This document discusses soft drinks as a risk factor for heart disease in obese women. It reviews two peer-reviewed articles that found associations between soft drink consumption and risks of cardiovascular disease and stroke. Currently, interventions aimed at reducing soft drink consumption include taxes on sugary drinks and bans on selling soft drinks in schools. An alternative intervention discussed is a proposed ban on large-sized sodas in New York City, which aims to educate the public on sugar and calorie contents in sugary drinks. Reducing soft drink intake could help lower obesity rates and medical costs related to diet-related diseases.

1. Running head: SOFT DRINKS AS HIGH RISK FACTOR…. 1
Pub Hlth Policy & Advocacy_Dr. Obumneke_Amadi- Onuoha _transcript 32
Soft Drinks as High Risk Factor of Heart Disease in Obese Women
Table of Contents
Title page…………………………………………………………………………1
Table of Contents……………………………………………………………… 2
Introduction............................................................................................................3
Public health issue..................................................................................................3
Justification .of problem ………………………………………………………... 3
Policies overview………………………………………………………………...4
Current Intervention(s)…………………………………………………………...5
Alternative Intervention(s)……………………………………………………….6
Impact……………………………………………………………………………7
Conclusion……………………………………………………………………….7
References………………………………………………………………………..8

2. SOFT DRINKS 2
Introduction
The purpose of this paper is to employ the process of conducting scholarly, peer-
reviewed research. The process will comprise of locating five scholarly, peer-reviewed articles
that provide evidence for and support the public health issue of concern.
Public Health Issue
The Topic: Soft Drinks as High Risk Factor of Heart Disease in Obese Women.
Justification of Topic as a Public Health Issue
The two scholarly, peer-reviewed articles and the overall findings of each article:
Article 1:
Eshak, E., Iso, H., Kokubo, Y., Saito, I., Yamagishi, K., Inoue, M., & Tsugane, S. (n.d). Soft
Drink intake in relation to incident ischemic heart disease, stroke, and stroke subtypes in
Japanese men and women: the Japan Public Health Centre-based study cohort. American
Journal Of Clinical Nutrition, 96(6), 13901397:
This article provides a broad overview of Soft drink intake which has been associated
with obesity and diabetes, but its states its relation with risk of cardiovascular disease
(CVD) is limited. The authors examined the association between soft drink intake and
risk of CVD in a Japanese population. The authors revealed after follow-up of incident
cases and certified the presence of ischemic heart disease (IHD) , cases of stroke, and
others illness, however, soft drink intake was positively related with risk of total stroke
and other chronic illnesses for both sex, more especially ischemic stroke for women
and. The author concludes that soft drink intake is connected with higher risk of
ischemic stroke for women. This article is very important for future intervention on
public health issues relating to obesity and health disease prevention.

3. SOFT DRINKS 3
Article 2:
Bernstein, A. M., de Koning, L., Flint, A. J., Rexrode, K. M., & Willett, W. C. (2012). Soda
consumption and the risk of stroke in men and women. The American journal of clinical
nutrition, ajcn-030205.
This article provides a broad overview that the consumption of sugar-sweetened soda has
been related with an increased risk of cardiometabolic disease, but its association with
cerebrovascular disease has not been thoroughly observed so far. The goal of this study
was to observe patterns of soda consumption and exchange of alternative beverages for
soda in association to stroke risk. The author’s pointed out that similar predictable
reductions in risk were seen for exchange of caffeinated or decaffeinated coffee for low-
calorie soda, after a prospective cohort study of two comparison groups who were
followed over a period of time from consuming 1 serving of sugar-sweetened soda, 1
serving of decaffeinated coffee was related with a 10% lower risk of stroke and 1 serving
of caffeinated coffee/d with a 9% lower risk. The authors found that there is significant
higher risk of stroke associated from consuming sugar-sweetened and low-calorie. The
authors concluded that this risk may be reduced by substituting alternative beverages for
soda.
Article Communicating Policy
The articles speak to policy and/or advocacy gaps and further prove the need for
intervention based on:
In article 1: The traditional Japanese diet consists of stable nutrient rich food, however drinking
soft drinks in Japan was uncommon, but since after the westernization of the Japanese diet after
World War II, beverages have become extensively consumed in the country. In addition,

4. SOFT DRINKS 4
epidemiologic studies have shown positive associations between soft drink intakes with many
risk factors for cardiovascular disease. In order to study the association between soft drink
intake and risk of CVD in Japanese men and women, the Japan Public Health Centre imitated a
policy and implemented a prospective study on cancer and cardiovascular disease Cohort I which
started in 1990, this project was meant to address the topic of soft drink intake and CVD in their
populations (Eshak, et al., n.d).
In article 2: Consumption of sugar-sweetened beverages and sodas, have really increased in the
United States currently, such that soda has remained the biggest source of added sugar in the
most diet (Bernstein, et al., 2012, p.1). Because of the relations between consumption of soda
and cardiometabolic risk factors, and CVD including morbidity, mortality, and health care
expenditures, and in addition, to the recognized overlap of this risk factors and prevention
strategies in the United States, the American Heart Association and American Stroke Association
and developed guidelines for the primary prevention of stroke and in support the authors of the
article evaluated the association between soda consumption and total stroke on the
population(Bernstein, et al., 2012, p.2).
Evidence That Speaks To Interventions Currently Being Used To Address Issue
Penny-per-ounce tax is a policy produced by the Rudd Center’s in 2009 on soft drink
taxes, to express the significant progress which has been made in the effort to reduce
consumption of sugar-sweetened beverages (SSBs) because of the substantial growth in chronic
illnesses linked to its effects. However the initiatives have been incorporated by many cities and
states, which have launched public health SSB campaigns, executed or proposed policies to
reduce SSB accessibility. The intervention however, have been considered as a significant
strategy by many public health specialists and lawmakers to improve the nation’s nutrition, raise

5. SOFT DRINKS 5
resources for health programs, and reduce health care costs of treating diet-related diseases
(Friedman & Brownell, 2012,p.2). Some e of the challenges of the intervention is may be
difficult to implement on a local level because it is readily affordable for low income (Friedman
& Brownell, 2012, p.4). Presently, tax on SSBs by evidence and estimates has proven the
possibility to reduce type 2 diabetes and coronary heart events caused by the consumption of
SSB (Friedman & Brownell, 2012, p.2).
School children who consistently consume sodas eat fewer nutrients but more calories,
and are more likely to be overweight or obese, causing school nutrition to become an important
political focus targeting the causes of obesity (Fried & Nestle 2002, p.3). Based on that, many
school around the country e.g. “Oakland school district have banned all sales of soda and candy”,
in addition, the “Los Angeles school board voted to take soft drinks off cafeteria menus and end
the sale of soft drinks in vending machines” (Fried & Nestle 2002, p.5). The intervention proves
an upward movement to banish soft drinks from schools, but retains challenges from production
companies who argue that problem is obesity on children is lack of activity rather than too many
calories.
Alternative Intervention That Could Address This Public Health Issue
An alternative intervention such as the “large-sized soda ban” is evidence that could have
addressed the consumption of soft drink or SSB in the population e.g. after the “New York
City’s Sugary Drinks Portion Cap Rule (Soda Ban), was suspended from becoming effective by
the New York City Department of Health and Mental Hygiene, but the lower court explained
that the Soda Ban was illogical and changeable. However, the Soda Ban initiative was designed
to educate the public to make informed choice of buying large and small soda drink and other

6. SOFT DRINKS 6
sugary beverages daily, with consideration of the amount of sugar and the number of calories
contained in them (Min, 2013, 194)
Overall Impact This Intervention
The high annual medical cost in U.S could be reduced by the absence of obesity, the
consumption of soft drinks and sugar sweetened beverages may control the resultant medical &
health problems, and social costs for both existing and upcoming generations(p.197), in addition
it will regulate successfully a reformed marketing practices and consumer behavior on soft drink
consumption.
Conclusion
In conclusion, the effort to curb soft drink consumption could represent a stepping-stone
in combating the obesity epidemic and promoting proper eating of nutrient rich diet that prevent
chronic illness related to heart diseases and obesity in women, men and children.

7. SOFT DRINKS 7
References
Bernstein, A. M., de Koning, L., Flint, A. J., Rexrode, K. M., & Willett, W. C. (2012). Soda
consumption and the risk of stroke in men and women. The American journal of clinical
nutrition, ajcn-030205.
Eshak, E., Iso, H., Kokubo, Y., Saito, I., Yamagishi, K., Inoue, M., & Tsugane, S. (n.d). Soft
drink intake in relation to incident ischemic heart disease, stroke, and stroke subtypes in
Japanese men and women: the Japan Public Health Centre-based study cohort. American
Journal Of Clinical Nutrition, 96(6), 13901397:
Friedman, R. R. & Brownell, K. D (2012). Sugar-sweetened beverage taxes: An updated policy
brief. Retrieved from http://www.yaleruddcenter.org
Fried, E. J., & Nestle, M. (2002). The growing political movement against soft drinks in schools.
Jama, 288(17), 2181-2181.
Min, H. M. (2013). Large-sized soda ban as an alternative to soda tax. Cornell JL & Pub. Pol'y,
23, 187-233.