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Comment by sitkack | Hacker News Reader

> Burdens of type 2 diabetes and cardiovascular disease attributable to sugar-sweetened beverages in 184 countries

https://www.nature.com/articles/s41591-024-03345-4.pdf

The data and the code used for the analysis appears to be available.

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One of the reasons that we don't have Universal Healthcare in the US is that things that are categorically unhealthy would be prohibited from being sold. Afterall, it would benefit not only the receivers of care but also the people funding the healthcare system. The sellers of those things will fight (to their death) to prevent that environment from existing.

Not allowing something to be mass produced, marketed and sold is different than banning it outright.

I personally think mass scale tobacco and soda should not be sold, at the same time I think people can hand roll and pack a pipe into the grave. Same for their at home bathtub soda.

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> One of the reasons that we don't have Universal Healthcare in the US is that things that are categorically unhealthy would be prohibited from being sold.

For the most unhealthy class of people that are most affected by things like T2 diabetes, we have universal healthcare. At 65 you get Medicare which covers diabetes treatment.

We have yet to ban sodas despite the added cost to the taxpayers.

> I personally think mass scale tobacco and soda should not be sold, at the same time I think people can hand roll and pack a pipe into the grave. Same for their at home bathtub soda.

For tobacco, the age restriction has been the thing that has limited use more than anything. People don't tend to pick up smoking once they hit 21. Millennials by and large do not smoke and the anti-tobacco legislation in the 90s is a large part of that.

Unfortunately, because the legislation didn't target all nicotine products that left the door open for vape companies to come in and get Gen Z and Alpha addicted to nicotine all over again.

A broad ban on the sale of nicotine products to minors should be in place. It certainly shouldn't be sold over the internet.

Soda is trickier. I don't think an outright ban would be right (though it would have a fair number of positive health benefits). A sin tax would likely be ineffective and age checks seems like it would be somewhat burdensome.

> Unfortunately, because the legislation didn't target all nicotine products that left the door open for vape companies to come in and get Gen Z and Alpha addicted to nicotine all over again.

Gen Z and Alpha nicotine use rates are still lower than Millennials in absolute terms; it's happily not a huge problem (nevermind that stuff like Zyn is unambiguously much healthier than smoking cigs).

> One of the reasons that we don't have Universal Healthcare in the US is that things that are categorically unhealthy would be prohibited from being sold. Afterall, it would benefit not only the receivers of care but also the people funding the healthcare system. The sellers of those things will fight (to their death) to prevent that environment from existing.

Perhaps you’re implying something unique about the US, but those products are still sold in other countries that have state-funded universal health care.

It's just your normal run-of-the-mill HN posting that makes no sense and doesn't match reality.

This argument by massive processed food industries, that if we get Universal Healthcare, that their products and practices will be curtailed because it will be for the actual monetary public good says nothing about what is sold in countries with public healthcare.

Are you saying that corporate processed food manufacturers are not making that statement?

Clearly there is a problem with soda consumption leading to obesity in countries with Universal Healthcare, but that isn't the argument I am making.

> Are you saying that corporate processed food manufacturers are not making that statement?

No. I have no knowledge of what statements such manufacturers are or are not making.

However, your original post said “One of the reasons that we don't have Universal Healthcare in the US is that things that are categorically unhealthy would be prohibited from being sold.” This phrasing implies that the statement is true, or at least you believe it to be true. So it seemed relevant to offer a counter-example.

Even if you had originally said “corporate processed food manufacturers claim their products will be curtailed and lobby heavily on this point,” I think it would still be useful to point out that such claims are highly likely to be false given past experience in other countries.

Those other countries already have Universal Healthcare, so no lobbying against UH will be effective or successful. The fact that other countries have a supply of unhealthy processed food doesn't have any bearing about how much effort US food companies will put in preventing UH.

You can see their concerted response when sugar taxes are instituted.

I think you strike a good balance between personal freedoms and health of the population.

You’re right in that availability is the problem.

If I go across the road to the store, there’s a whole WALL covered in hundreds, maybe thousands, of sugar drinks, all very very cheap.

You know what there isn’t any of in the whole store? Something healthy and low sugar / high protein.

I have the luxury of time and a little bit of money so I can choose, but what about the busy parent who just needs energy? The busy office worker with a bunch of projects due, or just the poor individual with not much money, I don’t think it’s fair to setup these kind of situations and then blame the individuals for their choices, we have to step in at a governmental level

FWIW - the convenient stores near me sell the Core Power Elite Protein drinks. I have picked them up and it helps make my protein goals on days where I come up short. They do taste pretty good but more expensive than a soda.

It's possible people are depressed and looking for the most tasty option.

One thing 7-11s have started stocking in recent years is packaged hard boiled eggs. The price is insane if you compare it to boiling your own, and they are a bit tasteless, but you don't have to peel them and the price is reasonable compared to other stuff there if you're stuck eating lunch from 7-11.

It is more than twice the price of Wal-Mart! Well, I guess that's the price of convenience.

2/hard boiled eggs - $2.09 @ 7/11

6/hard boiled eggs - $2.96 @ Wal-Mart

6/raw eggs - $2.62 @ Wal-Mart

Next compare the price of a donut vs the price of a bag of flour and sugar ;)

You're paying for footprint. There's 320 Walmarts in California and almost 2000 7-Elevens. There's zero Walmarts in SF and San Mateo county, and at least 50-Elevens. Those 7-Elevens are often in premium locations downtown.

I am not sure I follow the discussion and its tie into California - I am in the South US

I just picked a market.

Nice. "Tea eggs" are big in East Asian corner stores.

Two hard-boiled eggs and an apple is a pretty nutritious lunch for about $2-$3 tops.

It’s cheap but not nutritious. It’s less than 300 cal and 12g of protein + 4g of fiber. You would be hungry. Need fiber and protein to keep you full

I went little further. I could not find low or no sugar Nestle cereals at the local supermarket, then I asked their support if they have something with low sugar. Their rep wrote that they have lowered the sugar amount by 34% from 2000 to 2010, but it is still not clear if those amount are OK, when I taste the sugar amount is definitely high. I do think the government should step in and promote healthy food and habits

So many of these "we lowered X" things are simply "We cut the portion size down by 34% to hit calorie/sugar goals".

That's where you get dumb things like "Here's a candy bar with 3.5 servings" to try and trick a consumer into thinking it's not as calorie dense as it is.

It's really tragic that lots of Americans think this kind of garbage is a healthier alternative to other kinds of breakfast. It may actually have less sugar than pancakes drenched in some disgusting syrup, but it's still garbage. There's a real problem with nutritional literacy in this country. The manufacturers of these products really aren't helping here either. Cheerios have a big 'CAN LOWER CHOLERSTEROL' plastered on the front of the pack, but the contents are still literally 24% added sugar.

From the Cheerios box in my cupboard: 140 calories per serving, 1g added sugar per serving. 1g carb = 4 calories. 4 / 140 = 3%.

I would not be at all surprised if some flavor of Cheerios is 24% added sugar, but regular Cheerios are not so bad in the sugar department.

> 1g added sugar per serving

That is still a good amount of sugar given it’s every day and setting your morning baseline. If taken with e.g. a refined juice or sweetened coffee, that’s probably setting one up for sugar cravings in a few hours.

A slice of bread (in the U.S.) has more than 1g of added sugar (and less than 140 calories). (If you know of any besides Ezekiel that have less sugar, I would like to hear about it.) I don't think it is fair to villainize Cheerios when it is one of the least offensive options among ultraprocessed breakfast cereals. Especially based on... other things that aren't Cheerios? Juice (20+ g sugar) and coffee sweetener (4+ g sugar) would be the villains in this scenario.

> don't think it is fair to villainize Cheerios when it is one of the least offensive options among ultraprocessed breakfast cereals

You’re correct. I’m damning the whole category within the context of this discussion.

1g of sugar per serving is hardly anything. You are weakening your argument by being hyperbolic.

> 1g of sugar per serving is hardly anything

I'll stand by it being "a good amount" given it's incorporated into a daily ritual.

What is the serving size and more importantly how does the serving size compare to what people actually eat?

Serving size is 1.5 cups. Regardless of how much people eat, it's still only 3% added sugar.

There's nothing wrong with the "can lower cholesterol" banner on it because it's a source of whole grains and it has no saturated fat. That combo generally does lower cholesterol when put to the test, and it probably is one of the best cereals in the aisle.

Directing people towards better alternatives is a good thing.

Is this regular Cheerios, or Honey Nut?

The Honey Nut Cheerios are glazed in sugar, but the plain Cheerios (to my taste) don't have much if any. Don't have any here to check the ingredients though. If I want cereal for breakfast I generally make plain oatmeal.

I don't think people realize the scale of soda consumption that needs to happen to have health issues. By and large the people in these affected studies are not drinking water at all. They are getting all their thirst needs met by a sugary drink. That is so overboard. You can have a can of coke every now and then and not have your enamel slough off.

We had a family friend who is in her late 50s stay for a couple of days over Christmas, all she drunk was Diet Coke. Even going to bed at night she took a bottle of Diet Coke with her. The thought of waking up through the night for a swig of Coke grosses me out a bit. And yes, she is the absolute picture of health...

eh, Diet Coke is primarily water, aspartame, phosphoric acid and caffeine. I drink 5/6 of them a day (don't like water much). The paper linked actually says short term effects of diet soda are less problematic, but recent evidence suggests that aspartame may have harms on the microbiome and glucose tolerance generally.

That said, the idea of drinking anything either sweet or carbonated before bed, during the night, or in the morning, mind boggling to me, that does sound really gross.

Have you ever tried plain carbonated water? It's more interesting than still water, and for me more thirst quenching. Easy to make at home with a Soda Stream or similar, just don't add any of their syrup.

alright fine, you win universe. SoftTalker, I'll drink more water ok?

I mean, diet coke explicitly doesn't have the kind of sugar in this study.

Mostly from own experience I know poor people drink sodas and as you get used to the taste you don’t like taste of plain water - even when you have decent tap water.

As an adult I started drinking tap water and now I don’t like taste of sodas anymore. I am happy that I got over with it but still have some people I know stuck on sodas and disliking plain water taste.

I think "don't like the taste of water" accurately describes me. That being said I do have a rule of "never drink anything with calories" specifically to avoid the sugar. But I don't know what you plain water drinkers are on about, the added flavor tricks me into drinking way more than I would naturally.

Humans have been constantly flavoring our water for thousands of years, I think the verdict is in that water tastes kinda meh. I would take tea or flavor extracts every time.

I like my water flavored. I tend to keep some lime/lemon juice around and that works well for me, maybe something can work for you

Well exactly plain water doesn’t really have a taste so it is meh and requires getting used to.

Especially when all you drink are sweet sodas it is really hard to get used to plain water.

Can you not buy more or less as unhealthy products in countries with universal healthcare as in US?

e.g. smoking rate is considerably higher in France or even in Spain

Sugar consumption isn't relatively that high either compared to most European countries:

https://www.who.int/data/gho/data/indicators/indicator-detai...

> > smoking rate is considerably higher in France or even in Spain

But they somehow compensate with other good habits considering that lifespan and healthspan is greater than the US.

Then we can get into a whole different conversation about the intensity of one's life in the US v. Europe not just the lenght, but that is a whole different conversation.

America's poor use EBT/food stamps to buy massive amounts of junk food, including billions on soda. Those same people are almost 100% on ACA or state health insurance plans and milking the tax payer on treatment for obesity, diabetes, and cardiovascular disease. There is no way, in my mind, it is feasible to fund these lifestyles and provide the treatment for it. Its absolutely insane.

The soda is not consumed by the food stamp holder. It's used as a medium to convert the balance to cash.

Do they? Food stamps in most states have restrictions on what you can buy with them. My impression is soda is not on the list. Of course this is (mostly?) the states and every state has different rules so you probably need to cite 50 different state rules to verify this and thus an exception state is likely.

This is an ongoing debate, but afaik you can use them for soda [1].

[1] https://www.nytimes.com/2017/01/13/well/eat/food-stamp-snap-...

That isn't the argument I made. Processed food industries actively block healthcare reforms because they fear being regulated for the now obvious public good.

Any source of that claim? That processed food manufacturers lobbied against universal healthcare for fear of regulation against their products?

Perhaps. But I don't think that's the public consensus. So it's hard to accept such arguments without any evidence.

AFAIK in Europe most food safety regulation is coming from the EU directly and not the national governments. Also it's not like all countries in Europe have public tax funded healthcare systems.

Fundamentally some are inherently not that different from the one in the US (i.e. semi-private or even entirely privatized) it's just that they much better regulated and much more efficient.

Even if we exclude private spending the US government already spends more per capita on healthcare than most other countries so why would anything change if e.g. Medicare was extended to a higher proportion of the population?

> One of the reasons that we don't have Universal Healthcare in the US is that things that are categorically unhealthy would be prohibited from being sold.

Counter argument: Pretty much every other nation has socialized healthcare and still allows sugary beverages and tobacco products.

>I personally think mass scale tobacco and soda should not be sold, at the same time I think people can hand roll and pack a pipe into the grave. Same for their at home bathtub soda.

I'd be fine with that to be honest. I'd drink soda water going forward just to not have to smell cigarettes, but be fine with people backyarding some tobacco to make their own cigars.

It would probably even be healthier to force people to make their own syrup for soda at home vs the ease of obtaining it now.

Canada has universal healthcare and they drink plenty of sugary drinks there too.

Yes, but we call them pop, not soda :-)

Or at least used to. 51st-ifying is underway.

Before we go here, what is the alternative. If restrict soda and people switch to beer even if they will be driving that could be much worse. (I don't otherwise know how the effects of alcohol vs soda come up but that too is a question worth asking)

> what is the alternative

Shrubs [1]!

[1] https://en.m.wikipedia.org/wiki/Shrub_(drink)

There are many alternatives, but what is important here isn't what you recommend, it is what people choose.

> what is important here isn't what you recommend, it is what people choose

Do we have any evidence soda drinkers sub Coke for alcohol? I'd have guessed artifically-sweetened soft drinks would have been the substitute.

If I recall correctly part of the origin of soda was doing the reverse, from efforts to actively substitute for alcohol. Hence why they emphasized as "soft drinks" as a marketing category.

As for other substitutes, we've seen highly sweetened coffee drinks as the common one, to the point where soda taxes started to face accusations that they are actually thinly veiled classism due to exclusion of more white collar "Starbucks" type drinks. Rightfully or wrongly they have a point about it at least looking bad.

I wasn't intending to imply that is what would happen. That is the worst substitute I can think of. If high sugar coffee would also be counted as soda for the laws - something that isn't a given - this seems even more likely.

I don't know anyone who would switch from soda to beer?? probably tea, or coffee, or lemonade or flavored sparkling water

I don't think that's a relevant comparison. They're both beverages, sure, but that's about where the similarities end. As drugs they're entirely different. May as well add Ayahuasca to consideration as well.

I could see tea or coffee (particularly the sweetened varieties) and sparkling water, but honestly I think the most likely alternative will just be plain ol' water.

> One of the reasons that we don't have Universal Healthcare in the US is that things that are categorically unhealthy would be prohibited from being sold.

Yeah that not it boss. Never did I come across something getting banned in France because of healthcare costs.

I don't know that that's true. Most healthcare is subsidized. And so is the sugar. There's very little movement to restrict the sugar. There are profits to be made on both ends (selling the sugar and the insulin for example) by those who have captured the relevant parts of the government.

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