well-thought-out proposal. i want to say, you know, we'll be the first in the country to pass this kind of tax. no where in the u.s. has the tax been designed to reduce the sugary beverages the company comes in and has unlimited resources and spends and spends and pendz it's not passed anywhere else we won't be the first, because last year mexico passed a sugary beverage act bus they know it works and it's important, important the health of the people. we also know in addition to having the science and facts on our side we very an incredible community it speaks volumes and

the sugary industry doesn't think this will be effective if this would not be effective why would the california nursed association and our local society and the hospital of northern california and the dental society and the dental hi gifts and over and over those are the people responsible for the health of our community and their outline enthusiastically supporting this. this is a growing coalition in thirty in community and san francisco has been at the cutting-edge to improving the health of our city and colleagues, i look forward to the continuing discussion around this important topic today. >> thank you supervisor wiener. supervisor cowen >> thank you very much.

good afternoon, everyone thank you for joining us in the people's chamber in city hall this is the beginning of a very thoughtful yearlong conversation that's absolutely critical we need to have. this is not only critical for the health and vitality of the city and county of san francisco but specifically those who are living in the african-american community and the latino community and other that are effected by no access to healthy food actions to access to food. but the communities that are disproportionately effected by the high rates of type two diabetes and you've heard the list of disparities that plaque our community. this is a landmark legislation

not only can we hispanic the quality of health that we have here in our city but also have an impact across the entire country. today, i hope we'll hear the facts and have a thought of dialog on what this measure is and not specifically focused around the tax issue. thank you, mr. chair for allowing me to speak >> thank you supervisor cowen. supervisor avalos >> thank you. i have very little to add i'm a co-sponsor of the legislation. but i guess what i want to say this whole issue of affordability and a lot of folks are wearing t-shirts here. it would be great if they want to do something about our

eviction crisis and the dismr. president in the city rather than trying to defeat - (clapping) and what's really unaffordable with the health care costs with the people that have diabetes and other diseases that come from sweelgd beverages >> thank you supervisor mar. supervisor avalos we'll turn that over >> excuse me. may a make a special announcement we currently have 6 supervisors in the chamber we are now veend in the chamber and it is okay with 6. >> yes. the agenda says 6 members might attend this meeting 32 thank you chair we have a

number of speakers and public comment we have a very thick list of cards and if there's anyone else who wants to speak after the rep from the beverage departments i'll read everyone's names we have christen from the public health department and the director of food systems from the department of public health paula jones and we have dr. len in a in the unified school district food and fitness committee. and we have bob one of our superintendents in our rec and park department so let me introduce christen and also paula jones i'm not sure if she's here >> good afternoon supervisors. i believe my presentation is

loaded here it might not be so - my name is christen i'm the senior health planner in the department of public health. and i'm here today to talk to you about the impacts of sugary drinks. excuse me. while i get this up sorry about that. here it is. >> so we're waiting for the imagination there it is. >> so we've been working on the issue of sugary drinks since 2008 it's a public health issue.

i'm going to start with diabetes it's been mentioned several times in 2003 did centers for disease control and prevention reported that diabetes will afflict 1 in 3 people born in 2000, however, they noted for african-american and latino children the risk was one in 2. for 50 percent are we are expect to be afflicted with diabetes. when you take a look at our city and the per capita income you'll see a series of slides as noted earlier the diabetes and other related chronic diseases most impact our poor population. here you see those two red boxes highlighting some of the lower parts of san francisco when you

look at the soda expenditures they're happening as well in our lower income population. when you take a look at at the health survey most of the surey consumption is happening in the same area it doesn't match exactly but you're seeing trend and we're learning is that - >> mr. chair. >> i was wondering if we could have copies of the slides i can't see it on my screen. >> absolutely i did not bring copies with me. >> can you give those to the committee offices. >> or just e-mail. >> e-mail.

>> what we see here is lower income populations are drinking surey drinks as a rule we see that when you get to diabetes again looking hospitalstion you see the same pattern there's a could reckless between sugary brings and diabetes. there's a lot of new data on sugary drinks we're also learning that it affects different populations differently and the doctor has presented data on asian population for example, they might have the same body index as the caucasian but they're likely to get diabetes as a lower mp i that's new

information so this impacts every population and it might impact them different but the lower asian body weights are impacted more. diabetes is a very expensive disease to treat. hospitalized costs are very, very expensive on average. they cost you know the costs about 29 percent more to care for a diabetes patient. so that's a bottom line not to mention the fact that diabetes is a very chronic condition to manage. there's a significant human impact but there's significant costs associated. our budget and elective analysis did a report and the costs

attributable for sugary drinks at a low end of $48 million and at a high-end $60 million plus. they look at those city and county of san francisco with a low estimate of $10 million arranging to a high he estimate of $28 million per year. those are significant costs and the budget and elective analyst indicated those are relating conservative numbers we see the correlation in the data as sugary drinks have increased accident over weight prevalence among our children as increased. you're looking at a chart in the

60s into the 90. the ethnic graders that are con summers that are drinking at least one soda a day are likely to be over weight and you see a higher prevalence among latino and african-american students. why do we care about sugary drinks vs. candy bars or a piece of cake and the science behind this has really evolved and getting clear. sugar subpoena presses our body to burn fat and attests toxic by your liver that processes that first and it will process the sugar and get to the other food you may have eaten with the drink if you have not gotten to the bag he will when it comes to

our next sugary drink it starts on this and it turns into fat in our body. when you consume added sugars our liver turns the sugars into fatso what's happening is your bodies turning the sugars into fat. in our fat cells we carry a hormone a natural we've had enough to eat. you can develop this rinsing resistance if you're body is continual flooded you'll disregard that your brain starts to disregard it you eat all the time and what happens you gain weight.

too much sugar alternates the regard centers in our brain so sugar acts on the same receptors recycle alcohol and come back cane and nicotine. the more you eat and drink the more you crave. that's significant there are addictive properties >> excuse me. can we go back to the slides with the data i wanted to ask a couple of questions. >> where could you like to go? >> to slide the san francisco ninth graders. are the numbers that top the number of individuals that like there were 31 for example, >> it's a percentage. >> it's a percentage? so when you did the survey you surveyed all night graders in san francisco >> this is a survey conducted

by the health survey. >> so it was public not private schools. >> yes. >> so there was a survey done if public schools do you know how many kids were surveyed. >> i don't know. if the data weren't stable we wouldn't be able to use it but i can get back to you >> what i'm trying to understand the data i've seen a lot of data but not enough with specifics to understand the specific impact on the population. that's what i'm concerned about >> the data though mirror with the state but i'm happy to get more data will the states. >> i should mention i used to be around a lot of kids and they

drank things like snap he lives and red bull and those kinds of drinks but i didn't see those kids drank soda a lot and we didn't have a lot of kids that had type two diabetes as well. i want to know more about the cat. i want to know what were the years and how many and other specification to the data >> okay. >> thank you. >> absolutely. i think the place i was at was ultimately - >> mr. chair. >> supervisor wiener. >> just one thing to clarify in terms of in response to supervisor breed's question i believe when you're referring 0 those drinks whether you call

them sugary drink or soda that's all it includes sports and sugary snap he lives it's not just quote/unquote all on the sugary beverage. >> i definitely got that but i'm trying to because we're specifying and asking kids if they drink soda i'm trying to understand the numbers around the diabetes and what kids in would easier in particular. i see a lot of different information and i'm not sure how to read that information so i guess i'm just a little bit confused about the overall proposal based on the data >> so perhaps many wilson can clarify the day the soda

consumers can you clarify that and for example, we know that among teenagers in california sugary beverage consumption a going up and the industry is behind that. >> in the california health survey the question was yesterday humidities did you drink a can or bottle of soda like pepsi or sprite. those are standardized question some asked about sugary drinks and some soda so in this case it says soda >> so if this was asked specific to quote/unquote soda

then presuming if we include supports drinks and other this would be higher. >> i suspect they'll be higher. >> but we don't have data to support that. >> i think my point was they were only asked about soda he know it wouldn't go down the numbers but if expanded it would go up. >> and just so you know i'm trying to understand the data and the connection between soda consumption and diabetes that's what i'm looking for. >> that's what i'm here for . >> one other thing to clarify someone texted messaged me according to someone on the school board all children's taxes the survey unless their

parents opt them out of the service. >> so thank you for the clarification. >> so they have the number? >> i think afterward we can get it data supervisor. >> thank you. >> but those are important questions and, you know, there are stacks of literature that i won't give you but talk about the scientific correlation before sugary drinks and diabetes sugary drinks are linked to diabetes and our risk for diabetes goes up i believe it's thirty percent with each can of soda. so ultimately sugary drinks are empty calories and most people don't understand colonel la has

2 hundred and 50 calories so your brain is not getting the message your full so we've learned here that a calory is not a calory they operated different in our brain and body and operate in our liver the way it's ma tabled what attributes to the issue sugary drinks are common place they're what i have when you get a meal at the fast food restaurant back in the 50s they were 6 onces and today get

one over one hundred ounces that contains lots of sugar and those are the estimates so again, if the 50s they were 6 teaspoons of sugar in a once cola and you can spur size it's 27 spoons up to one hundred if you get one from 711. what the heart association recommends >> supervisor wiener. >> i think this is a very important slide i want to talk about it a little bit. so and i think sometimes you know when you can think about this drink has a lot of sugar in that but also you see or hear the number of teaspoons we don't realize and sometimes, people

are floored when they hear how much sugar so in the small 12 once cans has many teaspoons of sugar the sugar distresses is to file our entire refrigerator or at the convenience stores and even just having the one small can is you're drinking and those people can drink a can of soda you're drinking 10 teaspoons and if you get a gulp you're talking about how much ice make 10 or 12 once of sugar. i think it's a lot more sugar

than people realize them or their kids that are putting into their bodies. this graphic is incredibly important talk about someone getting a 6 pack of sod a you're talking about 60 teaspoons of sugar or one hundred and 20 in a 6 pack this is a very clear graphic and it's incredibly important understanding why those particular - this particular product is such a problem in terms of of the huge quantity of sugar you're very, very rapidly putting 200 in your body >> there's no nutritional value. >> even if we are you're correct but even if that you consume that amount of sugar

into the body and flooding our liver it's a unique problem and it's why we see diabetes and other metabolic problems. >> we know that ucsf has begun liver transplants for liver disease and that's not related to sincerely rose of the liver it's from liquid sugar we have about 15 percent of liver transports that's non-alcoholic that's a direct result of over consumption of sugary drinks. >> i know you have a number of slides and we have speakers but can you talk about cake or

cookies and you're making the comment about leptin and stopping your consumption can you talk about the leadership ton and other things that are dangerous. >> sugary drinks doesn't make you feel full because your leadership ton resrpts don't revoke it's overwhelming with the sugar so you walk around because the sugar helps turn off the leptin. >> thank you. >> but the science is complicated but it's quite clear and i think related to the previous slide is the federal government has not set standards

around sugar and so the heart association he went forward and recommended 9 teaspoons for men and 6 for women and 3 for children. as supervisor wiener appointed out co- la has one can 6 teaspoons plus. the health organization don't go want more than 5 percent of our daily calories so if you're doing a 2 thousand diet that's about 25 grams of sugar which is about 6 teaspoons they've gone lower and made a recommendation of lower added sugar for a healthy diet. so i think what is important

here on a regular basis theirs now a studies coming out from universities and academic institutions talking about the length of sugary drinks and our body. sugary drinks contribute to tooth decan i and other diseases and the metabolic onto is for high blood pressure and high triglycerine rids and the lower cholesterol and those are precursors to diabetes and they don't only impact people that are over weight.

you can have metabolic syndrome at a normal body worth you can not see of the normal weight people can have metabolic son drom it's about what happens inside our body. there are also newer studies looking at cancer that's newer research so there are many impacts and ultimately we're seeing over consumption of sugary drinks impacts many organs in your body and many organizations that have taken a stand on sugary drinks and have made he recommendations to reduce the consumption including

the department of public health the state public health department the manner association and cancer society and so you can see many themed health organizations that are making strong recommendations to reduce the sugary drink consumption. we think there are strong parallels to the tobacco city - >> stepping back you made a statement that's an important one about you made it with respect to the metabolic syndrome in terms of sugary beverages increasing our risks of getting type two diabetes my understanding is drinking 1 to 2 sugary beverages