Sugar Me Not

By  |  August 1, 2019 | 

My bugaboo on the nutrition front has been and will always be, sugar-sweetened beverages (SSB), aka, liquid candy (or death).  The causes for widespread use are many: sugar subsidies, marketing, social mores  (think soda in baby bottles or at nightly meals within certain groups), and education. The only proven strategy to reduce consumption, not just in select cities here, but internationally, is taxes. Whether taxes on SSBs shift purchasers to other equally unhealthy foods or sends them to the adjacent (non-taxed) state or county for bulk buying is a longer-term (ongoing) endeavor. Nonetheless, it’s the best we got now.

With that in mind, see the heat map below studying 2010 international liquid sugar intake. Just for kicks, see where the US (or your country of origin) sits. Mexico and Central America are outliers with the US not far behind. Also, note European consumption—with an intake  <50% of ours. If you want to see how corporate giants play the game, incidentally, read these excellent stories reported from Mexico or India–both from the same NYT series. It will boil your blood.

What to do?

Nurses, PCPs, and yes, even hospitalists have little time–and nutrition counseling is a 15-30 minute undertaking. If I have to focus on one thing, though, its all about SSBs in my book.

In fact, if you see the pic below the map, and maybe you have come across something similar, you will get an idea of how to make a clever point super quick. If you try and hammer home calorie limits, you will likely fail as many patients have no context or grasp on how to judge how to track them. But showing them a mound of white powder? That they get–and how, and several dentists have these types of filled bottles on their reception counters. It’s a skillful play in visual doing what words could never do.


One Comment

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    Emily T, RD August 2, 2019 at 11:22 am - Reply

    SSBs are often the lowest hanging fruit when it comes to positive diet changes, I think this is a great idea. Don’t forget that Registered Dietitians are here for a reason, we often have longer to spend doing nutrition counseling with patients and I think we are often underutilized. 🙂

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About the Author: Bradley Flansbaum

Bradley Flansbaum
Bradley Flansbaum, DO, MPH, MHM works for Geisinger Health System in Danville, PA in both the divisions of hospital medicine and population health. He began working as a hospitalist in 1996, at the inception of the hospital medicine movement. He is a founding member of the Society of Hospital Medicine and served as a board member and officer. He speaks nationally in promoting hospital medicine and has presented at many statewide meetings and conferences. He is also actively involved in house staff education. Currently, he serves on the SHM Public Policy Committee and has an interest in payment policy, healthcare market competition, health disparities, cost-effectiveness analysis, and pain and palliative care. He is SHM’s delegate for the AMA House of Delegates. Dr. Flansbaum received his undergraduate degree from Union College in Schenectady, NY and attended medical school at the New York College of Osteopathic Medicine. He completed his residency and chief residency in Internal Medicine at Long Island Jewish Medical Center in New York. He received his M.P.H. in Health Policy and Management at Columbia University. He is a political junky, and loves to cook, stay fit, read non-fiction, listen to many genres of music, and is a resident of Danville, PA.


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