A few months ago Dr. Maria Barrell, a family practice resident in Duluth, Minn., had a patient admitted to the hospital. The woman had recently been diagnosed with diabetes.
"I came into see her, and she had a big jug of Mountain Dew next to her," Barrell said. "I kind of glanced at it and said, 'Does that taste good to you right now?' Because she was really sick."
Barrell had had a long talk with the patient about the negative health effects of sugar-sweetened beverages. One 12-ounce can of Mountain Dew, for example, contains almost three tablespoons of sugar. They are linked to obesity and diabetes, cardiovascular problems and a heightened risk of stroke.
That has spurred some in the medical community to action. In the last few months, several hospitals in northeast Minnesota have stopped selling soda and other beverages that are sweetened with sugar. They are at the forefront of a growing national trend among health care facilities that are trying to combat the nation's obesity problem. Hospitals need to reinforce that message, Barrell said.
"If we're sitting in clinic telling them to stop drinking sugar-sweetened beverages, then [it's] the best place to do that," she said. "We've got a captive audience in the hospitals, and we have patients who stay several days at a time. We need to be promoting those practices within the hospitals."
St Luke's Hospital in Duluth stopped selling sugar-sweetened beverages last November. "Everything on that fountainhead is all zero calorie or sugar-sweetened beverage free," said Mark Branovan, the hospital's director of hospitality services, as he pointed to the cafeteria's options.
Since St. Luke's phased out sugary drinks, hospitals in Grand Rapids, Grand Marais and Two Harbors have followed suit.
Branovan acknowledged that the hospital could go even further.
"We can remove the cinnamon rolls and the cookies, and all the other sugary treats," he said. "But we look at this as the first step to promoting healthier food within our health care organization."
There are more than 5,000 hospitals in the country. Of those, probably fewer than 100 have banned sugary drinks, said Jamie Harvie with the Duluth-based Institute for a Sustainable Future. The health and environmental advocacy group has challenged hospitals not only to ban sugar-sweetened beverages, but also to buy local food and do more to promote breastfeeding.
"People, patients, community look to hospitals as models of health and wellness," Harvie said. "And so that's why health care engagement on this is so important."
The idea is also moving beyond hospitals. Several local governments, from San Francisco to San Antonio, have stopped selling sugary drinks in public buildings. New York City, in a highly publicized case, is trying to ban the sale of supersized sodas. After the soft drink industry challenged the ban, a judge struck it down, calling it arbitrary and capricious. But the city has appealed the decision.
Advocates of phasing out the drinks in northeast Minnesota hospitals say the new policies generally have been well received.
Some people have complained about losing choices, said Bri Solem, Healthy Communities Partnership guide for Grand Itasca Clinic & Hospital in Grand Rapids.
"At the end of the day, we really are not the food police," Solem said. "We're not trying to tell people what they can and cannot drink. If you want to drink a Coke, you can certainly bring one in your bag when you come to the clinic or hospital. We are just not providing it; we're not selling it or serving it."
Others have complained the hospital is effectively promoting diet soft drinks with artificial sweeteners, Solem said.
"And there's definitely some talk about 'are they healthy?' Probably not," she said. "But better for you than a sugar-sweetened beverage? Maybe."
Recent research has suggested a possible connection between artificial sweetener and obesity and higher diabetes risk.
But the link between sugary soda and health problems is much clearer.
Health care providers like Barrell believe banning sugary drinks can make a big difference.
Three months after her visit to the hospital, the Mountain Dew-sipping patient had lost nearly 15 pounds. "And she said, 'After talking with you in the hospital, I stopped drinking Mountain Dew, and all I drink now is water; that's all that tastes good to me,'" Barrell recalled.
That one change meant the patient no longer needed medication for her diabetes. Barrell hopes more hospitals phase out sugary drinks, and more patients see their health improve.