Workplace Ban on Sugary Beverages Sale Improves Employee Health

A recent study evaluated the impact of a workplace ban on the sale of sugar-sweetened beverages. According to the results, prohibiting the sale of sugar-sweetened beverages in the workplace not only reduced employees’ consumption of these beverages but also significantly reduced employees’ waist circumferences.

“This shows us that simply ending sales of sugary drinks in the workplace can have a meaningful effect on improving health in less than one year,” lead study author Elissa Epel, PhD, UCSF professor of psychiatry and director of the UCSF Aging, Metabolism, and Emotions Center, said in a press release. “There is a well-known pathway from soda to disease. High sugar intake leads to abdominal fat and insulin resistance, which are known risk factors for diabetes, heart disease, cancer and even dementia. Recent studies have also linked sugar intake to early mortality.”

According to Dr. Epel and her colleagues, the intake of sugar-sweetened beverages—including sodas, sports or energy drinks, “fruit” drinks, and sweetened bottled teas and coffees—is a significant risk factor in obesity and cardiometabolic disease and is associated with 180,000 annual deaths worldwide. Collectively, these drinks account for about 34% of the added sugar in the American diet and are consumed disproportionately by socioeconomically disadvantaged populations. Previous research has found that these beverages pose a greater risk for metabolic health outcomes compared to equivalent sugar levels consumed in foods.

The study, published in JAMA Internal Medicine, took place from July 28, 2015, through Oct. 16, 2016, and assessed sugar-sweetened beverage intake, anthropometrics, and cardiometabolic biomarkers. The participant population included 214 employees at a Northern California university and hospital who were considered frequent sugar-sweetened beverage consumers, which was defined as consuming ≥360 mL (≥12 fl oz) per day. Data were collected before and 10 months after the implementation of a ban on the sale of sugar-sweetened beverages in the workplace. Half of the cohort was also randomized to undergo a motivational sugar-sweetened beverage-reduction intervention. The main outcome measures included sugar-sweetened beverage intake, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and abdominal adiposity measures; the main associations analyzed were between sugar-sweetened beverage intake and HOMA-IR changes.

More than half of the participants (n = 124, 57.9%) were female; mean age (SD) was 41.2 (11.0) years, and mean body mass index at baseline was 29.4 (6.5) kg/m2. Participants reported a baseline daily sugar-sweetened beverage consumption of 1,050 mL (35 fl oz)—compared to 540 mL (18 fl oz) at follow-up, marking a 510-mL (17-fl oz) (48.6%) decrease (P<0.001). A correlation was observed between reduced sugar-sweetened beverage intake and improved HOMA-IR (r=0.16; P=0.03). Patients randomized to the intervention had a greater mean (SD) reduction in sugar-sweetened beverages compared to those who did not receive the intervention: 762.0 (84.0) mL (25.4 [2.8] fl oz) vs. 246.0 (84.0) mL (8.2 [2.8] fl oz). Significant reductions in mean (SE) waist circumference were observed from baseline to follow-up (2.1 [2.8] cm; P<0.001).

“This is a group of people who were at high risk for early onset of metabolic diseases and probably cancers as well,” said Dr. Epel. “They were drinking at least one sugared beverage a day. The participants who were overweight or obese already had very high levels of insulin resistance, in the pre-diabetic range, and the lean participants were also insulin resistant. Regardless of whether they were overweight or lean, most of the participants in the study tended to lose belly fat when they were offered a healthier beverage selection at work.”

One of the study’s limitations is that there was no control group, according to Dr. Epel; however, she said, “The natural trend over a year is to gain a small amount of weight and abdominal fat. Thus, it is encouraging we saw no average weight gain and a reduction in waist size. Nevertheless, it is critical to have a control group for changes in culture. Our research group is currently examining the effects of a sales ban in a large controlled multi-site trial of hospitals in collaboration with Sutter Health.”