The Minnesota-based health-care provider gave a simple reason for its decision: “to promote better health for patients, visitors and staff.”
HealthPartners’ announcement was well timed. Just a few days later, researchers from Tufts University published in the journal Circulation the first detailed global report on the effects of sugar-sweetened drinks on death rates. And the findings were anything but sweet.
The study, which used data from several sources, including 62 dietary surveys involving more than 600,000 people living in 51 countries, came to some disconcerting conclusions. It linked sugar-sweetened drinks — sodas, fruit drinks (but not pure fruit juice), energy drinks, sweetened teas and homemade sugary drinks (such as frescas) — to 184,000 adult deaths worldwide each year.
Most of those estimated sugary-drink-related deaths are from diabetes (133,000). The others are from cardiovascular disease (45,000) and cancer (6,450).
That’s about 1.2 percent of all deaths from those diseases worldwide. Yes, that’s a small number, but remember: These are all preventable deaths.
Three-fourths of the deaths occur in low- and middle-income countries. But the United States is far from spared. Sugar-sweetened drinks may be responsible for 25,000 deaths among American adults each year, according to the study.
In fact, the study identified the United States as having the fourth-highest death rate associated with sugar-sweetened drinks: 125 per million adults per year. Mexico topped the list with 405 deaths per million adults, followed by South Africa (153 per million) and Morocco (137 per million).
This was a modeling study, which means its authors had to make several assumptions about the impact of sugar-sweetened drinks on disease and death worldwide — assumptions that may or may not be correct. There is no ethical and feasible way, however, of conducting a large, long-term randomized controlled trial on the health effects of sugar-sweetened drinks, so we must use the results of studies like this one to help guide us on this topic.
Plenty of other research has found strong associations between sugar consumption and higher rates of chronic disease, however.
Research has also shown that most of us eat far too much sugar. Although sugar consumption in the United States has been on the decline in recent years, a study published in 2014 found that 71 percent of Americans get more than the recommended 10 percent of their daily calories from added sugars in food and drinks. (Many health experts believe that recommendation is too generous and should be lowered to 5 percent.)
In American diets, sugar-sweetened drinks are the main source of added sugars, according to the American Heart Association.
Mayo’s puzzling position
With the growing evidence about the negative impact of sugar-sweetened drinks on health, and with health-care organizations across the country — including, most recently, HealthPartners — announcing that they will no longer sell or serve these products in their facilities, the position of the Mayo Clinic on the topic seems, well, odd.
For, as Paul John Scott, a reporter for Rochester’s Post-Bulletin, explained in an article published over the weekend, Mayo — Minnesota’s largest health employer — has yet to do anything about selling and serving sweetened snacks on its premises.
“We strive to provide healthy options for our patients, visitors and staff,” the clinic told Scott in a statement, “but there are no immediate plans to ban soda or snacks in vending machines.”
Sugar has “a strong presence at Mayo,” writes Scott.
Catering trays at Mayo events still contain cookies, lunches often come with dessert, sheet cakes are still cut into at mid-afternoon Mayo Clinic celebrations, and employee-hosted bowls of candy greet visitors at many departments.
Clinic vending policy is likely a compromise factoring in the demands of hosting a 24/7 workplace and long-held regional preferences for baked treats and sweetened beverages. Clinic visitors come through its doors at a challenging moment in their lives, many of them no doubt hoping to take a break from difficult treatments with the familiar sugar-laden foods that give them comfort.
Internally, the clinic has made strides in offering alternative, healthier fare throughout its patient and employee dining areas. The Dan Abraham Healthy Living Center cafeteria, for example, offers extensive array of whole foods, and strives to educate diners about food preparation as well as feed them.
But the clinic also has scores of vending machines, in dining areas and staff break rooms, offering sweetened sodas including Pepsi, Dr. Pepper and Mountain Dew, a drink that contains 77 grams or 19 teaspoons of sugar; snacks such as Klondike Bars, Choco Tacos, Creamsicles and Drumsticks; and candy such as M&M’s, Reese’s Peanut Butter Cups, Snickers and Skittles. They’re in areas frequented by both patients and staff.
‘A terrible message’
Scott interviewed several national health experts who were astounded to learn of Mayo’s continued unwillingness to remove unhealthful foods from its medical settings.
As Janet Wojcicki, a nutritionist and epidemiologist at the University of California San Francisco, told Scott: “Wow.”
Wojcicki wrote a 2014 commentary in the journal Acta Paediatrica that called on hospitals to remove unhealthful food.
“I just feel very strongly that a health-care environment should be at the forefront in terms of a healthy lifestyle,” she said. “If we are selling clearly unhealthy beverages and food items, we’re sending a terrible message to the community and to those people that look up to health professionals for guidance in terms of lifestyle and nutrition.”