Swedish is Squeezing the Juice out of Pediatric Care

October 27, 2015

Swedish believes it will be the first hospital in the state of Washington to eliminate juice from its pediatric menu

As a pediatric gastroenterologist with Swedish Medical Group, Dr. Uma Pisharody cares for children with metabolic syndrome. This condition develops in children who have liver disease because of excessive fructose intake.

These children receive specialized medical care because of the excessive fat in their liver, which is identical to the diseased liver of an adult who is sick from years of alcohol abuse.

“Excessive intake of fructose is what leads to metabolic syndrome, which means kids need to cut back on their intake of sweets and soda,” said Dr. Pisharody. “This also means they need to eliminate juice, even the kind that’s 100 percent natural, because even 100 percent juice has a very high amount of free fructose. On the other hand, when children consume whole fruits, the fructose is bound to fiber, which protects it from being harmful to the liver.”

Dr. Pisharody first became aware of the harmful effects of fructose through the research of Dr. Robert Lustig, a pediatric endocrinologist at the Benioff Children’s Hospital of the University of California, San Francisco. Dr. Lustig is the lead author of a related study featured today in the New York Times.

A few months ago, a mother of one of Dr. Pisharody's patients who needed anesthesia to undergo a liver biopsy commented that shortly after her son awoke, he was offered a cup of juice in Swedish’ s surgical recovery unit.

“This was ironic,” said Dr. Pisharody. “I was advising patients to stop drinking juice and it continued to be served in the health care setting.”

This led Dr. Pisharody to work with her colleagues at Swedish to eliminate having juice routinely offered to pediatric patients, replacing it with something free of fructose when clinically appropriate.

She received a supportive response, and was encouraged to present a practice initiative to the Pediatric Quality Improvement Committee. The committee returned with a strong recommendation to put the practice into effect.

Since then, the campaign to eliminate juice is in effect at Swedish’s First Hill campus, where the majority of pediatric hospital care is provided. The practice to eliminate juice completely from Swedish’s standard pediatric menu is projected to be implemented across all five hospital campuses by the end of 2015.

While other hospital systems have removed sugar-sweetened beverages, Swedish believes it will be the first hospital in the state of Washington to eliminate even 100 percent juice from its pediatric menu.

“It is actually possible that Swedish is the first hospital in the country to eliminate juice for pediatric patients,” asserted Dr. Pisharody. “I have not been able to find information on any other hospital doing so.”