NHS England proposed action to cut sales of sugary drinks in hospitals
engage.england.nhs.uk
engage.england.nhs.uk
The hospital folks messed up reading a chart and put her on a broth diet, and since it was the double whammy of a weekend plus holiday none of the food court places were open, and most vending machines had been pillaged. Our aide/tech took pity on me and swiped a hospital pancake breakfast. I was so thankful that I hugged her... then I tried to eat it. The pancake was like shredded cardboard and elmers glue with that sugar free syrup that gives you the shits. But it was better than broth.
The ironic thing is that I live about 4 blocks from the hospital, and we could see our kitchen window from the room we were in. But navigating the labyrinth of corridors and circumference of the hospital takes 30 minutes (only one door is open on the weekend, because security) and being gone for an hour wasn't ok for me!
Florida Hospital - Orlando (the largest hospital in the U.S. by bed count and revenue) has been doing a lot in recent years to address this concern. They started by making the largest soda you could buy a 16oz (bottled or fountain), and have slowly phased out some food groups (such as fried foods) and have introduced entire cafeterias that only serve fresh vegetarian dishes. They have brought in community coffee shops that only serve fair trade coffee, and are working on setting up a food court type area that will house local restaurants that serve only healthy foods.
Florida Hospital Orlando is the Flagship hospital for Adventist Health, which operates 46 hospitals in the US and 26 hospitals/67 clinics in another 21 countries. It is a model that is being scaled to this other institutions.
FH Orlando isn't a hospital that is known for it's innovative care like the Mayo Clinic or MassGen, but it's size makes it a model for operations that these leading institutions follow.
Except that humans didn't evolve to eat a vegetarian diet and it isn't healthy for us.
The one vegetarian cafeteria is about making the option available to those whom desire it. The food quality is also much higher.
It always amuses me to see "vegetarian" used as a Pavlovian trigger to subconsciously suggest healthfulness. In fact, vegetarian food is often just as laden with starch, sugar, and trans fats as any Wendy's bacon burger.
There's a very similar phenomenon with "organic" - it automatically suggests "healthier", when in fact the pesticides used on organic crops may be even more harmful. More corporate green-washing.
I'll give the benefit of the doubt to your Florida cafeteria until I have a chance to try it, though.
Of course it's possible to make and sell bad vegetarian food, but suggesting that it's "often" just as bad as non-vegetarian food is simply nonsense.
People become vegetarians for all kinds of reasons. I became vegetarian when I learned enough about industrial meat processing to decide that I had absolutely no interest in eating anything that came out of it.
It's much harder to fuck up a salad or a grain/rice/nut thing than it is to disguise the presence of pink slime or some other random body part slurry that most people wouldn't touch if they saw it being made.
I suggest that the ideas of salad and grain have become normalized in our culture, and have taken a sheen of healthfulness beyond their nutritional efficacy. Some greens with a little oil and vinegar: sure. But I see people buy pre-packaged salads from Trader Joe's full of fried noodles, corn, croutons and sweet creamy dressing quite commmonly, apparently under the illusion this is more healthy than meat. And any kind of refined starch (wheat, rice) plays a huge role in diabetes and other modern diseases.
Someone please back me up here, it is fundamentally sick to rank hospitals by revenue, right?
Some hospitals do get higher funding, raise considerably more donations, and since even in the most "socialist" EU and other SPS countries state hospitals are still allowed to provide private healthcare services some also higher revenue through the private route simply by having better administration and more prestigious alumni and or patrons.
There is nothing sick about it, a hospital with better funding and revenue usually can provide better treatment, even the most bureaucratic healthcare systems are not immune to market forces, if nothing else than some hospitals will be better at attracting higher ranking doctors and surgeons and every country, region or large city has the "best" hospital for a specific condition.
At the end even the most equalized healthcare systems are still operating in a finite resource environment, even if the only finite resource is the availability of the best doctor in the country or region, this means that some will be better than the rest, ranking them by revenue usually is an easy way to find out which one it is simply because it's usually directly tied to the quality of the medical staff they can employ.
You are more than welcomed to go and check into the lowest ranked hospitals in your country when you'll get ill, if not then it's a pointless argument at the end regardless of how well you think you equalize your system it will always have better and lesser hospitals.
In fact centralization of talent and resources has a positive outcome rather than a negative one since it doesn't have a major downside but a huge upside.
It's considerably better to have 90 average hospitals and 10 great ones than to have 100 average hospitals since in the 10% of the cases when a great hospital, doctor or surgeon is needed you will still have a place to go.
There is no real way of assembling an all star surgical team in every hospital in the city, not to mention a nation, so even if you would want to forcibly spread doctors (and there were a few countries that tried) and prevent private funds the only thing you get is a worse healthcare system not a better one.
It's a pretty good indicator of operational efficiency.
But to be fair, Becker's has a list for almost everything in a hospital [1].
Also, FH Orlando and most of the other hospitals that dominate the list by revenue/bed size/etc are all Not-For-Profit institutions.
For example, a meat stew with potatoes and some steamed vegetables.
Boring food is probably appropriate for many patients, who won't be in the mood for anything else.
The site for food standards in hospitals is here, but it's not especially informative: http://www.nhs.uk/NHSEngland/AboutNHSservices/NHShospitals/P...
One hospital (group?) menu is here: http://www.salisbury.nhs.uk/InformationForPatients/Departmen...
There's no proposal here to restrict consumption. It's the hospital's choice what they want to sell at their own concessions. They can't sell every possible beverage, so it doesn't make sense to sell sugary ones at the expense of healthier alternatives.
Just like you need to bring your own cigarettes to the hospital if you want to smoke - don't expect the staff to provide them.
(It seems like a pedantic point anyway; the fact that you're under no obligation to provide X does not imply that you don't have a policy restricting your provision of X. Plus, the comparison was to hospital smoking bans not e.g. cigarette vending)
There are probably several factors that influence what foods they offer and which results in their current general policies about what to stock. It probably makes more sense to first audit what those factors are and why they exist; otherwise, additional restrictions are more likely to force them into more expensive options since they'd have to obey the existing (probably ridiculous) constraints.
Obese people and people with poorly controlled type 2 diabetes place considerable strain on primary and secondary NHS care, and thus someone's dietary choices do affect someone else's healthcare.
The health costs - from dental problems to heart disease to diabetes to other fatal illnesses - are beyond tragic.
My dentist told me she regularly has to extract some or all of the milk teeth from kids because they've been rotted by sugary soft drinks. She doesn't like doing it and the parents don't like watching it done. But cause and effect is a thing and she's at the wrong end of it.
Ending massive sugar addiction is going to be the next big social project for medicine.
People who already agree with you might get more energized.
Those who disagree are likely to either (a) dismiss you because they know any discussion is likely going to result in a flame war or (b) jump in because they like the heat.
Those that are concerned about sugar might agree, but hesitate to participate in the discussion because of the flame war potential. Similarly those who are interested in learning more.
You're also making factual claims without providing citations. Like I said, honest question. What's motivating your phrasing?
I would guess, the first time a person comes across this type of statement, they would simply dismiss it.
After hearing similar sentiments from 10 or 20 people, they may start to feel bothered and wonder if they're doing something wrong; if they ought to do research to justify their existing behavior.
Then they may come something like the New Nordic Diet, and find it has an aesthetic appeal; plus they are also primed to appreciate that it addresses the excess sugar problem. This offers a way forward.
Alternatively, they simply come to terms with the fact that other people disapprove of their lifestyle choices. It's just as important to be able to withstand social pressure as it is to eat healthy.
Tooth extraction is the leading cause of child hospitalisation in the UK. This is mentioned in the consultation document linked in this submission.
Employee's caught smoking on campus lose their health insurance (insurer's policy not FH Orlando's).
Not sure what the written reg is for patients, I just know security will show up if you are smoking and escort you back to your room or off the campus.
gosh, that's bad. a fine would be more appropriate.
A person with limited cooking skills and dietary knowledge might have concluded from the food I received, that healthy eating was an unsustainable form of suffering. Everything uniformly tasted like burnt cardboard. I choked it down because I knew that I needed the energy, and counted the hours until I would be released.
I've never understood the urge people have to dictate what other people do right down to what they can eat.
What's wrong with a hospital refusing to sell goods that are detrimental to the health of its visitors?
For US readers, many other nations don't quite have the same fierce focus on 'our freedoms' and so there's far more acceptance of government interventions for the 'greater good'.
As are the counterarguments, which, since we aren't bothering, I won't bother making either.
Just like tobacco.
The reality is that obesity is the cause of all of these food related diseases. Playing politics with which foods get taxed and which do not doesn't strike me as a winning game and will likely evolve into a battleground of special interest groups attempting to get their competition taxed.
You have a rather naive definition of "fact" my friend.
If two of the top hospitals in the world for cardiac care say it I'm willing to bet it's fact.
[1]https://health.clevelandclinic.org/2015/05/your-diet-and-hea...
http://jamanetwork.com/journals/jamainternalmedicine/fullart...
FACT does not mean that it is 100% true - you do not publish one piece of research and all of a sudden, it's FACT.
In science, nothing is ever 100%.
p.s not trying to advocate its bs aand we can eat all the meat we like, im a vegetarian.
Here's one example of terrible reporting: https://www.theguardian.com/society/2015/oct/26/bacon-ham-sa...
> Processed meats rank alongside smoking as cancer causes – WHO
> UN health body says bacon, sausages and ham among most carcinogenic substances along with cigarettes, alcohol, asbestos and arsenic
This headline is mixing up 2 things: the quality of the evidence (which is now as good as the evidence we have that smoking etc cause cancer) and the strength of the effect (smoking is very much more harmful than eating red meat).
It's frustrating that the news reporting was so bad, because it's caused people to reject the science: we know, with a high level of confidence, that processed red meat can cause cancer, although it probably doesn't cause very many cases of cancer.
Yes.
https://www.google.co.uk/amp/s/amp.theguardian.com/environme...
We would probably be just as healthy, if not more so, with two or three meat-free days a week.
1) The taxed items are based on solid, reconciled science rather than best-guess over-extrapolation like we did to fat and cholesterol.
2) Similarly, if and when the consensus shifts, there is a processs to ensure that thes taxes are promptly adjusted.
3) The taxes are diverted, auditably, to the specific maladies the products cause, and rebates against future tax increases if and when they turn out to be too much.
4) People are allowed to be credited the value of the tax paid if they can demonstrate their use of the good is responsible -- e.g. You collect your receipts, you demonstrate you're a healthy athlete, you get the sugar tax back. Show a health liver and clean record, get your alcohol tax back.
3b) (Implication of 3 above) If it turns out e.g. tobacco is saving on health care costs, by causing death before really expensive treatments are given, it starts getting a subsidy from health care revenues.
Measures that don't meet the above tend to come off as "stuff we wanted to do for other reasons and this is an easy target".
But I did not love the stuffy language occasionally found, such as the quote below from the"consultation document":
> Given due regard to the need to eliminate discrimination, harassment and victimisation, to advance equality of opportunity, and to foster good relations between people who share a relevant protected characteristic (as cited under the Equality Act 2010) and those who do not share it; and
To quote Samuel Jackson:
> English, motherfucker! Do you speak it?
And potentially this discussion about the role of language in politics: https://www.youtube.com/watch?v=9ha-PuJlgi0
George Orwell, Politics and the English Language: https://www.theorwellprize.co.uk/the-orwell-prize/orwell/ess...
LOL Three minutes in, Dennis Skinner: "Have you read Maastricht?"
Yes, it's not very readable
Quoting a government healthcare consultation document as an example of language used in the UK is about as meaningful as me going to healthcare.gov, clicking a few links, and then copying a paragraph here.
[1] https://www.cms.gov/Research-Statistics-Data-and-Systems/CMS...
> NHS England’s Chief Executive Simon Stevens is calling on patients and the public to have their say in a ten week consultation on plans to cut the sales of sugary drinks sold in hospitals.
.. whereas the one you quote appears to be aimed at the decidedly narrower audience of:
> Medicare fiscal intermediaries and carriers
You'd imagine if a cancer patient throwing up all the time wanted a Coke/Fanta, It'd great emotionally and health wise.
This, might be a small percent of patients and could be catered to in theory. If patients could chose their meals.
But certainly the hypocrisy you often see at cancer walks where they have sublet the catering to junk food providers can wear a bit thin.
I hope it doesn't go the way of minimum unit pricing for alcohol, which was announced and then withdrawn.
I can easily imagine I'd enjoy a sugary beverage to wash down the horrible hospital food. It isn't a huge stretch (no pun intended) that that might contribute to a more positive attitude and therefore faster recovery - especially if I was used to drinking it at home. Whilst it isn't healthy, I doubt a ban in hospitals would change my mind.
Finally, before implementing this they'd better be 100% sure drinks sweetened "artificially" (i.e. not sugar) are actually better for your health that the sugar-sweetened drinks. I think the jury is still out on that one.
No, the jury is very clear that SSBs are harmful, and very much more harmful than artificially sweetened drinks.
No one credible suggests that artificially sweetened drinks are harmless.
One SSB is pretty harmless. Two is not harmful, etc. Two cans a day for several years? Probably. Worse than eating bigger portions for two years? Depends.
So if we're ignoring nuance, you could say "the jury is very clear that food is harmful", or at least some amount of some foods are equally harmful as SSBs.
> and very much more harmful than artificially sweetened drinks
I know this isn't how science works, but e.g. I found this one meta-study [0] which suggests that "both artificially sweetened beverages and fruit juice were unlikely to be healthy alternatives to sugar sweetened beverages for the prevention of type 2 diabetes". So again, it's not so clear cut at all.
If anything, it's an example of how diverse human metabolism is and/or what a shit-show dietary "science" is.
t The effects of added sugars on various chronic conditions are highly controversial. Some investigators have argued that added sugars increase the risk of obesity, diabetes and cardiovascular disease. However, few randomized controlled trials are available to support these assertions. The literature is further complicated by animal studies, as well as studies which compare pure fructose to pure glucose (neither of which is consumed to any appreciable degree in the human diet) and studies where large doses of added sugars beyond normal levels of human consumption have been administered. Various scientific and public health organizations have offered disparate recommendations for upper limits of added sugar. In this article, we will review recent randomized controlled trials and prospective cohort studies. We conclude that the normal added sugars in the human diet (for example, sucrose, high-fructose corn syrup and isoglucose) when consumed within the normal range of normal human consumption or substituted isoenergetically for other carbohydrates, do not appear to cause a unique risk of obesity, diabetes or cardiovascular disease.
We conclude that the normal added sugars in the human diet (for example, sucrose, high-fructose corn syrup and isoglucose) when consumed within the normal range of normal human consumption or substituted isoenergetically for other carbohydrates, do not appear to cause a unique risk of obesity, diabetes or cardiovascular disease.
Which I believe can be interpreted as saying that looking at what's happening in the normal population doesn't show that added sugars cause unique risk. This, I think, says nothing about the level of sugars that are being consumed as contributing to the increased levels of obesity, diabetes, and cardiovascular disease we're seeing. I don't think it says anything about cutting back on sugar wrt reducing health risk. Subtle point, and perhaps one that's contradicted in the article text itself, but I didn't read the article.