In 2012, when the New York City Board of Health approved a size limit on soft drinks served in restaurants, the measure was fought in the courts and nullified. Barclays Center nonetheless complied with the restriction voluntarily for a time. The then just-opened home of the Brooklyn Nets, an 18,000-seat venue, allowed sodas to be sold in maximum 16-ounce container sizes at the concession stands. Those who wanted a jumbo soda were out of luck.
This civic-minded step by the new arena caught the eye of Brian Elbel, population health and health policy professor at NYU Wagner and the NYU School of Medicine. And, using a National Institutes of Health grant, he and other New York University researchers set out to gauge the potential impact of the arena’s portion limits on how much sugary beverages fans gulped during Nets games—as scientists have firmly linked heavy consumption of sweetened drinks to increased rates of obesity and type 2 diabetes.
The question: Could a cap on container sizes reduce intake, or would people just buy more?
Elbel and his academic team surveyed hundreds of adult Nets fans leaving the arena after 17 games while drink sizes were restricted. They then compared these 2014 responses to those collected from a like number of adults on their way out of New York Knicks games at Madison Square Garden, where soft drinks were still available in 24-ounce sizes.
“This was the best way we knew to get at the impact of the policy that was never actually implemented,” explains Elbel. His work explores the impacts on consumer behavior from public health initiatives, and in recent years he has led studies examining the effects of local laws requiring restaurants to list calorie information on their menu boards, as well sugary-beverage taxes and fast-food companies opening franchises near schools.
The beverage-size study came out in the February, 2022, issue of Preventative Medicine Reports and was coauthored by Christina Roberto, now a professor at the University of Pennsylvania. It found that fans at Nets games purchased fewer calories as a result of the temporary limit on drink sizes at Barclays Center—the intent of the 2012 Board of Health regulation. In fact, that reduction in calorie consumption was greater than from any other single health intervention designed to encourage healthful choices by consumers, the study concluded.
What’s more, fans’ sense of enjoyment and consumption of calories from foodstuffs at the Nets games were not diminished by the size limit, the researchers’ surveys showed.
NYU News spoke with Elbel about the implications of what he describes as the first real-world study of sugar-sweetened beverage consumption ever conducted.
It’s interesting that the Board of Health passed this policy in the first place.
These restrictions were proposed by then-Mayor Michael Bloomberg. Ultimately, a state appeals court panel struck them down, stating that the health board intruded on the authority of the City Council, which did not go on to address the issue. But Barclays complied as soon as the board policy was passed. It marked, in a way, a social experiment. It was watched nationally. Scientists wondered how the public would respond to limits on soft drink container sizes, and so did we.
What did you find?
That, indeed, a size limit could reduce the calories consumed from sugary drinks, at least in the context of a large arena where people go not to eat or drink as at a restaurant, but rather to enjoy the event itself.
What specific impacts on calorie consumption did you see?
With the 16-ounce (or 463-milliliter) cap, game fans at Barclays purchased an average of 2.24 fewer ounces and consumed about that much less—or 2.34 ounces. We asked people how much they purchased as well as how much they consumed, and zeroed in on those who bought at least one beverage. There was a 143-calorie difference among those who purchased 16-ounce beverages at Barclays in comparison to those who had the option to purchase a larger-sized soft drink at Madison Square Garden. At the Garden, the average drink size purchased was 24 ounces, our surveys found.
Do you view the 143-calorie reduction as a substantial change in fan behavior?
We do, and it is approximately equivalent to the number of calories in a can of soda.
Did the beverage limit affect how many hotdogs or lobster rolls people bought at Barclays Center?
Fans did not report any changes in food consumption and they did not report any change in satisfaction with the event.
When Bloomberg was mayor, he faced complaints from some quarters that he was infringing on personal freedom despite the increasing problem of obesity and diabetes.
Sugary beverages are the class of products that scientists believe are probably most directly linked to bad outcomes, in part because they don’t have any positive nutritive value and probably don’t stop you from purchasing or eating as many food calories as you would otherwise. But for any food policy that is restrictive in nature, the obvious question is always why shouldn’t people have the right to do what they want. And I think that is a reasonable question that policymakers have to contend with whenever they’re looking at these kinds of policies. In many cases, the sense from the policymaking community is that some small tweaks or changes designed to make the healthier choice the easier choice are warranted here.
How far might policymakers or large venues choose to go?
We haven’t seen any policies that suggested banning sugary beverages. The only place where we’ve seen that at all is in schools, including in New York City, where sweetened drinks are no longer sold in concession machines. Outside of that, there’s been no concerted policy push toward cigarette-type bans when it comes to soft drinks.
Getting back to the 143-calorie reduction you saw, why was that significant in and of itself—and for future policies and research?
One might say, oh, it’s only so many calories and it’s not going to matter. But a 143-calorie reduction from a single intervention is actually pretty darn good. Some evidence emerging on sugary beverage taxes, for example, suggest that they’re not going to have as great an impact. Secondly, and I think more compelling is our understanding that there’s not going to be any single policy approach that will do it here. There’s no magic bullet solution. We now increasingly realize that you’re going to need small, incremental approaches that hopefully combine together and result in some meaningful changes in health outcomes.