An Open E-Mail Letter to Sarah Kliff at Vox

  • Posted on: Nov 7 2014

By Jeff Ritterman, M.D.

Dear Sarah Kliff,

I found this Vox article “Berkeley Has Brand New Soda Tax That Won’t Reduce Obesity” to be both scientifically inaccurate and terribly offensive.

Three days after Berkeley’s historic victory over Big Soda, you publish an article suggesting that all of our efforts are really for naught.  And you base this on an exhaustive review of the scientific literature complete with a penetrating analysis into the data…no, not at all.  You base it on handpicking studies and making conclusions that are not supported by the data and pretending this is a science based article, when in fact it is pretty much Big Soda propaganda, even if you didn’t intend it to be that.

You fail to mention the most important data to date, which is what has happened in Mexico since the initiation of the soda tax.  Preliminary data show a 10% decrease in consumption and most of that was replaced by increases in water and diet drinks.  No place before Mexico has combined a public health campaign with a soda tax.  It seems to be working in Mexico.  Berkeley also has advantages over Mexico in that the SF Bay Area has safe drinking water for all.  Of course, it’s much too early for the Mexican Soda Tax to result in a decrease in obesity since the tax went into effect in January of 2014.

But a focus on obesity alone, misses the point entirely.  You may not be aware of it, but the medical paradigm about sugar consumption has shifted totally.  We now know that liquid sugar can cause heart attacks, strokes, high blood pressure and type 2-diabetes and that this can happen even in those who maintain a normal weight.  So a focus on obesity alone is misplaced. 

The decrease consumption, which is expected from the Soda Tax will translate into fewer cases of diabetes, heart attacks and strokes.  For the science behind this see the amazing work of Dr. Kristin Bibbins-Domingo at San Francisco General Hospital’s Center for Vulnerable Populations.  The possibility of reducing the cases of diabetes, heart attacks and strokes in Berkeley as a result of the soda tax is something you should be writing about.

What we know is that liquid sugar, in the doses we consume it, even a can of soda a day, increases our risks for heart attacks and type two-diabetes by about 25%.  We know that taxes help decrease consumption and that the spending habits of teenagers, a group of great concern, are particularly influenced by changes in price.  We also know that to be truly effective these taxes need to be part of a comprehensive public health campaign to limit sugar intake with an emphasis on limiting liquid sugar.

I would ask that next time you pan our efforts, you at least do us the courtesy of backing up your claims with sound science. 

I would also ask that nay-sayers like you realize that you are part of the problem and not part of the solution.  If you can’t lend a hand, do us the courtesy of at least getting out of the way.

Jeff Ritterman, M.D.
Vice President Bay Area Chapter of Physicians for Social Responsibility

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