The holiday season means special gatherings with family and friends. It also means overeating, as pre-season game plans and good intentions give way to caloric excess. Less obvious is the damage done by sugary drinks to the diets of adults and children.
The San Antonio Metropolitan Health District wants families, especially families with obese adults or children of individuals with diabetes, to reduce sugary drink consumption this holiday season. A single can or bottle of soda, energy drink, tea, and even eggnog, can contain more added sugar than the human body needs for an entire day.
According to American Heart Association (AHA) guidelines, no more than half of an individual’s daily discretionary calorie intake should come from added sugars.
“For most American women, this is no more than 100 calories per day (about six teaspoons). For men, it’s no more than 150 calories per day (about nine teaspoons),” states the AHA website.
A 12-ounce can of carbonated soda has 132.5 calories from sugar.

Metro Health Director Dr. Thomas Schlenker and his staff have spearheaded the local education/awareness campaign about the dangers of sugary drinks – and the benefits of less-sugary ones. The wording and messaging of the educational campaign to reduce sugary drink consumption in San Antonio is still under review while a series of focus groups and community feedback sessions are undertaken. During one such session last week, visitors were asked to select their preferred logo, message focus, and general “mood” of the campaign.
“We’re basically asking people what would motivate them to change,” said Jennifer Herriot, assistant director of community health for Metro Health. So far, these meetings seem to indicate a community that “doesn’t want to be told what they can’t do … people prefer the message of moderation, of family health.”
“I’m a doctor, it’s my job to tell people what to do,” Schlenker said, smiling, adding that he understands public messaging is a complicated thing.
For example, many people have preferred the use of positive, family images – a mother and daughter smiling as they drink water – associated with the message rather than an image of a diabetes-induced amputated leg or an obese man carrying bags of sugar.
Metro Health has already established one element of the awareness campaign: promoting healthy alternatives to sugary drinks. The Metro Health Staircase Art Gallery’s first show featured enlarged cards from the “Lotería de Aguas” game created for the campaign.

The game and its illustrations were developed through several partnerships, including one with local design and marketing firm Interlex Communications. The agency has donated its work to Metro Health for this project. The game follows the rules of traditional Lotería, a Mexican game of chance, but also provides health facts and recipes for more than a dozen refreshments that can easily replace soda.
“Most of San Antonio drinks at least one soda every day. Drinking soda is not healthy, it’s a big reason why our community is so overweight. The ‘Lotería de Aguas’ offers alternatives to soda that are healthy, tasty, and much less expensive,” the game’s overview states.

During a City Council B Session in May, Schlenker presented the early stages of this campaign to mixed reaction from council members.
“64% of the people who live in San Antonio drink soda every single day,” Schlenker said in May. “It’s not an accident. These soft drink companies spend more than $3 billion a year marketing these drinks in the U.S., much of it focused on youth.”
With obesity trends across the U.S. rising, eliminating or reducing soda consumption is seen as low-hanging fruit by health care professionals in the fight against obesity and diabetes. It’s not so easy, however, to communicate that educated insight to sugar-dependent consumers.
Some council members, including then-District 2 Councilmember Ivy Taylor, District 7 Councilmember Cris Medina, and District 9 City Councilmember Joe Krier,questioned focusing on soda and also questioned the role of city government in public health and anti-obesity campaigns, respectively.
“We’re not against soda,” Schlenker countered. “We’re only against too much soda. How much soda is too much soda? Drinking soda every day is too much soda.”
Metro Health was seeking support rather than funding from City Council. The mixed response from the Council sent Schlenker back to the drawing board to refine the message.
“I am meeting with individual members of the Mayor’s Fitness Council to assess their interest in supporting our campaign to reduce sugary beverage consumption,” Schlenker said. “When that is complete, we will consider returning to the San Antonio City Council to achieve consensus there. There is some hope also that the beverage industry will not actively oppose our work in that Coke, Pepsi and Dr. Pepper/Snapple have stated publicly their intention to reduce liquid sugar consumption in the US by 20%.”
Schlenker was unsure of a timeline for his next B Session presentation, but it’s likely to be in 2015.
In the meantime, Metro Health and other community partners continue ongoing efforts to reduce diabetes. Metro Health and the YMCA of Greater San Antonio offer free classes for diabetes prevention and management at various locations across San Antonio.
The 12-month YMCA’s Diabetes Prevention Program provides a supportive environment where participants work together to learn about healthy eating and increasing their physical activity to prevent diabetes.
The 12-week Y Living Program takes a holistic, family-based approach to chronic disease prevention.
“This unique program empowers families to obtain total wellness through enriching the spirit, mind and body. Families participate in seminars twice a week that equip them with the knowledge and tools necessary to prevent illnesses resulting from obesity and a sedentary lifestyle.”stated a press release. “Following each seminar, families have fun and get moving through a group exercise class or other physical activity.
Metro Health offers a six-week, healthy living workshop for individuals living with diabetes and their family members or caretakers. The evidence-based workshop, developed at Stanford University, provides a supportive environment for individuals to learn how to safely manage diabetes on a daily basis. Workshops cover a range of topics including healthy eating, goal setting and problem solving, dealing with stress and negative emotions, relaxation techniques, and working with your doctor.”
Again, these programs are free and open to the public. Visit www.DiabetesHelpSA.com for more information.
*Featured/top image: “Lotería de Aguas” cards. Photo by Iris Dimmick.
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