Can – and Should – Healthy Behavior Be Legislated?

The Governor of New York, David Paterson, has suggested a tax on sugary soft drinks, posting calorie counts in chain restaurants, banning trans fats in restaurants and junk foods in schools. These measures are aimed at preventing obesity and heart disease. The sugar tax would also raise revenues for New York State.

On the surface these seem like good ideas. But what would actually be accomplished?

Money in the empty coffers of New York? This is probably good. Giving people information so that they can make informed choices about the foods they eat? Also good. Banning trans fats in restaurants and junk food in schools? Maybe.

But, as pointed out in today’s New York Times News Analysis by Anemona Hartocollis, changing behaviors is not so easy.

For example:

The tax on sugary soft drinks – Such a tax MAY result in people consuming less sugary drinks. However, the need is to lower overall calorie and simple carbohydrate consumption. Sugar is only a part of this. If you use that diet drink to wash down a brownie, you have saved, perhaps, 150 calories. Better to have the sugary drink and skip the brownie, which has fat as well as sugar and other simple carbohydrates. But isn’t that 150 calorie saving better than nothing? Yes, it is. However, in the long run, you have gained nothing. You haven’t taken even one step towards curbing your desire for sweet foods nor have you made a dent in changing your eating habits. You would do far better to drink only half the sugary drink, eat only half the brownie and walk an extra block on the way home.

Calorie information posted in chain restaurants – This MAY work to help people make informed choices. But, I would guess, that most people in a rush won’t even be aware that calorie information is posted and won’t read it unless the waiting line is long. It might be better to write this information on the box AND suggest a lower calorie substitute that is available AT A LOWER PRICE. Education, behavioral change (perhaps only short-term) and cost savings for the consumer. I’ll leave corporate America out of this (at least for this blog).

Banning junk foods in schools – Banning from what? School-prepared breakfasts and lunches? Vending machines? Lunch boxes? Classroom parties? School sponsored events designed to help support school activities? Apart from inviting Big Brother into Mom’s kitchen, you have NOT changed behavior. It is overall consumption, not the occasional consumption of unhealthy foods, which will do you in. The answer is to limit, educate and offer choices, not ban. Except for those vending machines! Surely schools can find another source of income.

Banning trans fats in restaurants – I have to say it again. This does not change behavior, except possibly the behavior of dining out. Personally, I feel offended when I am treated like a child. If I eat food that is bad for me, I will probably undermine my health. But make me eat food that is good for me? Banning trans fats is not like banning smoking in restaurants. Secondary smoke affects everyone around the smoker, not just the smoker. And, another thing that I have to say again, it is overall consumption, not the occasional consumption, of unhealthy foods, that will do you in.

So, can healthy behavior be legislated? Not very likely. Should healthy behavior be legislated? Only when the unhealthy behavior affects others (philosophical and healthcare costs aside).

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Mary Lou Bernardo, PhD, MSN

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