public health department dr. also the director of food systems for san francisco paula jones and many asian and asian pacific islander organizations and leaders we have dr. lawrence chung who's the president of the medical society and i think today's hearing on the impact of sugar sweetened drinks on the asian pacific islander communities is a historic occasion to use fats and experience and data to shatter the minor things that the asian pacific islander are not impacted by the sugar beverages. as documented by an overwhelmingly body of research and personal stories the offer

consumption of sugary beverages recent research the asian pacific islander and teens are being targeted by big soda and among energy drinks in 2010 one in 3 san francisco children and condolence were obese over and over overweight. look to one side of you at least one of the 3 people sitting in this room who are if we were all children would be obese or overweight and if what we side nothing a third of the population will be obese and face the sugars like diabetes and many other health problems.

also youth and adolescence are up for sleep disorders and asthma and others. each extra can of the sodas and energy drinks each one me drink per day increases a child's likelyness of becoming obese so a drink of sod can they could become obese by 60 percent. everyone is impacted and carotid to the department of san franciscans are paying hundreds of dollars in confidence for programs directly attributed to sugar and it's impacting diabetes and other go health problems and costs to the city. also very importantly the

proposal that a number of supervisors on the board of supervisors with me are playing on the ballet in november it would allow $31 million a year to be used for impacted communities but also to fund schools, parks and public health programs like student ammunition programs and healthy ammunition programs and so much more. the funding for a soda tax in san francisco would be an accountability mechanism to make sure that experts and community members oversees is fund so every penny is preventing the health of our children. all low income community that a.d.vesical impacted especially in low income communities. there's a current report that

highlights the impacts on asian pacific islanders it is impacted by the center for the health advocacy by 3 members. it shows clearly that asian-american teens are targeted by big soda companies their consumptions is increasing. my daughter is among the age group and her and her peers this is the case at least in san francisco asian-american are surfer if type two diabetes and in my meeting with different dentists the asian-american dentists in san francisco they know this chart shows the general sense is that low income

community the color like 9 southeast neighborhoods of the bayview hunters point and the admission are heavyly impacted their lateral low income of color especially african-american and laminating latinos. but chinatown pops out as a clear danger zone dental and together decan i and chinatown and different low income xhaindz xhabdz heavily proposed by asian-american there's a a lot in the southeast part of the city so for dental and oral health problems and cavities the sugar sweet calories are health problems for asian-americans. i know from our difficult data

and many asian-americans community and as they consume sugar sweetened befrngz they'll see the other chronic issues that african-american and latinos and other communities of colorfast. other asian pacific islander populations also suffer from increased obesity and problems that come with obesities and many of the asian pacific islander community members from the church leaders and youth point to a lot of the key problems in asian pacific islander communities. i mentioned shattering the minor myth of the asian-american i think we see that big soda targets asian-americans and asian pacific islander whether hosting significant populations that are asian and asian pacific

islander. those are serious issues that the asian pacific islander health equity had focused on as we condition the discussion i wanted to say that the soda take into consideration on the november ballot there's a lot of misinformation from big soda was it taxes and not. i want to hold up a bottle to say that it's very important that we understand that sugar sweetened beverages are harmful but your sod a tax doesn't touch so i based drinks they're not taxed. the reason is even though some contain a little bit of sugar they also include healthy ingredients that have proton and

iron that make a a milk substitute and another type of drink it's a begin sing drink they're not taxed like monster drinks owned by the 3 of the big soda companies. this is an important thing it's got 10 calories not like the anyo montana stare drinks. this juice is made up of sugars waters it pretends to be juice it is taxation it is almost as dangerous as the sugar drinks i want to say the sugar types of

drinks masquerade as healthy drinks. today, the goal of the hearing is to hear from our public health department and experts and real people and people from our community on the harm of the folks in san francisco the asian pacific islander. i want to ask my colleagues, any questions before i begin. i see none i'll call up the cities chief officer to make the presentation. >> good afternoon. thank you very much for having me here to speak this is among the birth health problem and addressing sugary beverages is critical. i'm going to go over information and first of all, i want to say

thank you to key persons that have helped with the slides and research coming out of the research in san francisco. i'm going to do this morning i'm going to go over why sugary drinks it is important to focus on and talk about the issue in asian community with respect to the impact with respect to diabetes. dr. chung from the medical society is here to address that as well. the first thing i want to do i want to take a home message from the harvard school of public health the problem is sugary drinks include problems of obesity and heart disease. the evidence is the soft drink is on the rise and leading to

health problems. i want everybody to understand that sugar is different number one and number 2 sugary drinks are worse. here are some key take home messages the first one is that liquid calculations are not counted by your body if you drink 2 hundred calories your body doesn't know that. this is really important it is different from eating 2 hundred calories of food. the second thing when we get sugary drinks we flood our liver with problems. when i drink a sugary drink you get a rise in insulin it's your father stored harmony it caused your body to store fat and the

next thing sugar can be addictive. there is no control on how much sugar is added to an item when you pick up it won't say the daily requirement for sugar our body is not required for that. in chronic exposures to sugar can lead to fatty liver. so the 3 points under the evidence is sugary portion sizes have dramatically increased and children and adults are drinking much more than ever and 1/3rd of children and adults are over weight we spend over one billion dollars for obesity related conditions. sugar under these heat disease and we know that from random control cutting back on sugary

drinks leads to people having healthy weight. and here's the important point i want you to remember asians have a higher risk of diabetes at lower rates norms they're at risk at having diabetes as a lower mass body. it's rapidly growing under asians and asian pacific islander. it's effecting about 10 percent of the population. now the thing when we say sugar the part of showering i'm talking about is frustrate to say it's the worse the reason why it's frustrate to say it's sweet you can make cardboard taste good 80 percent of our

food supply has fruit to say. we're talking about most of those calories come in sugar drinks it's leading to fatty liver and excessive fat storage and less in resistance we call that metabolic onto our body buildings we have less fat stored our body is tricked into thinking we have less fatso our body eats more and moves less that's one of the primary reasons it's hard to lose weight. i'm going to give you won memory do add it's called sugar madness it's one page of a quick way to recall the key issues.

the first sugar remembers the cause sugar specifically frustrate to say the addictive sugar and fat shortage i'll cover quickly and the treatment is changing our stress and exercise. so the important thing to remember it it metabolic onto is the key issue we're worried about the metabolic symptom leads to diabetes and high cholesterol and you don't have to be overweight normal people can develop it and this will link in with when we talk about the asian population.

it's really important to realize you don't have to be overweight or obese to have a negative impact of sugar consumption we know it's having a worse effect in the journal of the medical association we know there are is a large study showing those who consume more sugar will have heart attacks it works as levels of awe definition and people can become addicted to sugar. we have to realize the food industry knows this that's why they design their food to develop loyalty. the last point of the memory aid

when we have metabolic onto we have a disorder of fat storage so when you have metabolic onto your brain buildings it doesn't have enough fat in the body so your brain says eat more and move less. we've talked to people they are hungry all day long >> dr. please speak into the microphone so we can follow this. >> and on the slides it has some of the key issues when this happens you have high chronic insulin and have leptin resistance it's your father kreltz telling your brain to stop eating but the fat cells can't speak and tell you that. that's the part on d.

so nutrition is the key to better metabolic health. we want to avoid added sugars and when i say that frustrate to say and we want to avoid it in a highly contained form like chocolate milk, etc. in ways to get other types of sugars that are not paratransit to say and change the environment. fast food is available 24/7 and soda vending machines and target advertisement you see a public advertisement about child obesity don't take it lightly and below did you see mcdonald's

turgz junk food people think that junk food is what the billed board above is saying. the industry is going to argue they'll say that all calories are alike and if you use common sense you'll know that's not true i have to do the simplest mind exercise if i have half a graph of poison and say mix it with one thousand classes and half a glass of soda are those calories equal no, because the poison will kill you it is what matters it's a not the colori coloringic calories it's easy to

counter the myth its not true this is actually very important to realize. i'm going to briefly go through a quick slides. we know that cross the world sugary consumption is increasing dramatically. we see on the right side in china it's increasing at an alarming rate so what do i expect to happen. this is hard to read the bottom line from this slide is that asians are more likely to develop the metabolic complications at a lower bmi. you may have a person lower worth and may not i think be

considered by the doctor for developing risks >> dr. i'm looking supervisor yee and myself we have lower bmi than the average person in san francisco but we're at much higher risk it sound like than the white population i think that's the data. >> correct. given the exposure your at the higher risk go the online the diabetes center it on the east coast they have a different chart there's a shift in the chart asians have a lower bmi than the white population >> the asian diabetes information is really helpful. >> i want to point out that's

an important point we know right away right now this is from the international diabetes federation the title is diabetes is asia's silent killer to in china the increase of person of diabetes they have the highest level of diabetes in china. so in san francisco we need to be concerned we have a large asian population this slide is showing the asian population is 33 percent and that's increased dramatically since 1990. we know with exposure to the deity our population is at risk. the good news that is the prevalent this is 5th and 9

graders and straight if i had by the social economic class of those who are on the benign light bars the social economically disadvantaged our likely to be overweight under asians they're actually doing better than the population that's particle why we need to focus on the population we want to keep healthy weight but recognize that are higher rates does that make sense it would be a little bit miss misleading we might is they're okay. we don't have to worry about them but, yes because they're at a higher risk at the bmi are that this is just to give you an idea of the prevalence of diabetes in san

francisco alice's is currently lower than african-americans and latinos. i'm not going to focus on this this is my data slides on the left-hand side is young folks children okay. and what we see there's a decrease in sugary consumption among young folks the parents are listening and learning but what happens when you have teenagers like i do i have 3 you can't control >> did you see say you have teenagers. >> yes, in this group this is access to the environment they can buy the soda and junk food

it's increased from the blue to the red bars it's an increase you look at the asians that's itself highest increase. and just a couple more slides this is the that case home message the more soda you drink the more overweight you are that's true in children and adults. this is the percentage actually of total soda expenditures in san francisco it's a targeted on the east side of the city. okay. i'm done i'm going to summarize again, i've summarized the problem and the evidence i've summarized why sugar is different and liquid sugar is the worse. and that are focus is on the fruit to say part of the sugar

and the 3 important point is that sugar consumption has increased dramatically and two it leads to disease and 3 cutting back can make a difference cutting back can make a difference and latest asians are at special risk. i'm going to end there and that's it. if there's any questions otherwise you'll i'll i'm going to turn it over to my colleagues >> the next is president chung of the medical society. thank you for coming as well. >> thank you for allowing me to address this committee on this very important public health issue i'm dr. lange chuck a practicing physician in san francisco and i'm the president of the metal society that represents all physician in san

francisco we're at 15 hundred strong society and represent the california medical association as well as a delegate but more importantly i'm a san franciscan of chinese decent this is an important issue. let me bin by stating statistics. diabetes is increasing in asians especially in chinese that's unrelated to the there in obvious the total number of people with diabetes in china eclipse that 84 million as opposite side to 24 million in under the circumstances this is 11 percent in china and 8.3 percent in united states.

dr. argon talked about this let me talk about this. in a 12-year-old children the risk for developing this in a hundred 50 pound person is the same in a chinese person at one hundred and 25 pounds. we know that added sugar he it's a cause but not the sole cause of obesity and sugar is the cause of metabolic symptom and frustrate to say promotes cellular damage. added sugar is a risk factor that is supportive of other metabolic symptoms. we have the american health association from a .22 continue

per day and 6 teaspoons for females. in california 41 percent of children between the age of 2 to 17 drank at least one soda evidence and years between 20 to 2012. nearly 2/3rd's of the asians drank at least one sugary beverage per day double the amount consumed from children between 8 to 12. and as dr. thomas pointed out the consumption of the sugar declined for all age groups except for adolescents and among adolescents consumption has increased with state of california significant increases monk latino and asian youths >> dr. chung can i ask you why

it is increasing for adolescents and increasing for younger children. >> i believe that's a because of the marketing and lifestyle. there is a large media campaign to promote the unhealthy diets there are targeting towards the asian for example i live in the richmond there are clearly adds from the beverage industry that targeted our populations in the native language in vietnamness and chinese so there's a way to entice more adults to drink soda i see that trend rising i've been in the city for 10 years. i also