Opinion: Big soda

POSTED: 06/8/14 11:52 PM

We know Big Tobacco, Big Pharma and Big Mac, but there is a fourth player in the market of bad stuff: Big Soda.

Two years ago Michael Bloomberg, then the mayor of New York, started the fight against Big Soda. He wanted to ban the sale of half-liter cups of sodas that are rich in sugars in fast-food restaurants, cinemas and stadium. The measure died just before it would have gone into effect in March of last year, when a court ruled against what it called an arbitrary and fickle measure. This was because certain sodas that are rich in calories were not included in Bloomberg’s law and because the ban did not apply to for instance supermarkets.

While one could debate the potential effect of the measure – and big soda did of course – Bloomberg’s successor Bill de Blasio has promised to continue the fight. This week his attorneys took action by presenting the case to the state of New York’s Supreme Court. The court will issue a ruling between one and three months from now.

With this action, New York has put obesity and diabetes – two of the downsides of drinking lots of sodas – again on the agenda.

The question we have is whether New York is not approaching this issue from the wrong end. There are two parties involved: the producers of soda and consumers. As things stand now, Big Soda is collecting a handsome income from consumers who slurp too much of their products.

And not consumers, but the society as a whole is the real victim. Obesity and diabetes lead to higher healthcare costs and loss of productivity – nobody will argue that point. We just read that the Netherlands – a speck on the face of the earth by any measure – performed last year more than 10,000 gastric bypass operations – a procedure to diminish the size of bulging stomachs.

Let’s stick with the number of 10,000 to assess how serious the situation really is. Remember, in St. Maarten we do not have the data, but Big Soda is everywhere and a casual observation of the foot traffic in town will show that obesity is among us as well.

The Antonius Hospital in Amsterdam published clear information about gastric bypass operations. Not everybody qualifies for it. The main requirement is simple: patients must have a body mass index (BMI) that is higher than 40.

Determining one’s BMI requires two numbers: weight in kilos and body length in meters. The BMI is kilos divided by the square of body length (for someone measuring 1.90 meters, the square is 1.9 x 1.9 = 3.61. The BMI of someone of that length weighing 80 kilos is then 80:3.61=22.16 – a healthy weight. Reversely, someone who stands 1.90 meter tall would have to weigh at least (3.61 x 40) 144.4 kilos – the entry level into the extreme obesity category.

The Antonius Hospital notes that a BMI between 35 and 40 in combination with physical complaints like cardiovascular diseases, high blood pressure, joint complaints or diabetes could also be reason for an operation. However, there is a condition – one we appreciate. These patients must show that they have made several serious efforts to bring their weight down. They must also have been psychologically stable for at least two years.

This shows that not just anybody qualifies for these operations that one could easily perceive as a shortcut to get rid of the results of bad behavior at the expense of insurance companies. Patients run by the way a 1-percent risk to die of complications after the operation.

Overweight and obesity could cause osteoarthritis, diabetes, coronaries, high blood pressure, apnea (breathing interruptions during sleep), gallstones, lung diseases and infertility. To cut a long story short: overweight seriously endangers longevity.

As we know from the Dutch data, there were at least 10,000 people in the Netherlands last year that qualified for a gastric bypass operation. On a population of 17 million that does not seem to be an awful lot – 0.06 percent. Projected on St. Maarten’s estimated population of 45,000 it would put the number of local super heavyweights around 27.

Something tells us –call it a gut feeling – that our numbers are more dramatic. That is because there are gradations of obesity. Adults older than 20 with a normal weight have a BMI between 18.5 and 24.9. From 25 to 29.9 they are considered overweight, above 30 they are considered obese and above 40 they are considered extremely obese.

The numbers? Research shows that 35.7 percent of the adult world population is obese and that 6.3 percent is extremely obese. Census data from 2009 put St. Maarten’s population at just under 41,000. Of these, 70.2 percent were 20 years or older. Assuming that our current population stands at 45,000, the number of adults aged 20 or older would be around 31,600.

Is 35.7 percent of these adults obese? That would be almost 11.300 citizens, while another 6.3 percent (1,990) would be extremely obese. These are frightening figures and even if they are not entirely accurate, they are reason enough for a big campaign accompanied by realistic measures, to bring this situation under control.

Let’s go back to that adult measuring 1.90 meters. The parameters for a normal weight are between 66.8 and 89.9 kilos. The perimeters for being overweight are from 90.25 to 107.9 kilos. From thereon, until 144.4 kilos, this adult would be considered obese, and above that limit, extremely obese.

Now that it is easy to do the math at home, what could people who are teetering on the brink of a dangerous weight category do to move back into safer and healthier territory? The first course of action should be: exercise, but within the limits of personal capabilities. Exercise could be jogging, running, power walking or simply walking. Anything is better than doing nothing – but don’t overdo it.

Where does Big Soda come in? Well, the best solution is of course to stay away from the stuff. There are plenty of healthy and tasty alternatives to still one’s thirst – from store-bought to home made.

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