Can Too Much Soda Lead to Diabetic Amputations?

A Look at Today's Health Headlines

The New York City Department of Health is raising eyebrows with its provocative new public-service ad linking type 2 diabetes and growing portion sizes.

By Amy Solomon, Senior Editor

WEDNESDAY, Jan. 11, 2012 — Globs of fat pouring out of soda bottles, bloodied drinkers slumped on the sidewalk: When it comes to their public-service ads, the New York City Department of Health has gotten a reputation for its brash, in-your-face attitude (much like the city it serves). In its latest campaign, the department is highlighting the connection between type 2 diabetes, portion sizes, and obesity. And, like a recent Georgia campaign against childhood obesity, the New York ad is causing lots of controversy.

In the ad, three full soda cups — small, medium, and large — are arranged in size order, with a diagonal line labeling them as "then" (the smallest cup) to "now" (the largest). In the background sits an overweight man whose right leg has been amputated at the knee; his crutches lean against the wall behind him. In arresting capital letters, a red banner imposed over the image reads, "Portions Have Grown: So Has Type 2 Diabetes, Which Can Lead to Amputations."

Thomas Farley, the city's health commissioner, is making no apologies for the arresting ad. "These are hard-hitting images because we really felt we need to drive home a point that large portions are not completely benign," he told Reuters. The campaign's overall message is that reducing portion sizes can reduce the risk of type 2 diabetes, which is linked to obesity and poor eating habits (unlike type 1 diabetes).

It's true that portion sizes have ballooned over the past decades. A 1950s-era ad for soda, found on the site Sociological Images, labels a 12-ounce can as "king-size" because it contains "two full glasses." Compare that to today's "small" beverage serving atMcDonald’s, which holds 16 ounces. If you're really thirsty, a large Coca-Cola Classic from the same burger chain holds 32 ounces — and contains a whopping 310 calories. And a 2011 study in the American Journal of Clinical Nutrition found that drinking sugar-sweetened beverages, including sodas, significantly increased the risk of type 2 diabetes in men.

People with diabetes are also at increased risk of amputation due to uncontrolled blood sugar levels. High blood sugar can lead to nerve damage, which can make feet and legs numb and increase the frequency and severity of injuries. By the time a cut or ulcer is noticed, an infection may have already spread.

Posters for the new campaign began appearing in the city's subway trains this week. According to the Daily News, New York's outspoken mayor, Michael Bloomberg, is a fan: “What do you want to do? Do you want to have people lose their legs? Or do you want to show them what happens so that they won’t lose their legs?" But the American Beverage Association, a trade association representing non-alcoholic beverage manufacturers and distributors, issued a statement saying that the health department is using "scare tactics" and creates an inaccurate picture.

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