Doctors have called on workplaces to ban sales of sugary drinks after research showed that removing them from cafes, canteens and vending machines helped reduce people’s waistlines and improve their health.
Researchers monitored more than 200 staff at the University of California in San Francisco and its associated hospital after a ban was introduced in 2015. Before the ban, the participating staff consumed on average more than a litre of sugary drinks daily, but 10 months later had slashed their intake by nearly half.
Medical assessments of the staff found they had lost an average of more than 2cm around the waist, and that those who reduced their sugary drink intake tended to have better insulin resistance and lower cholesterol.
“A simple sales ban has meaningful effects on employees’ health,” said Elissa Epel, a professor of psychiatry who led the work. “This is very exciting news, because to eliminate sales of sugary beverages is something any institution can do.” The ban was only on sales and did not prevent people from bringing sugary drinks to work, or buying them off-site.
Beyond investigating the impact of the sales ban itself, Epel randomly assigned half of the staff to also receive a motivational intervention. This involved showing them how much sugar they were consuming – for example, one sugary drink per day was equivalent to a plastic cup half full of sugar cubes. The staff were also given information on how sugar harms health and were helped to identify reasons they might want to adopt a healthier lifestyle.
Eating too much sugar contributes to people having too many calories during the day, which can lead to weight gain. Being overweight increases the risk of health problems such as heart diseases, type 2 diabetes, and some forms of cancer. Sugar is also one of the main causes of tooth decay.
The NHS advises that most adults and children in the UK eat too much of a type of sugar called ‘free sugars’. These are the sugars added to food and drinks, found in biscuits, chocolate, breakfast cereals and fizzy drinks. But they are also found naturally in honey and unsweetened fruit juices.
The UK government’s recommendation is that these ‘free sugars’ should not make up more than 5% of the calories you have every day. That is still quite a lot of sugar – it equates to seven sugar cubes worth for an adult. But bear in mind that one can of a fizzy drink can include the equivalent of 9 cubes of sugar. Children under 4 should avoid all sugar-sweetened drinks and food with added ‘free sugars’ in it.
Martin Belam
According to the report in the journal Jama Internal Medicine, sugary drink intake fell 49% on average. The sales ban alone allowed staff to cut their sugary drinks by 23% (246ml) daily. But the intervention had a greater impact, prompting staff to reduce their intake by 73% (762ml) daily.
“We found that for people with overweight or obesity, if they also got the brief counselling discussion, they showed significant reductions in their lipid levels as well. So for heavier people, the extra attention really mattered to them. They benefited the most,” said Epel.
Laura Schmidt, a co-author of the study, said the permanent ban on sugary drinks sales at UCSF was an obvious move. “These days, most of what we are treating in our healthcare system is chronic diseases, such as diabetes, heart disease, cancers and Alzheimer’s. All of these conditions can be linked back to the calorie-dense, nutritionally poor standard western diet”, she said. “It made sense for a health sciences campus like UCSF to say no to profiting off the sales of products that cause the very diseases we treat in our hospitals and clinics.”
Aseem Malhotra, an NHS consultant cardiologist and professor of evidence-based medicine, said: “This latest research not only solidifies the evidence that the positive health impact of sugar reduction is independent of body weight, but that removing the sale of sugary drinks from the working environment is a key solution to combating diet-related disease amongst staff.
“It’s an absolute scandal that our hospitals have become a branding opportunity for the junk food industry and not surprising that more than 50% of healthcare staff are now overweight or obese. If we truly want to reverse obesity and its associated diseases we must stop selling sickness in the hospital grounds.”
Simon Stevens, the NHS chief executive, said: “Since the NHS first asked hospitals to reduce sales of sugary drinks we have removed over 32 million teaspoons of sugar – or the equivalent of around 900,000 cans of fizzy pop.
“Obesity is a dangerous public health threat, leading to a string of serious illnesses for millions, with thousands of people ending up in hospital as a result, so every industry needs to take a look at what it can do to support urgent action like reducing sales of sugary drinks to prevent harm and safeguard children.”
