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 wanted to point out some other facts as well may i increasing the consumption we don't realize that one soda per day can add up to 60 percent

more chances of greeting diabetes within a summer vacation our kids can increase with weight because of soda consumption and one drink a day can double the risk of diabetes and increasing it can increase the rate of heart disease and by 35 percent with two more sifrgz were day. because of the very unsheltering scientific facts and statistics the san francisco medical society has unanimously support do this tax and the california association board of directors have also supported the local tax it's important because as a state organization we have the backing of the citizens from the state of california saying this

is a problem i hope you'll look at the facts and consider a decision >> thank you, colleagues any questions? i wanted to ask if doctor argon or dr. chung could address what dr. argon talked about the addiction people in the population that maybe become addicted to sugar sweetened befrngz. i know that from new books sugar salt and fat many of the big soda corporations additional food processing companies look for a point where we know if you have the sugar and salt and fat they know it effects the brain and put certain amounts into

their processed food to get people to buy the harmful product can you talk about the addictive and a half of the sugary beverages >> this is an area there's published materials that is compared across the criteria we consider for addiction. this doesn't happen for all people but what happiness when you become addicted to a substance when you don't become the substance you become depressed so to feel normal you seek it. we have an employee of the public health department that's addicted to sugar. if you take to this employee this employee will sound like

it's almost this person is talking about alcoholic so this problem is there i'm a expert but there's a citation in the slide from a specific study i don't know if dr. chung has things to add >> i remember in college getting hooked on caffeine. >> yeah. caffeine as addictive properties so i've tried to use science to show a certain issue they try optimize how they develop food to build brand loyalty and take advantage of things to help us get addicted

to food that's like the nick 10 industry. we know we're getting exposed to chemicals that have biochemical impacts on the brain and the science is emerging and frustrate to say is one of the materials. you referred to ucsf materials like the book fat chance of beating the odds against sugar it gets to the research how sugary products effect our brain and the impact on our bodies as well. i did want to ask you about that point upper making of the 2 hundred empty calories like a bottle of soda and the metabolic symptom being a part of it and the professor made a point you

can drink a soda and burn off the calories but it 0 floods your liver it's worse than burning off the empty calories >> the important thing the fruit to say is not what our body uses it's really gloous so your body doesn't use the from us to say it has to be ma tabbed by your liver. so of it will be converted by the problem is when your liver gets all the fruit to say remember we didn't evolve having frustrate to say in this form the fruit to say was in fruits

that comes with fruit. so the end ups causing fatty deposits in your body it causes insulin and leads to the metabolic symptom and ends up being high levels of insulin resistance and the leptin causes people to eat more and exercise less >> my comments on the asian and african-american and asian pacific islander population if we see the rise no health problems if we do nothing in san francisco what should we expect as growing challenges for the chinese community. >> that u when you look at san francisco on average it's healthier than other places.

it's true we have imagining equalities within the city we have an opportunity before the horse is out of the barn this is a good opportunity to help to protect and sustain the healthier san francisco we currently have. its costs a lot. once you develop those diseases it's hard to turn back the clock but the asian population it can be a population that gets missed they get missed because on average they're lower weight and unless we revoke and acknowledge their higher risk for diabetes the example that dr. chiang gave was good a hundred and 25 pound chinese person is at the same s