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Logo of archdischArchives of Disease in ChildhoodVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Arch Dis Child. 2007 October; 92(10): 860.
PMCID: PMC2083228

Mixed messages

Health promotion, an objective of most hospitals, can be compromised by commercial or other interests. The consumption of fizzy drinks, especially those with a high sugar content, is known to be harmful to childrens' health. There are also strong associations with tooth decay and obesity, the latter being linked to an increase in diabetes and cardiac disease in the adult population.1

Less well known is the interaction of acidic drinks with some drugs, most notably carbamazepine, which is an anticonvulsant commonly used in paediatric practice.2 There is also an association with fizzy drink consumption and reduced bone mineral density in girls, which may be related to these drinks displacing milk in the diet.3

Increasingly, machines dispensing soft drinks are being introduced into schools with the expected consequences.4

The vending machine shown in fig 11,, which was in a local paediatric unit, was placed beside the outpatient waiting area. There were no healthy alternative drinks available. Waiting children were drawn to this machine and often demanded these drinks from their parents. Ironically it is strategically placed close to notice boards advocating healthy eating and diabetes awareness.

figure ac125740.f1
Figure 1 The vending machine next to information on diabetes.

It has, finally, been removed following the closure of the adjacent inpatient ward.


Anthony Cohn, Watford General Hospital, Vicarage Road, Watford WD18 0HB, UK;

Competing interests: None.


1. Mrdjenovic G, Levitsky D A. Nutritional and energetic consequences of sweetened drink consumption in 6‐ to 13‐year‐old children. J Pediatr 2003. 142(6)604–610.610 [PubMed]
2. Malhotra S, Dixit R K, Garg S K. Effect of an acidic beverage (Coca‐Cola) on the pharmacokinetics of carbamazepine in healthy volunteers. Methods Find Exp Clin Pharmacol 2002. 24(1)31–33.33 [PubMed]
3. Wyshak G, Frisch R E. Carbonated beverages, dietary calcium, the dietary calcium/phosphorus ratio, and bone fractures in girls and boys. J Adolesc Health 1994. 15(3)210–215.215 [PubMed]
4. American Academy of Pediatrics Committee on School Health Soft drinks in schools. Pediatrics 2004. 113(1 Pt 1)152–154.154 [PubMed]

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