benchmarking studies group and finally from lucy ucsf fellow at the center for tobacco control and education and then after the presentations we'll take public comment. >> thank you dr. >> thank you committee members and supervisor mar i'm a puc doctor at san francisco general and with the university of the san francisco also a resident of the richmond district that is lirtdz with corn liquor store with market the sugar sweetened beverage to children i'm here on behalf of those kids and the patient i take care of at the san francisco general hospital on behalf of the city's needs with respect to the city health some of you may have heard me when i started out as a doctor in 1991

one out of two patient were men dying of aids and through a remark coalition of public figures and public health leaders and activists in less than a generation we've successfully tackled the aids epidemic but it took heroic and painstakingly efforts to do that especially the ward 5 a the famous aids ward men's were dying of aids no longer has patients with aids the bad news the wards as well as other wards in san francisco general hospital are now busting with patients dying of the complication of type 2 diabetes again in less than a generation when i started out at san

francisco general in the primary care clinic one of my 5 patient had twshz now 2 hundred and 50 millin dollar has type 2 diabetes that's an implosion of a which one illness in one generation as supervisor cohen this is proerpt effecting the south of market communities we see hospitalizations rates for type 2 diabetes ten times higher than in the north of market neighborhoods to give a sense the scale of that epidemic nationally i've used the analogy of the iraq wars 15 hundred men and women lots of their limitations to the war in the same decade 1 points

5 million americans lots of limbs to diabetes we were facing a war that it is one thoughtless times stronger than the afghanistan war so this is critical for the war in california hospitals one in 3 patients has diabetes in public hospital it is about one in two. >> now we tend to think of type 2 diabetes as a disease of older people. but i think much of the legislation your introducing is targeted not only to adults who are well-informed but perhaps more so to young adults or youth who's ideas are being formed as they decide what to purchase and commune u consume we know that type 2 diabetes is the prominent form of diabetes in young people

that it would have been unheard of thirty or 40 years ago if a child in my classroom had type 1 now in san francisco schools over half of the kids are twubz as mentioned added sugar is a stape he will of teenagers deity 1 in 5 calories from sugar and one in that is sugar sweetened beverages i'm positive that given what we now know about the untoward effects of sugar sweetened beverages the metabolic height of young people how it leads to fatty liver and insulin resistance and develops

into tb's by and large we've been asleep at the wheel i recently implemented a term for the department of public health for the state of california and we we were asleep at the whole it was very difficult to move this issue in front of of the decision makers for a variety of reasons i think the measures you're putting forward represent the behold moves that took place in san francisco a lot of moves that were unpopularity but critical to get my head around it they're clearly health risks if we don't act; right? the trajectory of diabetes is clear the health risks the acting, however are going to be positive

as far as i know no negative health consequences of drinking less sugar sweetened beverage so i think we can feel safe we've noted cause harm i'll close with one set of thoughts the sugar sweetened beverage industry in trying to counter those types of measures tends to make the case that we are unfairly targeting their products why don't you tax ice cream or cupcakes or put warning labels on cake and it is the same argument the tobacco companies made thirty and 40 years ago about cancer we never said that cancer was caused by one agent but a multi

bacteria tobacco was a major contributors to lung cancer so we regulated it we put warning labels on the car tens in exactly the is that you tobacco and sugar sweetened beverages are not the sole reason for heart disease the evidence is they're a major contributor to those diseases and as such we owe it to ourselves and communities to regulate them i will just close by reminding us all in the thirty years since warning labels and other forms of regulation were placed on tobacco over one billion lives have been saved that's the power of regulating unheath products over one billion lives we're

saved thank you very much >> thank you (clapping.) >> i too feel ethnic if you hear something you like as powerful communicate it by silent communications dr. is that all you have perfect supervisor wiener has a few questions. >> dr. thank you very much for your work in trying to make our community healthier sometimes, we - i'm not a physician not a scientist i don't pass myself off as a medical expert but i have a met and spoken with and left hand to and read analysis from many different positions

and scientists unifying included what i have seen is it in terms of the impacts of sugar on the liver, on the body in terms of increasing the risk of type 2 diabetes and other health problems seems to me to a be a linkage, of course you know one factor is the absolute hundred percent cause can you comment am i right. >> i'll say yes i'll say that probably one of the most important experts at ushering davis dr. stan if you want to dig deep the yes is that a number of experiments and trials and highly controlled

circumstances have shown that sugar leads to quick metabolic effects the liver what's less clear whether it is a high fructose corn or the glucose in reality some saying the effects are mitigated if it is pure glossoglue close in reality the market is flooded with those in publicity health terms liquid sugar the consensus is toxic but if you have a comparison trial comparing blue glucose to corn syrup the jury is out. >> so sugar let's talk about high corn sugar soda and other

sugar sweetened beverages that is in terms of is there a scientific incentive for corn syrup from liquid form is a significant contributor to type 2 diabetes and other medical problems. >> among the scientists that study this there is a clear consensus whether unify surveyed all scientists of all diseases they might not doubt that be as up on the latest research but. >> but there is a consensus. >> right. >> thank you very much. >> supervisor mar. >> yes. thank you, dr. i want to ask you to quantify the harm of regular drinking of sugar sweetened beverage i know you mentioned a lot of limbs like the war in afghanistan i know that dr. alyssa at ucsf have

done a groundbreaking study of sugar sweetened beverages on our aging cells it can take up to 5 years of live with a person are type 2 diabetes can you talk about the harm in loss of years if you drink the sugar sweetened beverage. >> to repeat question is it possible to quantify the number of years of life lost through the accumulation of sugar sweetened beverages i'm not aware of any study that has done that particular it requires a mathematical modeling so the answer is going to be no however, we do know that type 2 diabetes is in itself reduces our lifespan from 8 to 9 years

and as far as sugar sweetened beverages just having one increases diabetes by 25 percent you can make some back of the envelope estimation to the best of your knowledge not done but by drinking sugar sweetened beverage you might make the that's the back of the envelope. >> you said it can lead to 8 to 9 years loss ever your life. >> type 2 diabetes you - one the complicated issues you made we tend to talk about this problem as an average xhujs problem the average teenager drinking 1 points 7 drinks in reality consumptions is clustered within an individual and communities so you have individuals drinking 2 hundred and 50 millin dollar or 4 a day for the reasons district in

terms of marketing to to really do the calculation you wanted to look at the distribution of consumption and answer it that way. >> all right thank you very much i have a quick question for you what is in our professional opinion an opinion what did you building with some of the ways we can begin to reduce the accomodation of sugar sweetened beverages. >> well, i think that much like what we've done in tobacco is going to require a multiplied prong approach that includes regulation and tax which includes counter marketing and finally a real changing of social enormous so that when you're going to the corner store not to buy the 20 ounce of sugar

sweetened beverages that's endorsed by labels and talk drinking water instead of soda so is it really requires a multi prolonged effort and often takes decades we have to be in it for the long haul. >> thank you. we appreciate our time and commitment to this item. >> thank you. >> i'm going to call the next speaker from the benchmarking studies group welcome and thank you for joining us today we welcome you. >> good afternoon. my name is a fernando i'm a xhujsz strategist at benchmarking media group today, i'm here to talk about the problem of target marketing of sugar sweetened beverages to low income families and communities of color

communities of color as we've mentioned as we've heard have been the harder hit by the nutrition recommended diseases and in the meantime the communities of color is targeted by marketed of junk food with fat and sugar sweetened beverages when contribute to childhood obese it awhile communities is a routine business practice many foods and beverages marketed to community of color increase the or interfere with this management upon a condition especially with the absent ever healthier foods for example an 2014 study published in the prosperity medication many were quoted to the childhood at fast food

restaurants and children that eat fast food will consume for fats and sodium and sugar sweetened beverages there's also less likely to meet the deityy recommendations for frutsz african-american children and teens saw more twice the as on tv compared with twhoit children and teens in 2013 according to a report released last fall if yale just as beverage companies with targeted african-american youth they're pursuing latino youth and other youth of color advertising for sugar sweetened beverage shot an spanish tv increased by 44 percent anymore 84 percent of all food and

beverages advertised to children on spanish tv are unhealthy a review included it effects the children's food preferences and purchase requests and diet and health some refer to as a manufacture youth of color the researchers term a double dozens of sugar sweetened beverages marketing because their exposed to take into account to maine mainstream campaigning with the media it research shows is impounded by youth of color more frequently than by white youth marketers target youth of color their deemed trend seters and therefore existed for the market branding their ambassadors in

addition the companies exist the colors for promoting unheath food and sugar beverages it is misunderstood as the 4 p pursuit place and promotion targeting to communities of closure occurs in all 4 categories companies has designed priorities especially for that communities of color their priced the prices are designed to appeal to income groups like value memos and targeting low income communities with the targeting marketing when their dispromoting recommended and place that are sat down rad with unheath promotion like the zoning in certain communities that allows

complication of fast food restaurants or proliferation of outdoor advertising among unhealthy informed and sugary beverage promotion that exists commercial and intovm and language to sell products or build brand loyalty it is problematic when the foods and bernlz that are marketed using the techniques are unhealthy and in addition to the four ps soda companies direct corporate roshltd to the campaigns and philanthropic support for those often strapped for youth organizations some companies also provide important financial support for students of color like pep could scholarships for the folks or

coming back cola for our native those companies in air marketing have long promoted positive images of people of color and sadly, this is something that is lacking in other media but all this support from food and beverage companies didn't mitigate the fact their products tributed to the devastating here recites of diabetes so what can we do about targeting marketing ever food to communities of color because they're targeted a targeted approach is needed to address the marketing of their unhealthy products especially to our children and youth we must insure that responsibility begins with those who produce and present the marketing of

unhealthy products that's a shared responsibility we can strengthen the federal, state, and local we asking can give customers a fair chance at making healthy choices and fund programs that a we must cover all forms of marketing to include packaging and sponsoring and mobile devices and more at the end we must reduce the exposure to foods and especially among kids that are suffering the most this dprauf predatory market value of food and beverage products that are proven harmful is unfair to the vulnerable communities especially children and this must change thank you. >> it up for your presentation.

>> colleagues, any questions? okay. we appreciate our time here next speaker comes from ucsf lucy >> i'm lucy the doctor and a at university of san francisco and with the tobacco controls and research education i'd like to talk about warning labels on tobacco warning labels on tobacco are a great example how health warnings are are informing the public about the harms of tobacco i'm going to talk about 1 he know health warnings are effective and 2 hundred and 50 millin dollar since introduced tobacco companies have been fighting to put through tare implementation and 3 the public

actually likes them and supports them so health warning labels on cigarettes was in 4 did 66 and 1940 required for advertising. >> this is age ad was the first warning you see the warning at the bottom it is tiny it reads warning the surgeon general has determined the cigarette smoking is dangerous to our health and since 170 the 3 things remain the same they're effective two tobacco companies are fighting and 3 people still support them so the health warning labels on

tobacco we know it informs the public into studies found the smokers and non-smokers find them informative and their credible health warning labels on tobacco they change the understanding and knowledge of the harm of tobacco products they also have effective in influence and behavorial intentions and make people think about quitting and effective to some stent to help smokers stop smoking the bigger the more space the more effective so the current legislation for the sugar sweetened beverage is the first step and but certainly

shouldn't be the only step but given it is the first step what stent to putting the label on the advisement is effective we have one on electronic cigarettes that begs the question we show most smokers and non-smokers an advertisement so we took the south side they're a product that is completely unregulated we took for the warning that says warning this product is not a safe alternative to cigarettes this is current required and we published 20 percent off the e cigarettes add we asked smokers before and after showing them the is it so time what smokers and non-smokers how harmful are

e cigarettes for the health we found this simple warning increased the understanding of the harm for the e cigarettes this one study thas there's some evidence this warning might be effective and because tobacco warning labels are effective tobacco companies realize that they've been fighting implementation or increase in the warning labels here at the ucsf we have the documents where researchers go and read them and what they find is since the beginning tobacco companies were trying to do anything necessary could to avoid of warnings on tobacco products here's an example of the

documents from the british american tobacco companies and similarly a governments suggests that smoking has increased concern diseases tobacco companies are aggressively fighting and the legislation without this industry you're going to see similar tactics from other industries, however, awhile tobacco companies are fighting did warning labels the public actually supports them a research shows for example in brazil after the warning labels were published 76 interviewed approved the measure and similar

finding in canada district attorney and thooilz and in australia 45 percent of respondents thought that was of wide importance that the government has health warnings on tobacco and that also included the majority and we know that the level of product support keeps increasing after the - as time passes after the warnings are produced in scluks the health warnings are an effective measure along with the other measures that regulation and education they're effective and educating the public about the harms of tobacco thank you. >> thank you very much supervisor mar. >> yeah. i wanted to ask dr. i know that the berkley group talked about the aggressive predatory marketing by big soda

your comparing tobacco or big tobacco i'll call it their tactics how would you compare with big soda is doing with those types of policies with the tobacco i know we have the lobbyist sitting in the back of the room and representing big soda can you compare the tactics with big soda today. >> i'm a tobacco researcher so i'm not familiar with the tactics of the sugar sweetened beverages but i hope to learn more with the tobacco centers industries has done to resist they've come up when they directly influence the effected officials by funding and giving sponsoring they as argue about this this is the first