If you have been paying close attention to the health news the past month or so, you have probably heard that the organization to which I belong -- the American Academy of Family Physicians -- has teamed up with Coca-Cola to promote health.
I am not kidding. This has actually happened.
The AAFP has received, in my opinion, well-deserved criticism for this connection. Some background: The academy has launched its Consumer Alliance Web site, which aims to partner with corporations to increase health-education messages.
In the case with Coca-Cola, the academy received an educational grant in the strong six figures to "enable consumers to make informed decisions about what they drink based on individual need."
There are several glaring problems with this goal. The first is that an informed decision does not need to be made. The unequivocal advice that family physicians should give to most of their patients is to stop drinking beverages sweetened with high-fructose corn syrup. This is because, according to the Centers for Disease Control and Prevention, two thirds of American adults are overweight and must cut out the empty calories that Coke contains.
Second, high-fructose corn syrup is not a benign sweetener. Numerous studies have shown that this product, compared to other forms of sugar, induces more weight gain, particularly abdominal and inner-organ fat build-up. These deposits of so-called adipose tissue (fat cells) are metabolically quite active and play a strong role in the development of heart disease, cancer, stroke -- and even inflammatory conditions such as rheumatoid arthritis or low back pain. Fat deposits in these areas also strongly increase the likelihood that a person will develop diabetes.
Third, high-fructose corn syrup worsens cholesterol and other fats in the blood stream more than other sugars do. This adds even more heart-attack risk to the already increased risk from abdominal and inner organ fat deposits.
Fourth, since high-fructose corn syrup induces abdominal obesity, it thereby promotes the release of inflammation molecules and other hormones that cause cancer. Indeed, abdominal obesity (to which soft drinks disproportionately contribute) is associated with breast cancer, prostate cancer, colon cancer and uterine cancer.
The argument for "an informed decision based on individual need" is ridiculous. Drinking fructose-sweetened beverages might be an individual choice. It might be an individual desire. You probably could even call it a First Amendment right of free expression. But it is not an "individual need." It is closer to an individual poison.
I counsel patients every day on diet, exercise and weight loss. I even have a $1.6 million grant from the National Cancer Institute to train medical students in all aspects of overweight and obesity -- from the connection to cancer to learning helpful counseling skills with patients who want to lose weight.
Many of us in the academy are extremely disappointed in its decision to accept funding from Coca-Cola. I liken it to accepting money from a tobacco company to help smokers make an "informed decision" about smoking. There is no informed decision. You need to stop.
Some family physicians have quit the AAFP over this issue, even as the academy digs in its heels. According to Food Navigator-USA.com, Dr. Douglas E. Henley, the academy's chief executive officer, stated, "We will move forward with this commitment together [with Coca-Cola] by providing educational materials on sweeteners and how to maintain a healthy, active lifestyle while still enjoying many of the foods and beverages consumers love."
Maybe that's what I ought to do with my tobacco-using patients. Provide them educational materials on smoking and how to maintain a healthy, active lifestyle while enjoying the cigarettes which they love.
Dr. John Spangler is a professor of family medicine at Wake Forest University School of Medicine. The Journal welcomes original submissions for North Carolina Voices on local, regional and statewide topics. Essay length should not exceed 750 words. The writer should have some authority for writing about his or her subject. Our e-mail address is: Letters@wsjournal.com. You may also mail a typed essay to: Letters to the Journal, P.O. Box 3159, Winston-Salem, NC 27102. Please include your name and address and a daytime telephone number.
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