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Given sugary drinks’ health dangers, why does the Mayo Clinic still sell them?

Soft drink vending machines
Tufts University researchers linked sugar-sweetened drinks to 184,000 adult deaths worldwide each year.

Two weeks ago, HealthPartners announced it was going to eliminate 80 percent of all sugar-sweetened sodas and other beverages from its vending machines and cafeterias by Jan. 1.

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). 

Limitations

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.”

You’ll find an abstract of the Circulation study on that journal’s website. You can read Scott’s article on the Post-Bulletin’s website.

Comments (4)

  1. Submitted by Pavel Yankovic on 07/13/2015 - 12:34 pm.

    Mayo Clinic….

    sells “sugary” drinks because it is profitable.

  2. Submitted by Wes Nigon on 07/13/2015 - 03:01 pm.

    Wow

    Were does personal accountability come into play?

  3. Submitted by Ray Schoch on 07/14/2015 - 07:03 am.

    Yes

    Both Mr. Yankovic’s and Mr. Nigon’s comments have merit. So does the implication in the article that, as a leading health care institution, Mayo has an ethical obligation, if not a legal one, to provide an example for patients, staff and the community. That said, I didn’t see anything in the article demanding that Mayo eliminate sugary drinks altogether. Perhaps if, as HealthPartners has done, Mayo cut back the number and amount of sugary drinks to 20% of what’s offered in vending machines and eating facilities, the example would have the desired effect. Suppliers of said sugary drinks can be counted upon, of course, to complain loudly about the unfairness of being singled out, though their arguments will be strictly self-serving.

  4. Submitted by Bill Schletzer on 07/14/2015 - 09:07 am.

    WOW – I’m just “ASTOUNDED” by this “TERRIBLE MESSAGE”

    …that there are vending machines dispensing candy instead of carrot sticks and tofu. Nothing takes away that craving for a brownie or Reese’s Peanut Butter Cup like a nice dish of kale.

    Is it true that one of the “assumptions” in this “modeling study” is that if there were no sugar in the world then all humans would live to 100, when they would just naturally pass their expiration date free of all disease? It is my understanding that death is not “preventable” and that manipulating statistical data to show some alarming result to try to create some knee jerk reaction is just silly. Every day humans eat meat, drive cars, snack, sleep too much, fail to exercise, age, exist. But there is always an expert pushing an agenda that is shocked and dismayed by those choices and wants to take those choices away. I don’t drink sugared drinks because I don’t like them but I don’t see where the Mayo has an “ethical obligation” to prevent me from having a candy bar if I am visiting someone ill enough to be under their care. Maybe they should first get rid of all the ash trays outside the employee entrances.

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