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Coming Together as a Community to Help Families Choose Healthier Beverages


Vanessa Salcedo, MD, MPH, FAAP
May 6, 2019

Seventeen teaspoons! The young mom looked at me with a mix of disbelief and shock, her eyes slowly welling up with tears. I was explaining at her daughter’s well-child visit that a single, 20-ounce soda contains about 17 teaspoons of sugar.

Her daughter, who is only 13 and has obesity, had developed a dark ring around the back of her neck. It’s a sign of insulin resistance, a risk for diabetes. During this visit, my patient discloses that she mostly drinks soda, sports drinks, sweetened-iced tea and does not drink much water. This does not come as a surprise, since statistically adolescents have the highest rates of daily sugary beverage consumption. They freely let me know whenever I ask.

I continued to explain that in the medical community we now know that the risk of developing diabetes is 26% higher for people who regularly drink one or more sugary beverages a day. Now, the tears start free flowing down the mother’s face as she tells me that her husband’s leg was recently amputated -- a consequence of his uncontrolled diabetes.

Families are shocked when @DrVSalcedo tells them a single can of soda has 17 tsp of sugar & drinking it daily, as many do, harms children’s health. With the Bronx leading NYC’s sugary drink consumption, the borough stepped up to support healthier options. #AAPvoices

Sugary beverages: breaking the cycle of overconsumption
As a pediatrician in the Bronx, New York, these stories have become all too familiar. The Bronx leads New York City in consumption of sugary drinks, with nearly a third (31.5%) of our adult residents drinking at least 1 sugary beverage daily, compared to 22.7% citywide. My young patients suffer from preventable diseases such as tooth decay, obesity, diabetes, and even fatty liver disease. And the evidence is clear that sugary beverages are a large contributing factor to these chronic diseases.

For the past decade, the Bronx has placed dead last out of New York State’s 62 counties for health outcomes in the Robert Wood Johnson Foundation County Health Rankings Report. In 2015, community members came together to form a neighborhood health strategy called “#Not62—The Campaign for A Healthy Bronx.” Out of this came The Healthy Beverage Zone project, which was launched in 2017 by Union Community Health Center in partnership with Bronx Health REACH, and the Bronx Neighborhood Health Action Center.

“The goal of our grassroots, cross-sector collaboration is to make it easier for families in our community to make healthier beverage choices, such as water and seltzer, with health care providers and other professionals serving as role models.”


The goal of our grassroots, cross-sector collaboration is to make it easier for families in our community to make he
althier beverage choices, such as water and seltzer, with health care providers and other professionals serving as role models. Healthy Beverage Zones now has 63 official partner organizations, including several community health centers and a local hospital with close to 3,000 employees participating. Staff members are educated on the hazards of sugary drinks, and asked to become “champions” who model healthy drink decisions at work. 

Healthy Beverage Zone also has worked with Bronx health institutions, community based organizations and school to eliminate beverages with added sugar from vending machines, the cafeteria and meetings. In addition, the Healthy Beverage Zone also supported local policy to pass a Healthy Happy Meals bill which will make water, low-fat milk, and 100% juice the default option for all “Kids Meals” in New York City. 


Community-wide change to help families rethink their drinks  
Since the Healthy Beverage Zone launched two years ago, it has received both local and national attention for what is considered an innovative approach to addressing a public health concern. It represents an example of the sort of system-wide change called for in a joint policy statement released last month by the the American Academy of Pediatrics and the American Heart Association to help reduce consumption in children and adolescents. I am thrilled to take part in a small, collaborative, evidence-based approach that can make big and positive impacts toward the health of our community.

I continue to talk with families about how reducing sugary beverages can have a big impact on a child’s health.  Many are still shocked at how much sugar a single can of soda contains. They want to make healthier beverage choices. As health care providers, they deserve our support in and outside the clinic to help make this happen.  

* The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.

About the Author


Dr. Vanessa Salcedo, MD, FAAP, is Director of Health Promotion and a practicing pediatrician at Union Community Health Center with academic appointment at City University of New York School of Medicine/ St Barnabas Hospital Health. Her AAP involvement includes serving as an Executive Committee Member of the Section of Early Career Physician and serves on Council on Community Pediatrics, Council on Communications and Media, Section on Obesity, and Section on Minority Health. She was named one of the 2017 National Minority Quality Forum’s 40 Under 40 Leaders in Minority Health. Follow her on Twitter at @DrVSalcedo, @TheBronxHBZ, and @UCHC_Bronx.