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New York City and San Francisco Considering Warnings for Sodium, Sugar-Sweetened Drinks


In New York City, the health department proposed menu warnings – in the shape of a salt-shaker symbol – for all high-sodium foods sold at chain restaurants. In San Francisco, city lawmakers passed a law requiring warning labels on all advertisements for soda and other sugary drinks.

Why the emphasis on warning labels? Because they work, experts say.

Just look at how warning labels on tobacco products caused their sales to drop over the years, said Dr. John Maa, MD, a general surgeon at Marin General Hospital, chair of the University of California Office of the President Tobacco Related Disease Research Program and member of the board of the American Heart Association in in San Francisco.

“You have to look at the larger picture of a multipronged effort that’s led to the dramatic reduction in the prevalence of smoking in the United States, and clearly, the warning labels have played a key role,” he said.

“There are many purposes for the warning label, both to deter the individual who’s about to purchase the product, and to enhance education. The downside is that people may become desensitized to it after time,” said Maa. “But borrowing from the valuable lessons in tobacco control efforts, warning labels have proven to be very robust and effective.”

In San Francisco, the Board of Supervisors unanimously voted on Tuesday to approve legislation to require health warnings on ads for all beverages with more than 25 calories from sweeteners per 12 ounces.

The measure, which still must go through a second vote before it lands on the mayor’s desk for signature, would require all billboards and other ads for sugary beverages to read: “WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay. This is a message from the City and County of San Francisco.”

San Francisco Supervisor Scott Wiener agreed with Maa that warnings labels are often considered initial steps in a broader effort toward changing consumer behavior.

“By taking this important first step, we hope that other cities and towns and states and ultimately, the federal government, will follow suit,” he said.

Health warnings also serve as reminders about dangers consumers may not be aware of.

“The health warnings work when you see these soda ads that make it look like drinking soda and other sugary drinks is all about rainbows and puppies and happiness,” he said. “We’re just reminding people, ‘Hey, this increases your risk of diabetes, obesity and other health problems.’ It’s a dose of reality. Anything we can do to help people make the connection is a positive step forward.”

The next steps Wiener would like to see are health warnings on actual products and a sales tax on the beverages, he said.

In New York, the city’s health department on Wednesday proposed requiring chain restaurants to put warnings on menu items containing 2,300 milligrams of salt, or roughly equivalent to one teaspoon of salt.

The warnings, which would look like a salt-shaker inside a triangle, are intended to make it easier for consumers to make knowledgeable food choices when going out.

The move formally opened a public comment period on the proposal. A public hearing has been scheduled for July 29, and the New York Board of Health could vote on the measure as early as this fall.

Americans currently consume more than 3,400 milligrams of sodium daily, more than double the amount recommended by the AHA for ideal cardiovascular health.

Health studies show that about 77 percent of the sodium Americans consume comes from packaged and restaurant foods. Increased sodium intake leads to elevated blood pressure, which is a leading risk factor for strokes and heart disease.