Have a Coke and a Mile (or Five)

Intent

My original intent for this post was to share a study wherein researchers labeled caloric values on sugar sweetened beverages in terms of physical activity expenditure requirements as opposed to actual kcals per serving. Not only was I fascinated by this concept, I thought it was a great idea. So good, in fact, that I shared my findings with a friend and, in turn, she offered another enlightening perspective that I'll share toward the end of the post.

Research

First published in February of 2012, the study, “Reduction in Purchases of Sugar-Sweetened Beverages Among Low-Income Black Adolescents After Exposure to Caloric Information” hypothesized that researchers could reduce purchases of sugar-sweetened beverages (SSB) among adolescents by providing easy-to-understand caloric information. Researchers claim that providing relative caloric information, such as converting calories into a physical activity equivalent, would not only impact the sales of SSBs to adolescents, but also reduce consumption of SSBs, which have been associated with adolescent obesity. They further claim that translating caloric values into “interpretable equivalents” (Bleich et al. 329) made information more accessible to low literacy and low nutritional-literacy populations.

The intervention provided caloric information of SSBs in four corner stores in West Baltimore, Maryland. Some inclusion criteria were that the stores had to be five or fewer blocks from a middle or high school (i.e. within walking distance), the population within the zip code was at least 70% Black, and each store had to sell water and diet soda in their respectable beverage cases. Researchers identified the following three “caloric conditions”: 1-providing an absolute caloric count; 2- a percentage of total recommended daily intake (i.e. percentage daily value); and 3-providing a physical activity equivalent, represented as the number of minutes jogging (Bleich et al. 330). Baseline data was collected at each corner store four weeks prior to the intervention and at two-week periods between each caloric condition (as they were rotated within the six-month study period). Researchers conclude that providing easy-to-understand caloric information, especially when translated into physical activity equivalents, may reduce caloric intake from SSBs among low-income, Black adolescents.

Lead researcher Sara N. Bleich of the Johns Hopkins Bloomberg School of Public Health, conducted a follow-up study wherein she and fellow researchers examined whether the effects (i.e. low-income, Black adolescents purchasing fewer SSBs, based on translating caloric information into relative term) were persistent.

Opinion

When I shared the findings of this study with my friend – an RN and very opinionated about health issues, particularly as they relate to SES – she had a myriad of responses but the one that struck me the most was this: If a kid [who doesn’t have a lot of money] walks into a convenience store, picks up a bottle of Coke and notices it will take 60 minutes to “work off” that beverage, then the same kid looks at a bottle of water, notices the PA expenditure compared to the Coke, what keeps the kid from choosing the bottle of Coke?  If the kid has two bucks and is getting ready to shoot hoops with his friends, he might think he’s getting “more for his money” similar to putting fuel in a car. Why would I drink water when I know I’m going to be playing ball for the next hour?

Admittedly, it took me a minute to wrap my brain around what my friend was saying as I had to really shift my way of thinking, not just in terms of nutrition but in terms of economics. Then, of course, it made perfect sense. Why wouldn’t an adolescent want more for their money? What has more impact: money or health? My knee-jerk response would be, given the fact the target demographic is both young, thereby seeking instant gratification, and lower SES, the answer is money.

 

Bleich SN, Herring BJ, Flagg DD, Gary-webb TL. Reduction in purchases of sugar-sweetened beverages among low-income Black adolescents after exposure to caloric information. Am J Public Health. 2012;102(2):329-35.