hospital cafeterias: the war on sugar-sweetened beverages

Sodas, juices, energy drinks, lemonade, and sports drinks are some examples of sugar-sweetened beverages, or SSBs. SSBs are any beverages that have added sugar (1).

According to the American Heart Association, SSBs are the main source of sugar in the American diet (2).

High consumption of SSBs is associated with increased risk of obesity, type 2 diabetes and cardiovascular disease in both children and adults (2, 3).

Offices, cafeterias and hospitals sell SSBs on site (4).

If SSBs are associated with such high risk factors...why do hospitals sell them?

Hospital cafeterias are a business (5). They may not always make a big profit, but the goal is usually to sell food and drinks that people will buy.

City officials, legislators, and hospital administrators are catching on and want to change the way hospitals serve food to visitors. They want to set an example for visitors and patients by offering healthier drink options. Some hospitals even lower the price of healthier drinks and raise the prices of SSBs (6)!

Many hospitals are just now changing their policies to reduce or eliminate the sale of SSBs in their hospital cafeterias (7). While this is not yet a widespread change, there are hospitals that have started this trend.

While some hospitals chose to remove all SSBs, others are taking a more moderate approach, utilizing the stoplight system (8).

The stoplight system labels SSBs with colors, like this graphic from the Boston Public Health Department:

This stoplight technique is a quick tool to let you know how much sugar you could be drinking, and lets the consumer decide from there. The stoplight approach can reduce SSB intake and supports healthier drink choices (7).

Other facilities may use the Rethink Your Drink campaign with signs to ask people to think about the extra sugar they are drinking. Bringing awareness usually leads to people making healthier drink choices.

This war on sugar-sweetened beverages continues to sweep our country. You may see other companies, schools, and offices adopting the stoplight system or Rethink Your Drink campaign.

While SSBs are only one part of the obesity epidemic, offering healthier options will continue the fight for public health.

Written by Caroline Wiswell, MS RD LDN


(1) CDC. (2017, April 7). Sugar sweetened beverage intake. Retrieved September 6, 2018, from

(2) Malik, V. S., Popkin, B. M., Bray, G. A., Després, J.-P., & Hu, F. B. (2010). Sugar sweetened beverages, obesity, type 2 diabetes and cardiovascular disease risk. Circulation, 121(11), 1356–1364.

(3) Zheng, M., Rangan, A., Olsen, N. J., Andersen, L. B., Wedderkopp, N., Kristensen, P., … Heitmann, B. L. (2015). Substituting sugar-sweetened beverages with water or milk is inversely associated with body fatness development from childhood to adolescence. Nutrition, 31(1), 38–44.

(4) Wojcicki, J. M. (2013). Healthy hospital food initiatives in the United States: time to ban sugar sweetened beverages to reduce childhood obesity. Acta Paediatrica (Oslo, Norway : 1992), 102(6), 560–561.

(5) Lederer, A., Toner, C., Krepp, E., & Curtis, C. (2014). Understanding hospital cafeterias: results from cafeteria manager interviews. Journal of Public Health Management & Practice, 20(1), S50–S53.

(6) Roeder, A. (2010, June 18). Price increase may be best motivator to swap sugary drinks for healthier ones. Retrieved September 6, 2018, from

(7) Hartigan, P., Patton-Ku, D., Fidler, C., & Boutelle, K. N. (2017). Rethink your drink: reducing sugar sweetened beverage sales in a children’s hospital. Health Promotion Practice, 18(2), 238–244.

(8) Franckle, R. L., Levy, D. E., Macias-Navarro, L., Rimm, E. B., & Thorndike, A. N. (2018). Traffic-light labels and financial incentives to reduce sugar-sweetened beverage purchases by low-income Latino families: a randomized controlled trial. Public Health Nutrition, 21(8), 1426–1434.

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