WHY IT MATTERS

Sugary drinks, including full-calorie soda, sports drinks, lemonade, energy drinks, sweetened coffee and teas, and fruit drinks with added sugars, are the number one source of added sugars in the U.S. diet. [i].

Consuming too many sugary drinks can lead to harmful health effects, including heart disease, weight gain, obesity, type 2 diabetes, kidney diseases, non-alcoholic fatty liver disease, tooth decay and cavities [ii]. The American Heart Association, along with national partners, recommends that children avoid sugary drinks[iii]. On average, children in the United States consume 143 calories from sugary drinks a day [iv].

The American Heart Association also recommends that adults consume no more than five to nine teaspoons (~80-145 calories) of added sugars per day [v]. A 20-ounce bottle of soda contains the equivalent of approximately 17 teaspoons of added sugars [vi]. Adults in the United States consume an average of 145 calories from sugary drinks on a given day [vii].

DANGERS OF

SUGARY DRINKS

NATURAL vs. ADDED SUGAR:

It all comes down to how fast sugars get absorbed. For example, your body spends more time digesting an apple than regular soda. The apple contains fiber, so the natural sugar is absorbed more slowly. Because the added sugar in soda hits your system all at once, your body absorbs those sugars much more quickly. Keeping tabs on how much sugar you’re consuming is an important part of a heart-healthy lifestyle, especially if you’ve been diagnosed with diabetes or prediabetes [viii].

PREDATORY MARKETING

Big Soda has relied on tobacco marketing techniques to push their sugary drinks to the most vulnerable members of our community.

Efforts include:

Product placement at child eye level in stores and check out aisles.
Contracts between bottlers and schools to provide exclusive vending machine placement.
Funding playgrounds and community groups in Black communities.
Disproportionately more outdoor ads on billboards, bus benches, sidewalk signs, murals, and store window posters for sugary drinks in lower-income Black neighborhoods.

ENERGY DRINKS

Energy drinks have as much sugar as soft drinks, enough caffeine to raise blood pressure, and additives with unknown long-term health effects [xiv].

CAVITIES

Frequency of sugary drink consumption is associated with tooth loss among young adults even when the average sugary drink intake is less than one can per day [xvi].

OBESITY

One study found that for each 12-ounce soda that children consumed each day, the odds of having obesity increased by 60% [xviii].

DIABETES

People who consume sugary drinks regularly—1 to 2 cans a day or more—have a 26% greater risk of developing type 2 diabetes than people who rarely have such drinks [xx].

HEART DISEASE

A study of 40,000 men who averaged one can of a sugary drink per day had a 20% higher risk of having a heart attack or dying from a heart attack than men who rarely consumed sugary drinks [xxii].

Women who drank more than two servings of sugary drinks per day had a 40% higher risk of heart attacks or death from heart disease than women who rarely drank sugary drinks [xxiii].

ARTHRITIS

A study of 80,000 women found that those who consumed a sugary drink a day had a 75% higher risk of arthritis gout than women who rarely had such drinks. Researchers found a similarly elevated risk in men [xxv].

BONE HEALTH

Soda may pose a unique challenge to healthy bones:

Soda contains high levels of phosphate.
Consuming more phosphate than calcium can have a deleterious effect on bone health [xxvii].

LIVER CANCER

A study of older women found that participants who drank one or more servings of sugary drinks daily had an 85% higher risk of liver cancer than those who drank three or fewer servings of sugary drinks per month [xxviii].

MORTALITY

The more sugary drinks people consume, the greater their risk of premature death — particularly from cardiovascular disease, and to a lesser extent from cancer [xxix].

HOW A SUGARY DRINK

DISTRIBUTOR TAX HELPS

Since Berkeley passed the Sugary Drink Distributor Tax in 2014, it has raised more than $12 million to pay for a wide range of programs and fund grantees to work throughout the city to overcome the ill effects of sugary drinks.

Because prevention is a critical part of this program, the Sugary Drink Distributor Tax also funded nutrition education courses for students and communities most aggressively targeted by Big Soda.

REDUCED CONSUMPTION

After Berkeley adopted the nation’s first sugary drink distributor tax, sugary drink consumption declined significantly. Three years after the tax took effect, residents in surveyed neighborhoods were drinking about half as many sugary drinks as before the tax [ix].

HEALTHIER CHOICES

A before-and-after study covering 15.5 million supermarket checkouts after the first year of Berkeley’s Sugary Drink Tax found that the volume of sugary drinks sold in Berkeley declined by 9.6%. Because sales for healthier beverages also rose, there was no negative impact on overall beverage sales at studied local businesses [x].

BMI REDUCTION

A 2024 Kaiser Permanente study in JAMA Network Open followed nearly 45,000 youths in four California cities with sugary beverage taxes and compared them with 345,000 youth in 40 matched cities without one. Youth in tax cities had significantly lower Body Mass Index (BMI) percentiles after the tax started. Berkeley showed the strongest results of the four: a 3.55 percentage-point reduction in mean BMI percentile and a 4.44 percentage-point reduction in youth classified with overweight or obesity, relative to its control cities [xi].

SCHOOL GARDENS

17 school gardens have been funded by Berkeley’s Sugary Drink Distributor Tax.

MEDICAL CARE ACCESS

From 2018- 2022, 20,000 primary care referrals and 9,032 dental referrals were made because of the programs funded by the Sugary Drink Distributor Tax [xii].

CAPACITY

Sugary Drink Distributor Tax funding helped build organizational capacity, allowing grantees to expand their reach and spread health education and direct services to vulnerable populations [xiii].

FOOD ACCESS

he Sugary Drink Distributor Tax prioritizes food access, including food pantries (BUSD, Berkeley Youth Alternatives and Multicultural Institute) and vouchers for farmers’ markets (Fresh Approach) [xv].

WATER ACCESS

With funding from the Sugary Drink Distributor Tax,16 indoor and outdoor drinking fountains and water refilling stations were installed in priority locations throughout Berkeley to improve access to water [xvii].

INFORMATION

Thanks to nutrition education funded by the distributor tax, Berkeley residents are more aware of Big Soda’s predatory marketing techniques [xix].

POLICIES

The success of the Sugary Drink Distributor Tax helped pave the way for the City of Berkeley’s Healthy Checkout Ordinance, which was passed in September 2020, and requires large grocery stores and other retailers to replace sugary drinks and sweets at checkout with healthier options like water, nuts, seeds and fruit [xxi].

INTERNAL POLICIES

The Sugary Drink Distributor Tax grantees and the City of Berkeley adopted internal organizational policies to limit sugary drinks in the workplace [xxiv].

EQUITY
In addition to funding the Berkeley Unified School District cooking and gardening program, funding focused on righting historical wrongs and disinvestment in Berkeley’s communities of color by putting critically needed resources back into the hands of organizations best suited to decide how to do the work [xxvi].

[i] U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. www.dietaryguidelines.gov: 2020.

[ii] U.S. Centers for Disease Control and Prevention. Get the Facts: Sugar-Sweetened Beverages and Consumption. Updated April 2022. Available at: https://www.cdc.gov/nutrition/data-statistics/sugar-sweetened-beverages-intake.html.

[iii] Healthy Eating Research. Consensus Statement on Healthy Beverage Consumption in School-Age Children and Adolescents. January 2025. Available at: https://healthyeatingresearch.org/wp-content/uploads/2024/11/HER_ConsensusStatement_FINAL.pdf

[iv] Rosinger A, Herrick K, Gahche J, et al. Sugar-sweetened beverage consumption among U.S. youth, 2011–2014. NCHS Data Brief. 2017;(271):1–8.

[v] Malik VS, Li Y, Pan A, De Koning L, Schernhammer E, Willett WC, Hu FB. Long-term consumption of sugar-sweetened and artificially sweetened beverages and risk of mortality in U.S. adults. Circulation. 2019; 139:2113-2125. doi: 10.1161/CIRCULATIONAHA.118.037401.

[vi] Wang, YC, et al. A penny-per-ounce tax on sugar-sweetened beverages would cut health and cost burdens of diabetes. Health Affairs. 2012. 31(1), 199-207.

[vii] Rosinger A, Herrick K, Gahche J, Park S. Sugar-sweetened beverage consumption among US adults, 2011–2014. NCHS Data Brief. No 270. Hyattsville, MD: National Center for Health Statistics. 2017.

[viii] https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sugar/difference-between-sugar-free-and-no-added-sugar

[ix] Source: UC Berkeley School of Public Health / peer-reviewed research UC Berkeley: Do soda taxes work?

[x] Silver LD, Ng SW, Ryan-Ibarra S, Taillie LS, Induni M, Miles DR, et al. (2017) Changes in prices, sales, consumer spending, and beverage consumption one year after a tax on sugar-sweetened beverages in Berkeley, California, US: A before-and-after study. PLoS Med 14(4): e1002283. https://doi.org/10.1371/journal.pmed.1002283

[xi] https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821695

[xii] Shayla Spilker & The Praxis Project (2024, May). Changing Culture & Building Power: Evaluating a Decade of Berkeley’s Sugar-Sweetened Beverage (SSB) Tax. Retrieved from https://www.thepraxisproject.org/resource/2024/berkeleyssb.

[xiii] Shayla Spilker & The Praxis Project (2024, May). Changing Culture & Building Power: Evaluating a Decade of Berkeley’s Sugar-Sweetened Beverage (SSB) Tax. Retrieved from https://www.thepraxisproject.org/resource/2024/berkeleyssb.

[xiv] Health facts from: https://nutritionsource.hsph.harvard.edu/healthy-drinks/sugary-drinks/

[xv] Shayla Spilker & The Praxis Project (2024, May). Changing Culture & Building Power: Evaluating a Decade of Berkeley’s Sugar-Sweetened Beverage (SSB) Tax. Retrieved from https://www.thepraxisproject.org/resource/2024/berkeleyssb.

[xvi] Study: Kim et al., Permanent tooth loss and sugar-sweetened beverage intake in U.S. young adults, Journal of Public Health Dentistry, 2017;77(2):148–154. DOI: 10.1111/jphd.12192.

[xvii] Shayla Spilker & The Praxis Project (2024, May). Changing Culture & Building Power: Evaluating a Decade of Berkeley’s Sugar-Sweetened Beverage (SSB) Tax. Retrieved from https://www.thepraxisproject.org/resource/2024/berkeleyssb.

[xviii] Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet. 2001;357:505–508. DOI: 10.1016/S0140-6736(00)04041-1.

[xix] Shayla Spilker & The Praxis Project (2024, May). Changing Culture & Building Power: Evaluating a Decade of Berkeley’s Sugar-Sweetened Beverage (SSB) Tax. Retrieved from https://www.thepraxisproject.org/resource/2024/berkeleyssb.

[xx] Malik VS et al. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care. 2010;33(11):2477–2483. DOI: 10.2337/dc10-1079.

[xx] Health facts from: https://nutritionsource.hsph.harvard.edu/healthy-drinks/sugary-drinks/

[xxi]Shayla Spilker & The Praxis Project (2024, May). Changing Culture & Building Power: Evaluating a Decade of Berkeley’s Sugar-Sweetened Beverage (SSB) Tax. Retrieved from https://www.thepraxisproject.org/resource/2024/berkeleyssb.

[xxii] Health facts from: https://nutritionsource.hsph.harvard.edu/healthy-drinks/sugary-drinks/

[xxiii] Health facts from: https://nutritionsource.hsph.harvard.edu/healthy-drinks/sugary-drinks/

[xxiv] Shayla Spilker & The Praxis Project (2024, May). Changing Culture & Building Power: Evaluating a Decade of Berkeley’s Sugar-Sweetened Beverage (SSB) Tax. Retrieved from https://www.thepraxisproject.org/resource/2024/berkeleyssb.

[xxv] Health facts from: https://nutritionsource.hsph.harvard.edu/healthy-drinks/sugary-drinks/

[xxvi] Shayla Spilker & The Praxis Project (2024, May). Changing Culture & Building Power: Evaluating a Decade of Berkeley’s Sugar-Sweetened Beverage (SSB) Tax. Retrieved from https://www.thepraxisproject.org/resource/2024/berkeleyssb.

[xxvii] Health facts from: https://nutritionsource.hsph.harvard.edu/healthy-drinks/sugary-drinks/

[xxviii] Health facts from: https://nutritionsource.hsph.harvard.edu/healthy-drinks/sugary-drinks/

WHY IT MATTERS

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