FW: Soda Pop and Caries Summary

[Gleason, Carolyn]

For your information, from a dentists' listserv

-----Original Message-----
From: "Mark Siegal" <MSIEGAL at gw.odh.state.oh.us> at INTERNET 
Sent: Thursday, October 05, 2000 12:21 PM
To: <dental-public-health at list.pitt.edu> at INTERNET
Subject: Soda Pop and Caries Summary


From:  Mark Siegal, DDS, MPH     Ohio Dept. of Health

Recently, I posted a question about peoples' experience with this
issue.  I received several responses that were sent directly to me. 
One person asked if I would report the responses back to the List.
Here 'tis:

A. Where has this (political) issue been tackled and what was the
outcome?

* ADA has a resolution in the hopper addressing this issue.
* The Michigan Dental Association passed a resolution.

* In "City School District Calls Off Pepsi Deal" (Sacramento Bee,
7/11/00), it was reported that the Sacramento City Unified School
District board of trustees removed a proposed district-wide deal ($2
million over 5 years) from their agenda.  They called for healthier
snacks, for strengthening nutrition programs in the district's schools
and possible phase-out of sugary, caffeinated drinks. Nearly all of
the district's schools have individual contracts with soft drink
companies. 
An editorial, "Just Say No: City Schools' Pepsi Deal is Rich, But
Wrong" was               published 6/21/00 and 6/28/00.

* This was a major issue for the City of Madison, WI.  In August, the
City of Madison school board voted 5-2 to terminate the contract with
Coca-Cola as the sole supplier of soda in the schools. The contract
was worth $615,000 over the last 3 years.  Renewal was to be for
$100,000 over 2 years with bonus commissions of approximately
$200,000.

* In Rhode Island this spring, the Dept. of Education was dealing
with 2 school superintendents that had quit the school lunch program
and were serving pop with lunch.  The state attorney general was
involved.
      Suggested contact: Maureen Ross maureenr at doh.state.ri.us.  

* Seattle Public School District, in spite of an effort of the
Washington State Oral Health Coalition, accepted a deal ($6 million)
with Coca Cola a couple of years ago with the money to be used for
sports programs and other non-funded school activities.  

* From: center for commercial-free public education
<andy at commercialfree.org>
       Date: 9/14/00 1:08AM
       Subject: School Policies on Commercialism, GAO study
released!

September 14, 1999 
For Immediate Release 

Contact:  
Andrew Hagelshaw, Center for Commercial-Free Public Education 510
268-1100 
Jill Wynns, San Francisco School Board member 415-828-7204 or
415-241-6427 
Danny Weiss, of US Representative George Miller*s office 
202-225-2095 

Sample School Policies on Advertising to Kids Released 
Thursday*s GAO Report Finds Such Policies Missing or Incomplete in
Most
School Districts  


Oakland, CA<The Center for Commercial-Free Public Education on
Thursday
released Sample School Board Policies on Commercialism, designed for
use in
any school district in North America. The Center*s Sample Policies
are
intended to help schools districts define what is and isn*t
acceptable with
commercials in schools.  A  GAO report issued Thursday  confirms the
existence of advertising in many public schools across the US, and
concludes
that most districts are lacking  adequate policies to deal with the
problem.

"The GAO is confirming what our Center has known for years- brand
name
advertisers are disrupting the public school environment by using
valuable
time and space to push  their products on a captive audience of kids"
said
Andrew Hagelshaw, Executive Director for the Center.   "It is
inappropriate
for schools, as publicly funded institutions, to promote particular
brand
name products to their students. School districts obviously need
policies in
place so that they can address this problem before it gets out of
hand."  

The Center*s  Sample Policies are compiled from five already existing
school
board policies around the US. One of these policies, the "Commercial
Free
Schools Act" passed in 1999 by the  San Francisco Unified School
District,
has already stood up to a challenge from a proposed exclusive
contract with
Pepsi.  

"San Francisco illustrates why every district needs a comprehensive
policy
on school advertising- because policies protect  the district from
the song
and dance routines marketers use to take advantage of public school
s", said
Hagelshaw. "Policies can also prevent school districts from falling
down the
slippery slope of commercialism. Once a district allows one brand
name
advertiser, they often end up allowing another, and on and on until
the
community has lost control over who is really teaching their kids. A
school
board policy allows a district to put their  foot down and draw the
line." 

Among the items the GAO found in schools were Channel One (the TV
news show
that contains ads), ZapMe (the computer version of Channel One),
exclusive
cola vending contracts with Coke and Pepsi, and curriculum
advertising such
as the McGraw-Hill textbook for sixth graders with ads right in the
story
problems. The GAO study was ordered by US Representative George
Miller. 

To View the Sample Policies, visit www.commercialfree.org 


B. Studies/References

* Nutrition, Diet & Oral Health
Rugg-Gunn & Nunn
Oxford University Press 1999    
Page 165

"There is evidence from Australia & England that banning the sales of
sweets in school tuck shops reduces the development of dental caries
in children."


* I recently looked into this question and put together the
following
comments.

SUGAR, CARBONATED DRINKS, AND DENTAL CARIES IN SCHOOLCHILDREN

Howard Pollick, BDS, MPH
Clinical Professor, Department of Preventive & Restorative Dental
Sciences,School of Dentistry, UCSF

(Prepared for The Dental Health Foundation)

A review of recent studies from a Medline search 1995-2000, using
keywords: caries, sugar, and children yielded 59 citations.
Abstracts
were reviewed and all but 7 were excluded due to lack of information
relating to associations between sugar and/or beverage consumption
and
caries.


Recent studies of children have shown a positive correlation between
dental caries and total sugar consumption,(1,2,3)  particularly for
those with high sugar consumption,(2,3) dental caries and frequency
of
sugar consumption,(4)  and consumption of cans of carbonated drinks
and
dental caries.(1,5)   Reported use of sugar-free drinks was not
found
to be associated with better dental health.(1) Availability of
fluoride
reduces the effect of sugar on caries. (6,7)  One study has shown
deterioration in dental health of children to be associated with the
increased consumption of sweets and other cariogenic between-meal
snacks after starting school.(3)


Thus efforts must be made to reduce sugar consumption and the
consumption of carbonated drinks in schools, particularly in
communities lacking fluoridated water, particularly for children who
do
not use fluoridated toothpaste twice a day, and for children who
have
excessive sugar intake.


Schools wishing to enter into a financial contract with companies
promoting carbonated beverages should ensure that there be an
enhanced
effort to prevent dental caries in schoolchildren. It would be
preferable to find alternative sources of funding that would not
encourage excessive use of carbonated drinks in school.


References:

1. Jones C; Woods K; Whittle G; Worthington H; Taylor G. Sugar,
drinks,
deprivation and dental caries in 14-year-old children in the north
west
of England in 1995. Community Dental Health, 1999 Jun, 16(2):68-71

2. Szpunar SM; Eklund SA; Burt BA.  Sugar consumption and caries
risk
in schoolchildren with low caries experience.  Community Dentistry
and
Oral Epidemiology, 1995 Jun, 23(3):142-6

3. Holbrook WP; Arnadottir IB; Takazoe I; Birkhed D; Frostell G. 
Longitudinal study of caries, cariogenic bacteria and diet in
children
just before and after starting school.  European Journal of Oral
Sciences, 1995 Feb, 103(1):42-5

4. Ruxton CH; Garceau FJ; Cottrell RC.   Guidelines for sugar
consumption in Europe: is a quantitative approach justified?
European
Journal of Clinical Nutrition, 1999 Jul, 53(7):503-13

5. Freeman R; Breistein B; McQueen A; Stewart M. The dental health
status of five-year-old children in north and west Belfast.
Community
Dental Health, 1997 Dec, 14(4):253-7.

6. Gibson S; Williams S.  Dental caries in pre-school children:
associations with social class, toothbrushing habit and consumption
of
sugars and sugar-containing foods.   Further analysis of data from
the
National Diet and Nutrition Survey of children aged 1.5-4.5 years.
Caries Research, 1999, 33(2):101-13

7. Walker AR.  Nutritional and dental implications of high and low
intakes of sugar.  International Journal of Food Sciences and
Nutrition, 1995 May,  46(2):161-9


Additionally:

  Journal of THE  AMERICAN DIETETIC  ASSOCIATION
  APRIL 1999           VOLUME 99/NUMBER  4                            
                                                        
                                        (ISSN  0002-8223)
              ABSTRACT   

Soft drink consumption among US children and adolescents: Nutritional

consequences

Lisa Harnack, DrPH, RD, Jamie Stang, PhD, RD, and Mary
Story, PhD,  RD 

Objective To determine whether carbonated soft drink consumption is
associated with consumption of milk, fruit juice, and the
nutrients  concentrated in these beverages.
Design Data collected as part of the 1994 Continuing Survey of Food
Intakes by Individuals were analyzed. Information on food and nutrient
intake was derived from 2 days of dietary recall data collected via
an in-person  interview. 
Subjects and participants Nationally representative sample of people
of all ages residing in the United States (response rate=76.2%).

Analyses were restricted to children aged 2 to 18 years (N=1,810).  
Statistical analyses performed Logistic regression analyses were 
conducted to predict the odds of low milk and juice consumption by
soft  drink consumption level. To determine whether intake of select
nutrients varied by soft drink consumption, multiple linear
regression
modeling was conducted. Analyses were conducted using sample weights
and software appropriate for the survey design. 

Results Energy intake was positively associated with consumption of
nondiet soft drinks. For example, mean adjusted energy intake was
1,830 kcal/day for school-aged children who were nonconsumers of soft
drinks compared  with 2,018  kcal/day for children in this age group
who consumed an average of 9 oz of soda  or more per day. Those in the
highest soft drink consumption category consumed less milk and fruit
juice compared with those in the lowest consumption category
(nonconsumers). 
              
Conclusions Nutrition education messages targeted to children and/or

Their parents should encourage limited consumption of soft drinks.
Policies that limit children's access to soft drinks at day care
centers and schools should  be promoted.             
   (J Am  Diet Assoc. 1999;99:436-441.)


* PubMed-articles that relate to caries, soda and schools:
1. ASDC J Dent Child 1997 Jan-Feb;64(1):55-60
Soft drink logos on baby bottles: do they influence what is fed to
children?
Siener K, Rothman D, Farrar J
Department of Pediatric Dentistry, University of the Pacific, USA.

2. J Am Dent Assoc. 1999 Aug;130(8):1158
On soda pop.
Folgert E, Fallon T, Schopfer G.
No abstract available.


* JADA 1999 Mar;130:308-312
Outrageous (editorial)
Meskin L 
Above Message Sent By: "Mark Siegal" <MSIEGAL at gw.odh.state.oh.us>
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Date: Thu, 05 Oct 2000 15:21:35 -0400
From: "Mark Siegal" <MSIEGAL at gw.odh.state.oh.us>
To: <dental-public-health at list.pitt.edu>
Subject: Soda Pop and Caries Summary
Sender: owner-dental-public-health at list.pitt.edu
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Reply-To: "Mark Siegal" <MSIEGAL at gw.odh.state.oh.us>