Addressing supersized sugary drink portion sizes: New York city's (NYC) portion cap rule

INTRODUCTION Sugary drinks have consistently been linked to weight gain, obesity and type 2 diabetes. In NYC, 30% of adults and 44% of children consume one or more sugary drinks daily. Portion sizes have steadily increased – the original Coca-Cola bottle was 6.5 ounces, which is significantly smaller than the vast majority of sizes available for sale today. Numerous studies demonstrate larger portions lead to increased caloric intake. APPROACH To address excessive sugary drink consumption, the NYC Department of Health introduced an amendment to the City's Health Code requiring food service establishments to limit portion sizes of these beverages to 16 ounces or less. This rule defined sugary drinks as non-alcoholic beverages with > 25 calories/8 ounces, sweetened by the manufacturer/establishment, that contain no more than 50% milk. Following the amendment's introduction, there was a 6 week public comment period. RESULTS Over 38,000 comments were received – 32,000 in support and 55 individuals testified at the public hearing. Supportive comments focused on obesity's health consequences and the positive health impact of the rule. Opposition to the rule questioned its health impact, feasibility and effect on consumer choice. The Board of Health approved the amendment in September 2012 by a vote of 8-0-1; it is scheduled to go into effect March 12, 2013, with a 3 month grace period from fines. DISCUSSION NYC's experience highlights the challenges local governments face when taking action to reduce sugary drink consumption. These include mobilizing stakeholders, addressing opposing arguments, and battling a well-funded, litigious industry.