Last year, thirsty people in the northern Minnesota town of Fosston bought 2,539 bottles of sugary drinks from the local hospital’s pop machines.

Those sales went flat on Jan. 1 when Essentia Health-Fosston joined the small but growing trend of medical centers eliminating the sale of sugar-sweetened beverages.

“We’re trying to make a small step to improve the health of everyone in this area,” said Kevin Gish, the hospital’s administrator.

Hospitals have become another arena for public health advocates who previously pushed to reduce or eliminate sugary drinks from schools and other workplaces. The beverage industry is troubled by the trend, saying people should have the choice to buy what they want. Advocates counter that the changes are helping give healthier choices the prominence they’ve lacked in the past.

Hospitals are trying to balance both goals, even as more are tipping the scale toward concerns about the link between beverages and obesity. Along with Fosston, several hospitals in Duluth and the Twin Cities are cautiously making changes to their vending machines, cafeterias and meals served to patients.

The Minnesota Hospital Association doesn’t know exactly how many medical centers are shaking up sodas. But in focus groups last fall, the trade group asked Minnesotans about the idea of eliminating the choice of sugary drinks in the hospital.

“It was very clear — don’t take away the pop,” said Wendy Burt, spokeswoman for the group. “As much as we think it might be helpful [to eliminate the drinks], there is a public opinion we have to take into account.”

At Hudson Hospital in Wisconsin, it all started when the cafeteria got rid of its deep-fat fryer in 2008. The hospital wanted to tout healthier food and drink options, and Marian Furlong, hospital president, admits some in the community were bothered by the change.

“We got rid of our very popular fish fry,” Furlong said.

Even so, the health kick continued over the years. It branched out to include more locally-grown food in the hospital cafeteria and fewer sweet drinks. Last year, Hudson Hospital sold its lone vending machine for sodas, and now sells only sparkling and infused water, fruit juices, milk, coffee and tea.

Like other hospitals that have made the change, workers and visitors are allowed to consume sweetened drinks at the hospital, but it’s strictly BYOB.

Hudson Hospital patients recovering from surgery used to be offered ginger ale, since some think ginger helps with nausea, said Jean Weiler, manager of nutrition care. Now, those patients are offered ginger tea and ginger lozenges.

“How we’ve been going about this is to gradually change the environment, so you’re having a situation where the better choices are easy, because it’s part of the environment that you’re in,” Weiler said. “People gradually go in that direction.”

Coffee drinkers at Hudson Hospital still can find sugar packets for their drinks, but that wasn’t the case when St. Luke’s Hospital in Duluth started making changes in 2012. The hospital eliminated sugar-sweetened beverages, offering instead such drinks as sugar-free Snapple and Diet Coke.

Some have questioned whether diet drinks actually constitute healthier options, noted Michael Boesalager, the hospital’s director of materials management and hospitality services. But at this point, St. Luke’s hasn’t passed judgment on the issue, Boesalager said.

Occasionally, some complain that the hospital’s policy is uneven, he said. Why sell cookies, but not sugared beverages? The general response is: “We’re not here to change all choices around food items or drinks,” Boesalager said. “You’re not going to meet 100 percent of all needs.”

In the year following the change, sales of cold beverages from vending machines at St. Luke’s dropped by about 30 percent, Boesalager said, and held steady during 2014. St. Luke’s recognizes that changes aren’t set in stone — sugar packets, for example, are once again available to coffee drinkers.

In Fosston, hospital officials decided to toss sugary pop at New Year’s to correspond with people’s fitness resolutions, said Gish, the hospital administrator. He’s rolled with the change himself, switching from Mountain Dew to daily purchases of sugar-free water infused with vitamins.

At least one patient has been surprised by an inadvertent purchase of diet soda.

“He didn’t look quite closely enough at the button he was pushing,” Gish said.

Essentia Health-Fosston collected 15 cents from the sale of each bottle of sugary soda, generating about $380 last year.

“I think we will look back on those days when we were almost contributing to diabetes, profiting from the sales of those beverages — and we will say: What were we thinking?” Gish said.

An advocacy group in Duluth called the Institute for a Sustainable Future has a challenge program for hospitals that asks them to drop sugary beverages. About 10 health care groups in Minnesota and Wisconsin have done so.

Two national groups also are pushing hospitals to promote healthier food and beverage options, said Julie Ralston Aoki, a staff attorney who is tracking the hospital trend for a public health center at William Mitchell College of Law in St. Paul.

Last fall, Minneapolis-based Fairview Health Services said it would join one of these programs, which calls for hospitals to buy 80 percent “better-for-you beverages,” such as water, juices, milk, coffee and tea. In 2010, the Cleveland Clinic became one of the first hospitals to stop selling sugar-sweetened beverages, Ralston Aoki said, adding that medical centers in at least seven other states have followed suit.

Good health is central to a hospital’s mission, so it makes sense for medical centers to eliminate drinks that have been linked health problems and offer little or no nutritional value, Ralston Aoki argued.

“Sugary beverages are the low-hanging fruit of the obesity crisis,” she said. “Why is it that there should be so much junk food … so cheap and so easy to buy, and it’s so hard to get healthy food?”

Tim Wilkin, president of the Minnesota Beverage Association, said his trade group appreciates that Minnesota hospitals seem to be making changes as part of a broader push that doesn’t single out soft drinks.

The industry is already dealing with tough sales with soda consumption on a nearly decadelong decline in the U.S. through 2013, according to Beverage Digest magazine. Nielsen reports that U.S. soft drink sales dipped another 2 percent for the 12 months ended in November.

Beverages contribute a small share of all calories that most people consume, Wilkin said. The obesity problem in the United States can’t be solved, he said, without looking at all foods plus the need for exercise.

Manufacturers, bottlers and distributors are making available more low- and no-calorie options for soft drink consumers, Wilkin said, and have made calorie counts more prominent on cans and bottles. But they oppose restricting choices.

“You’ve got hospital situations where you’ve got a family that’s clearly in a stressful situation,” he said. “They just want to go down to the cafeteria, have their meal, and enjoy their beverage of choice.”


Twitter: @chrissnowbeck