f e a t u r e s a n d n e w s

No -coating the crusade against

hen Barry Popkin, PhD, advocates for a “The Beverage Guidance Panel that Barry national tax on sugar-sweetened beverages, convened produced a first of its kind—a W guide for the kinds of beverages that have the soft- makers and food-industry groups attack. best value for your health,” says George Bray, MD, Boyd Professor and chief of the division “Everybody comes after me,” he says. of clinical obesity and at the Pennington Biomedical Research Center in But Popkin, an internationally recognized He says sugar-sweetened beverages are to Baton Rouge, La., and a member of the panel. expert in nutrition and obesity, is unfazed. blame for much of the weight gain. “You are Now, Popkin works with governments Savvy, passionate and eager to speak out, what you drink,” he says. In 1960, the aver- around the world to establish beverage guide- he says, “I want to have an impact.” age American consumed 100 to 200 calories line policies. The Carla Smith Chamblee Distinguished a day in beverages. Today, the figure is 500 “France and the U.K. have banned caloric Professor of Global Nutrition in the Uni- calories. beverages in schools,” he says. “Mexico has versity of North Carolina’s Gillings School In 2005, Popkin assembled leading nutri- created beverage guidelines, and now I am of Global Public Health and director of tion experts from Johns Hopkins, Harvard, working with the U.K. and China on this topic.” the UNC interdisciplinary obesity program Louisiana State and Oregon State universi- In the U.S., he advocates a tax on sugar- makes an impact often. ties, and other institutions, to study available sweetened beverages to discourage people You may have seen his comments in The literature and provide guidance on risks and from drinking them, he says. He and six New York Times or Time magazine or heard benefits of various beverage categories. Their other scholars wrote a 2009 report in The him on National Public Radio or Al Jazeera. results were published in The American Jour- New England Journal of Medicine that advo- He’s such a seasoned media source that he nal of Clinical Nutrition in 2006. cated a consumer tax of one percent per might show up for a satellite inter- view at the UNC television stu- dios in a shirt and tie—and shorts Percentage of daily caloric intake from beverage, by age group and sandals. He knows he’ll be visible only from the waist up. % 25 Now 66, Popkin was among Other milk beverages the first researchers to start track- 20 Coffee and tea ing the effects of diet and activ- Alcohol ity. His data are based on four 15 Fruit decades of observation of indi- Milk viduals, households and com- 10 munities, from Russia to Mexico Fruit and China to Brazil. The worst 5 problems used to be hunger and Soft drinks malnourishment. Now, obesity is epidemic in both developed and 0 Age 2-18 19-39 40-59 60+ All Ages developing countries.

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ounce on sugar-sweetened beverages both to reduce consumption and bring in money Popkin says sugar-sweetened beverages are to support health programs, as tobacco taxes have done. His latest study, published March to blame for much of the weight gain. 9, 2010, in Archives of Internal Medicine, shows that people eat less , such as “You are what you drink.” pizza and burgers, when the prices go up, supporting his proposal to tax these foods ists in the first nine months of 2009 to fight a Medicine, Journal of the American Medical in addition to sugar-sweetened beverages. potential national tax and other regulations, Association, Science, Obesity, Circulation and Not surprisingly, soft-drink makers, according to The Huffington Post. the American Journal of Clinical Nutrition. supermarket companies, the fast-food indus- Popkin’s recent book, The World is : His research covers the whole spectrum of try and other groups poured more than $24 The Fads, Trends, Policies and Products that life —for example, he’s published articles million into the coffers of Washington lobby- are Fattening the Human Race, draws on what in both Pediatrics and the Journal of Nutri- he’s learned throughout his tion of the Elderly. His work has appeared

n career. He makes a strong in renowned peer-reviewed publications in case that lifestyle changes, Europe, China, the Philippines and the Asia- tlema s including eating more sug- Pacific region. ary and fatty foods, as well His most innovative work, say colleagues, da k a in l as government policies and has been developing the concept of “Nutri- globalized , tion Transition,” a way of understanding are fueling the weight gain. long-term nutritional status changes by look- “How we eat, drink and ing at shifts in the stages of eating, drinking move has changed so drasti- and activity, underlying societal shifts and cally in the last 60 years,” he resulting effects on body composition. says. “Our biology clashes He also has pioneered large longitudinal with modern marketing and studies around the world, including ones in technology.” China, Russia and the Philippines. He’s led His research exam- related studies in Brazil, Mexico and other ines health implications of countries, studying some populations for those policies and lifestyle four decades. “When I came into the field, changes, and his findings such studies were not a focus,” he says. have been published in more His work has played a major role in estab- than 300 articles in peer- lishing databases for scholars to study diet reviewed journals, including and activity. More than 10,000 researchers The New England Journal of have downloaded his longitudinal studies. 8

Dr. Barry Popkin takes personally his professional campaign for good health, regularly biking to campus for exercise. (Note: Popkin removed his helmet to pose for the photo, but he never bikes without it.)

c a r o l in a p u b l i c h e a l t h | 7 f e a t u r e s a n d n e w s

“Barry has made many important con- tributions to nutrition research,” says Penny Gordon-Larsen, PhD, UNC associate profes- sor of nutrition, who has published several articles with Popkin. “He is probably most well known for his work on the nutrition transi- tion and global obesity. Yet he also has made major contributions in investigations on the role of dietary fat in obesity, sugar-sweetened FLUID OUNCES beverages and obesity, health disparities, and Total = 104 economic determinants of diet and obesity.” Popkin —tall, wiry and agile —attacks obesity many different ways. On a personal level, he rides his bike to work and around SWEETENED BEVERAGES town. He is part of an international board [20 oz.]

of scientists helping to develop simple front- SWEETENED n of-the-package labels in European countries, BEVERAGES WITH

NUTRIENTS [15 oz.] SWEETENED tlema Israel and India. He’s working with the BEVERAGES WITH s NO CALORIES [5 oz.]

Mexican Ministry of Health and Finance to TEA/COFFEE da k a

LOW FAT in develop a similar program in that country. UNSWEETENED [15 oz.] MILK [3 oz.] l He also has waded into the U.S. Food and Dr. Barry Popkin is a frequent guest at Carolina News Studio, giving interviews that are Drug Administration’s review of nutrition broadcast around the world. labeling guidelines. In the Feb. 8 issue of The WATER [46 oz.] New York Times, he wrote: “Placing compli- “We also need to remove all false advertis- No wonder he’s a target. cated labeling on the back of the package simply ing that says ‘contains antioxidants’ and tries However, he also tries to reach out to the does not work. Studies from the Netherlands, to connote that a product is ‘heart healthy’ food and beverage industry, encouraging the U.S. and elsewhere have found that system when there is no reality to that claim,” he them to be part of the solution to obesity. In to be confusing and that it does little to affect writes. “We need ways to stop food manufac- 2007, he started an annual “Global Obesity consumer decisions. Front-of-the-package turers from making misleading claims, and Business Forum” with senior executives labeling, which has emerged in the past three we need scientists independent of the food from food, beverage and infant formula to four years, promises to be more effective.” industry to set healthy guidelines for various companies. The meetings are private, Popkin But he doesn’t stop there. food categories.” says, so the executives can be frank and open about their concerns and processes. FLUID OUNCES CALORIES As a college student in the 1960s, Popkin Total = 104 Total = 464 was active in the civil rights movement nation- ally and in his home state of Wisconsin. Those experiences, he said, taught him to take the slings and arrows of criticism in stride. “There

SWEETENED were people who loved you, and people who BEVERAGES hated you,” Popkin says. “That’s the way it is [20 oz.] when you’re fighting for a cause.” n SWEETENED SWEETENED BEVERAGES WITH BEVERAGES –Susan Shackelford NUTRIENTS [15 oz.] SWEETENED [211 calories] BEVERAGES WITH NO CALORIES [5 oz.] Americans drink too much and drink unhealthily. TEA/COFFEE LOW FAT UNSWEETENED [15 oz.] MILK [3 oz.] These figures show the beverage intake pattern of adults in the U.S., in volume and calories. SWEETENED Drinking 35 oz. of sweetened beverages in a BEVERAGES WITH day (out of a total 104 oz.) accounts for about WATER SOME NUTRIENTS [46 oz.] SWEETENED [213 calories] half of the calories consumed from beverages. BEVERAGES WITH NO CALORIES [1 cal.] Popkin’s Beverage Panel suggests the average adult might best consume 98 oz. in beverage TEA/COFFEE LOW FAT MILK [29 calories] each day, including up to 50 oz. of water and no UNSWEETENED [11 cal.] without nutrients. WATER [0 calories]

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CALORIES Total = 464

SWEETENED BEVERAGES [211 calories]

SWEETENED BEVERAGES WITH SOME NUTRIENTS SWEETENED [213 calories] BEVERAGES WITH NO CALORIES [1 cal.]

TEA/COFFEE LOW FAT MILK [29 calories] UNSWEETENED [11 cal.]

WATER [0 calories]