that has the potential for great effect on the lives of children in Tennessee. Public opinion on stricter school regulations is already beginning to turn positive: a slight majority (53%) opposed vending machines in elementary and secondary schools.[11] Many schools have already begun to remove soda machines from their campuses on their own. In 2008, Tennessee ranked sixth in the nation for the highest number of schools that did not sell junk food (soft drinks, fruit juice that was not 100% juice, candy, and baked goods) in vending machines, school stores, canteens, or snack bars.[12]

Cutting vending machines may cut a source of funding for school activities. However, the disease ramifications of obesity are enormous and unless we take action now, we will approach a state and national emergency. Revenue from soda is no longer an appropriate source of funds, the way that revenue from cigarette machines would not be appropriate source of funding. We must shoulder the responsibility to build an environment for our children that is nutritious and healthy. The consequences otherwise, are just too heavy.


[2] Eat Well Play More Tennessee, “Childhood Obesity”, n.d., tools/data-and-evidence/childhood-obesity.html.

[3] Kelly D. Brownell et al., “The Public Health and Economic Benefits of Taxing Sugar-Sweetened Beverages,” New England Journal of Medicine 361 (October 15, 2009): 1599-1605.

[4] Gladys Block, “Foods contributing to energy intake in the US: data from NHANES III and NHANES 1999–2000,” Journal of Food Composition and Analysis 17 (June 2004): 439-447.

[5] Rodrick D. McKinlay MD, “Childhood Obesity: The Link to Drinks”, n.d.,

[6] Office of the Surgeon General, “Overweight and Obesity: Health Consequences.”

[7] April Wortham, “Tennessee health ranking improves, but obesity looms,” Nashville Business Journal, November 18, 2009,

[8] Rudd Center for Food Policy & Obesity, School Food Opportunities for Improvement, Policy Brief (Yale University, 2009),

[9] Jeffrey P. Koplan and Kelly D. Brownell, “Response of the Food and Beverage Industry to the Obesity Threat,” JAMA: The Journal of the American Medical Association 304, no. 13 (October 6, 2010): 1487 -1488.

[10] State of Tennessee Comptroller of the Treasury, Weighing the Costs of Obesity in Tennessee, March 2006,

[11] State of Tennessee Comptroller of the Treasury, Weighing the Costs of Obesity in Tennessee, March 2006,

[12] Office of the Governor of Tennessee, “Tennessee Among Top 10 in Improving Schools Nutritional Environment,”press release, October 19, 2009,

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  3. Allen Thomas

    I think that vending machines are the best option in every place. If we can discuss schools, then also it's a good option. Vending machines provide healthy and safe food. There is not any other machine available which provides the food facility in a fast and healthier way. There is not any chance to oppose vending machines at school. You can use coffee machines at school so that children can enjoy tea and coffee.

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