W82GO Obesity Programme
Children’s University Hospital
Temple Street
10/04/2004

To Whom It May Concern,

Obesity levels in Ireland have reached epidemic proportions, draining resources from healthcare providers and causing a multitude of health problems. For the first time in a century we may be about to enter an era where children’s life expectancy will drop.

Over the past year members of the W82GO team and other hospital staff have developed concerns regarding the current content and location of the vending machines within the hospital. Whilst it may be the case that families attending outpatient appointments require snacks and drinks, the current content of the machines is unjustifiable. The machines currently contain large 275g bags of sweets in place of regular 52g packets, few healthy choices with greater nutritional value and the Coca Cola supplied machine contains few diet options.

Research has shown that consuming foods of high glycaemic index and little nutritional value contributes to childhood obesity ¹´². It is the mission of this hospital to promote good health and we believe it is not appropriate that children awaiting health care in the outpatients department or other areas be subjected to the temptation of sweets and sugar-laden fizzy drinks whilst being given no option to purchase water, milk or healthier snacks. We have also found that the visual bombardment by these machines contributes to children ‘acting–up’ in clinics such as the physiotherapy department. Many children arrive into the outpatients’ dept, purchase a snack before physiotherapy and then behave in a manner during treatment that guarantees a further treat once their session is over.
We are aware that the revenue generated by these machines is valuable to the hospital, but as health care providers can we, the staff of The Children’s University Hospital, in good conscience stand over the range of drinks and snacks we are currently marketing to our service users?

Our suggestion is that the drinks machine should be stocked with water, juice and more diet-drink options. Why not follow the practice of some American hospitals and schools, by providing juices and water at a cheaper price to encourage purchase and also keep profits stable. Between 2002-2003 sales of diet fizzy drinks increased by over six percent³ and as such the substitution of these should not displease our corporate partners. Perhaps we should follow along the lines of the Broadcasting Commission of Ireland and request that the vending machines issue a warning that products should be consumed in moderation and as part of a balanced diet?

The Children’s University Hospital offers a Paediatric Obesity Intervention Service; the W82GO Programme, in an effort to deal with the ever-increasing number of children requiring medical management of this condition. Although the hospital benefits financially by the presence of vending machines, their short-term value in their current form may ultimately contribute to a ‘penny-wise but pound-foolish’ situation in the future, with hospital resources being drained by the medical complications experienced by overweight and obese children. As members of the W82GO team we find it incredibly challenging to continue promoting good eating behaviour and physical activity when our patients receive mixed messages through promotion of products within the hospital.

We ask you that you take the time to reflect both on the current practice and the potential solutions we suggest. If you are satisfied that the current situation is not in the best interest of the children under our care, would you please raise the matter within your sphere of influence.

Looking forward to hearing your views on this subject,

Grace O’Malley
Physiotherapy Dept.

¹ Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of
sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet 2001;357:505-8.

² Harnack L, Stang J, Story M. Soft drink consumption among US children and adolescents: nutritional consequences. J Am Diet Assoc 1999; 99: 436-41.

³ John Sicher editor of Beverage Digest Dec 21 2004