particularly sugary beverages on human health. one of the newer set of findings, with tremendous amount of scientific consensus is the impact of heavy fructose consumption of sugar. fructose is one form of sugar but a very common form of sugar. it can have anywhere from 45-90 percent from when laboratories produce it. fructose is metabolized in the liver. that is where the difficulties start. the fact that fructose is metabolized in the liver. as christina gets from the health department alluded to. when it is metabolized in the liver, if it

is in large quantities and in a very quick dose such as the kind of heavy dose you might get from having a sugar sweet and beverage on an empty stomach, the liver is bombarded by a large quantity of fructose and this particular substance within the liver is known to be toxin. it's what we call a hepatic toxin, a substance toxic to the liver like alcohol. this is when we see non-alcoholic liver cirrhosis, non-alcoholic fatty liver disease and what we used to see as belly is now sugar belly. for people who don't have alcohol have a considerable amount of fatty deposits around the weight with the sugary products. so very complex

cascade of events that go on inside the human body. it's not exactly easy to present to the public but there is a very, a growing and important body of evidence that fructose is a toxic substance that harms the liver and causes a very similar set of consequences in the human body and in the liver to alcohol. it makes perfect sense when you think about it because where does alcohol come from? sugar. so the connection that we are seeing between alcohol and sugar is related. i'm speaking from the journal one of the most prestigious journals in the world and one of the most rigorously received journals in our scientific community. i'm not speaking

from -- i'm speaking from a place of high scientific credibility when i report to you this new research. this is largely not well enough publicized and we at ucsf part of the service mission are doing everything we can to get the word out to the general public about what we are learning about the effects of fructose on the liver. >> can i say that alcohol depending on the affects on the liver that we have one from department of public health organizations to talk about the double whammy of sugary and alcohol. he's going to speak about that too. >> the reason that sugary benefits are a special concern is that if you are consuming, say you are consuming fructose which is the sugar that comes

in fruit or take it out of corn and turn it into a very concentrated fructose. if you eat it with an apple, it comes with fiber. when you eat that apple, that fiber slows that fructose in the body and you are not flooding the liver with hepatotoxin. when you take it out of nature and we put it out of products that do not include fiber and when we take those substance and sugary substances on an empty stomach is a real shock to the liver. what we are seeing over time is a rising rate of fatty liver disease that has no relationship to alcohol consumption in the american public to the tune of 33 percent of adults with some level of fatty liver disease that is not related to alcohol

consumption. this is a new thing for the scientific community. we are doing the fastest rising cost for liver transplantation in america and what we see in our own medical center is non-alcoholic liver cirrhosis. this is a public health crisis. unfortunately the science is new and the public isn't aware. one of the things i would be welcomed with your effort is helping the san franciscans learn more about these toxics affects about hour -- how sugar in packets our health. we have data from neuro imaging studies that show the brain how it's affected by concentrated sugar consumption or craving of sugar in very much the same ways that we see in neuro imaging studies of

cocaine and alcohol and other drugs of abuse. this was work pioneered by the director of national institute on drug abuse. it's highly regarded in my field of addictive research as the most cutting edge research. dr. vocal herself, director of nih has been a person who has published some of the premiere medical journeys specifically about the effects of sugar of dopamine response in the limbic region of the brain. i want to also speak about the work that is recently done by the disease control, senior scientist there who are showing that one 112 ounces can of soda a district -- day increases

cardiovascular disease by 1/3. we are seeing epidemiology seeing a high rate of cardiovascular disease. very severe disease. i also want to speak to some of the research that we have that is demonstrating that some ethnic populations maybe not only vulnerable from a social standpoint in that they are disproportionately bombarded by marketing by sugary beverage companies, but in addition there may be genetic vulnerabilities to heart disease and diabetes who have relationship with sugar consumption. these are doubly vulnerable populations and deserve all we can do to

mitigate the impact and these saturated communities and lack of healthy alternatives ideally i would urge you to develop legislation that would compensate those communities for the disproportionate harm that is being done to them by the under health product marketing. to sum up, i wanted to just applaud you for the efforts, this is a very courageous effort and i want to remind you that you are not alone. there are policy makers all over the world, in 14 nation states already that are doing this. and i would love and be thrilled to see san francisco be on the forefront of making a real difference in america and really break through the barriers and doing what you guys really need to do as government officials in your

capacity to protect public health. >> thank you so much, dr. smith. >> any questions? >> i see no questions, thank you. that's all of our presentations. i have a number of speakers from the audience. i'm going to call on them. beatrice duncan. people don't to have come up in this order, the presses of the san francisco board of education rachel norton. >> good afternoon supervisors, my name is beatrice did -- duncan and a senior citizen and advocate for healthy living and wellness. as a member of two communities of color. i find this report timely, important and essential. scientific research data. which i hope will be able to contradict the

current misinformation that has been printed in the written media. as the report indicates, the connection that sugar sweetened beverages has to chronic disease such as obesity and diabetes, seeing this increase amongst adults, children and youth, as a grandmother and great grandmother, i find this quite frightening. it is therefore that the current discussions that are taking place and i am thankful to be part of a stake holders such as shape up san francisco. the medical entities present here, the community activist that have worked so unselfishly on this issue. regardless on the critical subjects taken place by perhaps the other side of the fence. i think that this is very important and i have learned a lot and again as a senior

citizen in the late 60s it's very very rewarding to be able to learn all of this. i pledge to be the messenger that brings this data to my contemporaries. the many grandmothers and great grandmothers who are care takers of our children to be better care takers and aware of sugary beverages. it is essential since the children will be our next generation and we want them to be health and immune to the effects of diabetes and obesity and stop the consumption of sugary sweets and drinks. >> just one more. on behalf of our families in our communities, i thank you to bring this very critical issue to the forefront on a scientific and clear manner in making a difference to our society, to our community and the residents of san francisco.

thank you very much supervisor mar, wiener and those paying attention to this very critical issue that not only affect you, affects your siblings and your children. thank you very much. >> thank you, miss cardenas duncan. next speaker. president norton? >> thank you, supervisors, i want to comment four taking up this issue. i don't think i could be further appalled by this condition and the doctor's presentation really appalled me. this is a crisis in san francisco and across the country. i think it's really important for us to do this. i want you to know that i have introduced a resolution, that will be voted on by the breks e board of education on january

13th, and i'm hoping my colleagues will support it and i'm hoping that i can pledge the district's full support in getting this education campaign and passed by the voters in san francisco. i think that i also want to say that i am very agnostic as far as the proceeds how the proceeds of a revenue measure would be provided and i think they would be directed in various ways to physical education and public activity and so i'm going to leave it to your wisdom to figure out how to divide that up whether it goes to parks or schools. the important thing is to encourage a decrease in consumption of these beverages and bring about a healthy encouragement for our kids. i'm not going to be here when you consider the items but

i hope you support the mission land swap. >> have you heard other data and other attempts in our city. it's an honor to have you in our chambers. >> thank you for the warm welcome. i just want to say personally to supervisors scott wiener and to you eric and also to supervisor avalos and i have not met you supervisor cohen that it's important that you are taking this on. there is a lot of discussion that your currently for doing it, i respect and your foresight and the end of the day it's about our children. a child doesn't decide to get fat. a child responds to what we give in terms of food and drink. those children are losing years of life. and you can make a

difference for those children here and those ripples will go everywhere. i am impressed to have heard the analyst report, roberto reminding us that this is a health inequity and a health disparity and -- who is working with my children and one of my teachers who i have learned from and who you are obviously learning all of this important information. we are part of a movement. you are sphere heading that movement now. san francisco is just the most important place for this to happen. if colleagues that i am working in anyway, that will

be an honor. and you will do a lot to change the health of this city. i think you have a winning strategy with going with the two-thirds, with spelling out where the money is going to be spent so people know before hand and this amazing network that already exist of people who are understanding this issue and being able to address it. so. i am with you 100 percent. thank you for the very very kind words that you said about me. they are all a little bit over exaggeration but appreciated anyway and let's go forward together. thank you. >> next speaker sharon roads from uc sf hip oral health and dental issues. doctors amanda

and lena from ucsf. >> thank you for letting me speak on the issues of oral health and those i work with on the san francisco partnership know is extremely relevant to this issue. when we think of soda we automatically think of tooth decay. it's the most common in children. more than 65 of 6-19-year-olds have had a cavity in their teeth. it's one of the most prevalent problems in the world. it can be traumatic to a child, costly to the city. data on that is that in the country, more than 51 million school hours are lost because of dental disease. and 164 million work hours are lost to people due dental disease. so there is an economic and educational impact due to oral

health. the frus trating thing about these statistics is that it's preventable. but sugary benefits make it more difficult. there is a lot of bacteria in the sugar and turns to acid and causes decay. it is object 52 us that soda consumption is leading to this serious problem. we can do a lot to carries or cavities rates down. if we can educate parents, if we can apply ceilings and varnish can help and we know that taxes are extremely effective. they all work together. if supervisors can identify funding streams from the tax then we can add

more fluoride varnishing. is that bell for me? >> if you can wrap up. >> sugary consumption is detrimental to all ages. i have this map of areas of oral health decay. >> we have brian from the neighborhood tndc and today davis from parent pack and other groups and a few others that i have mentioned we are going to close public comment in a moment. >> thank you, my name is margaret fisher with the department of public health. i came this morning in my scrubs

because i came directly from a screening of our preschoolers in our state subjectssidized preschools. many children have experienced decay. some low income families are especially susceptible. so 39 percent of our state is subsidized children of preschool already have decay. soda consumption nearly doubles the risk and increases likelihood in adults. the cost of sugar based drinks, the cost of sugar and dental decay is a cost. the cost for 3-year-old is about $10,000. by

seeing children earlier preventative dental services saves money. safety net dental clinics like the dph dental services provide critical preventative treatment. unfortunately access to a preventative dental treatment continue to be a major obstacle to having healthy teeth. i include nutritional guidance. clinics are under staffed and dental appointments will become harder. in 2007, we had 1263 emergency room visits due to dental problems. you know the cost of emergency room visits. nine of these visits were from children less than 1 year of age. one more thing. treating

dental problems cost $6500 per visit. additional preventative visits cost much less for an exam. we encourage you to decrease the availability of sugary drinks and increase the ability to provide benefit educational information. >> thank you. i should say we also have brittany from the american heart association. if there is anyone else that would like to speak, please come forward. >> my name is ryan ther. i want to applaud you all as other folks have said to try to take this on. i think we have a big fight ahead of us with the soda companies that poisoning our communities and running smear campaigns and i think this is really winnable. we are not

trying to fight against the soda companies but providing benefits and services that's on the ground. i found it roo really interesting that the map that was looking at the soda expenditures pretty much over lays the food and security maps which correlates with the folks who are living with poverty here in the city and serving those communities what it brings around health and food access and preventative care around health and food and nutrition is really a lot. even reading a label is something and people are not aware of serving size and the amount of servings when they are drinking 2-liter bottles which is really important to be aware of that. if we can use some of these funds how we can create these

programs on job training models to provide job economic opportunities to these people. i think there is a big potential around looking at food access and nutrition preventative care as a model for providing economic opportunities to folks living in these communities that are facing the most impacts. thank you. >> thank you, mr. ther, mr. living stop >> good afternoon supervisors, my name is bruce living ston. we help people who are affected by alcohol consumption especially youth. we support

this effort. several years ago supervisor avalos led a fight for harm for an alcohol mitigation fee of 3-$0.05 for $18 million for by city services in emergency room treatment and jail house detox and other treatment services. the fee was vetoed by mayor news om. the sugary tax is a charge for harm. it's a charge to the residenting -- residents and harm done to the residents and the city of san francisco just like tobacco tax can pay for services and tobacco fee. it's time to charge for the harm for our

residents from sugary benefits. >> you have 30 seconds. >> you've got my testimony. i want to say flavored drinks are loaded with carbohydrates. there is 280 calories in this. 44 grams of carbohydrates in bud light and there is tons of calories that kids consume. we would like to put in initiatives for revenues for education among youth. you can't tax this directly but you can do this with sugar tax that impacts our youth directly.

thank you. thank you. my name is todd davis. i want to thank supervisor march for joining us in our committee meeting and san francisco action committee has fully endorsed the sugary benefit tax and confident that we'll have 1 piece of legislation moving forward. a couple of things i want to talk about that are some of the talk on the street that is out there with the november 2014 ballot that the sugar beverage tax can hurt the education fund or the children's fund. i provided supervisor march with research that was done boo i the u.s. mccarthy school and the polling that was done and the pipeline

support was 86 percent and the top line for children's support was 85 percent. it was plus one what was needed to pass. anyone making claims that the sugary beverage tax could pull down the reauthorization is stretching. in 2014 presents an opportunity for san francisco to prove that we are a city that cares about it's children. if we pass the reauthorization, the children's fund and pass the sugary beverage tax we have the opportunity to provide every school child with actual physical education and physical education teachers. this is an historic opportunity that we should not miss out on. thank you very much. >> thank you, mr. david. is there anyone else from the public that would like to speak? please come forward.

the doctors from ucsf. >> good afternoon, thank you for the opportunity for hearing us. we are doctors at the hospital and pediatrician at uc sf. everyday in our clinic we countier -- encounter children that are over weight. this is not a cosmetic issue. it is a serious and lifelong problem with psychological consequences ranging from heart disease to diabetes and bullying and self-esteem issues. obese children will most likely become obese adults. >> recent data tells us that two -thirds of our children are

consuming sugar beverages many it's higher in adolescence than any other age group. more 20 percent of adolescence are consuming over 500 calories per day. our most vulnerable children which is our racial minority and less educated and poorer families are likely to increase their risk. >> sugary beverages, a child's risk in obesity rises nearly 60 percent. when kids decrease the number of sugar sweet and bevenlgs that they drink, they lose weight and their over all health improves. sugary drinks increase