Abstract
During this past school year, many people have begun to seriously question the wisdom of having soft drinks and other nonnutritious snacks readily accessible to students in schools. Factors that have spurred this discussion include the epidemic of obesity among children, the increase of Type 2 diabetes in youth, and the importance of developing and reinforcing healthy lifestyles during childhood. Having soda pop and other snack foods available in vending machines located in schools is contradictory to the positive health messages learned in health class and the prevailing knowledge of what constitutes a healthy diet. At this time, many schools are reexamining their policies about what vending machines should dispense, where they should be located, and what hours they are available. Other schools have decided not to renew existing contracts or to add healthy options at affordable prices in their vending machines, whereas others are considering prohibiting the sale of soda pop and snack foods altogether (Severson & Delgado, 2003).
However, as we are all aware, eliminating soda pop and nonnutritious foods from schools is not as easy as it might seem. Schools have had a difficult time in fully funding their program and equipment needs for years. With the current economic turndown, nearly 40 states are now experiencing serious budget deficits, necessitating draconian cuts in state budgets involving basic services—including education at all levels. Faced with dwindling budgets and no relief in sight, schools are understandably anxious to find revenue sources to replace lost funds. By signing an exclusive contract with a soft drink vendor, schools can expect to add thousands of dollars to their coffers. These monies are used to fund extracurricular activities, to update equipment, to purchase academic materials, and even to fund salaries. The National Soft Drink Association (1999) estimates that about 60% of middle and high schools have soft drinks available, illustrating the extent of the availability of these products to students. Contracts with schools are not only profitable to the schools, but are also profitable to soft drink companies, which also gain access to children, who begin using their product early. In addition, the soft drink companies get name recognition of their products through advertisements and their presence in the school setting. This name recognition will produce loyal consumers long past the time students are in school.
Soft drinks are a major part of the diet of American children, who begin consuming these products early in life. In fact, children and adolescents are the heaviest consumers of these beverages (LaDuca, 2001). So why the concern? As we examine the dramatic rise in overweight children and teens, it becomes evident that there are many factors to consider, including total number of calories consumed and the decrease in physical activity by today’s children. A major concern is that students who drink soda pop are less likely to get the recommended amount of calcium and other nutrients in their diets. “As adolescents have increased their consumption of soft drinks by two or three times since the 1980s, they have also cut their milk consumption by more than 40%” (National Association of School Nurses, 2002). Many female adolescents avoid milk because they believe it is fattening. Instead, they substitute diet soda, which not only has no calories but also provides none of the nutrients so essential during this period of rapid growth and maturation.
Another consideration that needs to be emphasized is the effect of soft drinks on dental health. Dental caries is considered the most common chronic disease in children (Iowa Department of Public Health, 2002). Frequent ingestion of high-sugar foods and beverages is a major risk factor for dental caries or decay. Bacteria, which are normally present in the mouth, break down or digest the sugar in soft drinks or high-sugar drinks to produce an acid. This acid gradually dissolves or erodes the enamel or hard surface of the tooth, resulting in decay. The acidity of beverages is measured in units known as pH. “A pH below 7 is considered acidic. For example, tomato juice has a pH of 4.1 and lemon juice has a pH of 2.3” (Marshall & Cunningham, 1998). All soft drinks are acidic, creating an environment that may promote dental erosion over time (Table 1). The highly acidic pH of soda in combination with sugar in soda pop creates an ideal environment for the development of dental caries. Although diet soda does not contain sugar and cannot form acid from this beverage alone, when consumed with other foods high in sugar or carbohydrates, it can produce acid that leads to erosion. Dentists have noted an increase in teens presenting with rampant decay associated with soft drink consumption, especially among those who work in fast-food establishments where there is unlimited access to soda pop. The continual bathing of teeth with a liquid that is acidic and high in sugar can result in dental decay that is not only disfiguring but also presents serious health risks.
Although soft drinks are a major part of the diet of America’s youth, it is evident that they do not contribute to their health during these years of high activity and rapid growth. In fact, the extra calories consumed may contribute to obesity, and contact with this acidic beverage may promote dental caries. The role of schools is not only to educate children about good health, but also to promote an environment that is conducive to health by providing healthy choices. This is especially important as we attempt to prevent the many long-terms effects of chronic illness seen in today’s adults.
School nurses have the opportunity to let their voices be heard on this important issue (Denehy, 1999). They need to role model healthy eating habits and lifestyles to the children and staff of their schools. They also must lead in the “Cultural Transformation” recommended by Surgeon General Dr. Richard Carmona in choosing a healthy lifestyle in our fight against the epidemic of obesity and the pressures for nonnutritious choices in today’s culture. The National Association of School Nurses’ Position Statement: Soft Drinks and Candy in the Schools(2002) recommends that school nurses work with administrators, school organizations, and the community “to encourage them to reconsider the selling of soft drinks and snacks by companies that profit at the expense of the health of American youth.” This issue has brought us to show what we are made of as a society. “What is more important, children’s health or funding?” (Iowa Department of Public Health, 2002, p. 1).