High Fructose Corn Syrup and Your Health

English 147 Advanced English Composition
Chamberlain College of Nursing/DeVry University

June 01, 2016

High Fructose Corn Syrup and Your Health
Introduction:
Your food might be killing you. No one wants to die and no one wants to be fat, yet hundreds of thousands of Americans die every year because of obesity. According to the National Institutes of Health, obesity and overweight people (defined by high body mass index or BMI) suffer from the second leading cause of preventable death in the United States (NIH, 2012). Almost 70% of the U.S. adult population is defined as overweight or obese (per BMI), with an estimated 300,000 attributed deaths per year (NIH, 2012). We learn in healthcare that any disease spreading at a rate faster than expected is considered epidemic. There has been great consternation about the rise in obesity and other health-related problems that is out of proportion with our increase in population. This paper will question whether the addition of fructose and high-fructose corn syrup (HFCS) in beverage and food items has contributed to this problem. There are popular theories about decreased physical activity or perhaps the dissolution of the nuclear family mealtime as possible sources for increased obesity rates. Yet time and time again scientific food research has observed changing trends in eating habits, food choice, and ingredient additives as likely causation. The data that I have found through researching credible sources supports the theory that HFCS additions have contributed to obesity (as measured by BMI) and gout in addition to other health-related problems such as high blood pressure and visceral abdominal fat collection. The public is poorly informed in regards to the actual amounts of HFCS that is added to typical food items and correlative potential for untoward health effects of epidemic proportion. Education in regards to the risks associated with HFCS-rich diets and improved label identification of the amount of fructose-based additives in food are needed.
Problem Analysis: The addition of fructose and high-fructose corn syrup (HFCS) in beverages and food has contributed to an increase in health problems such as obesity and gout (Lin, et al. 2011) and should be regulated and better identified on food packaging for the awareness and safety of the consumer. Millions of people suffer from obesity, hypertension, and hyperurecemia (Zhu, et al. 2011) and yet is not commonly knowledge that a significant nutritive detriment of their health can be found in most common food items. The prevalence and availability of sugar-sweetened beverages (SSB) and food items containing fructose and HFCS has contributed to a marked increase in health problems without the general public’s knowledge. The lobby for the food and beverage industries has heavily advertised defending the practice of adding large amounts of fructose and HFCS in food and has done so without close scrutiny or regulation despite the research that has provided evidence of the harm caused. The audience for this paper is the general public as well as the health and wellness care provider. Of special concern is the elementary age adolescents that have been identified in the research as heavy users of SSB. Many are skeptical when it comes to the argument over HFCS content in food. This audience may be convinced with the scientific data as well as the conclusions of experts in the fields of study including statistical food consumption research, endocrinology, rheumatology, pediatrics, and cardiology. In the mainstream media there seems to have been a casual lassie faire approach to addressing the burgeoning bellies of the typical U.S, midsection. Now that is changing with multiple political, scientific, and celebrity voices calling for attention to the problem. Last year the largest association of physicians in the United States, the American Medical Association, declared a policy that “… recognizes obesity as a disease requiring a range of medical interventions to advance obesity treatment and prevention [and] this will help change the way the medical community tackles this complex issue that affects approximately one in three Americans” (AMA, 2013). Multiple studies correlate the relationship between “added sugar” and specifically the use of HFCS and total fructose consumption with weight gain (Bray, et al., 2004) and the epidemic rise in the prevalence of diet-related diseases including obesity and gout in the United States and this points to the need for action. (Zhu, et al., 2011). The singular greatest food item that contains added fructose or HFCS are soft drinks and fruit juices and are considered “sugar-sweetened beverages” (SSB). Although there is a trend in adding sugars into beverages, there is a noted differentially significant increase of the amount of calories in foods containing HFCS, specifically soft drinks, fruit juices, sweetened tea, and dessert foods (Duffy & Popkin, 2008). Drs. Duffy and Popkin (nutritionists and obesity researchers at the University of North Carolina at Chapel Hill School of Public Health) have studied almost four decades worth of data culled from U.S. Nationwide Food Consumption Surveys and National Health and Nutrition Surveys. They discovered that there was an increase of 222 calories per person per day from beverages that were, “… resulting largely from increased intake of calorically sweetened beverages” (see Figure 1, page 5). Unfortunately there have been also been other studies to show that the prevalence of SSB drinkers is high (especially amongst adolescents) and there is a strong correlation between SSB consumption and the increase in risk factors for obesity and gout (Lin, et al., 2013).

Figure 1. US trends in per capita calories from beverages among children and adults. Source: Duffy & Popkin, 2007.
Benefits:
Increased knowledge through education can elicit lifestyle changes. This is significant, as diet-based diseases are some of the biggest determinants of the health state for the patient struggling with metabolic disorders such as diabetes and obesity (Uusitupa, 2002). Education would appear to be the key for the public to learn about the dangers contained in their food. Unfortunately the government agency that address this topic seems defensive in their position on the potential harm that HFCS can cause. The Food and Drug Administration dietary guidelines recommend limiting added sugars in one’s diet but does not confirm any increased risk of health-related problems associated with additive fructose or HFCS (USDA, 2014). Over 75 million of people in the United States alone suffer from obesity, hypertension, and hyperurecemia (Zhu, et al. 2011). The public is poorly informed that a significant contributor to the demise of their health can be found in most of their common food stuffs: breakfast cereal, root beer, iced tea, “juice drinks”, chocolate milk, lemonade, flavored coffee, whole grain bread, lifesavers, ketchup, miracle whip, pop-tarts, fig newtons, oreo cookies, cough syrups, wheat thins, flavored cottage cheese, relish, mustard, applesauce, etc. The prevalence and availability of sugar-sweetened beverages (SSB) and food items containing fructose and HFCS has contributed to a marked increase in health problems without the general public’s knowledge. The lobby for the food and beverage industries has heavily advertised defending the practice of adding large amounts of fructose and HFCS in food and has done so without close scrutiny or regulation despite the research that has provided evidence of the harm caused. Popular advertising campaigns that suggested that “HFCS is simply a form of sugar made from corn” were grossly misleading and border ethical malfeasance. We can battle these misinformation maneuvers with direct consumer information (such as Public Service Announcements) and by having the sugar addition highlighted by a specific label on the product or in the ingredients. Product labels are concise and direct forms of consumer education about foods that may contribute to health concerns or food allergy problems. Current examples of regulated product labels include cigarettes, alcohol, and foods containing iron, trans-fat, and nuts (USDA, 2014).
Solution:
So how do we bring about the change in the food consumption habits of millions of people who drink and eat sugar-sweetened beverages and food items? Are product labels identification going to be effective enough to elicit change? Authors’ Chip and Dan Heath wrote a book about the difficulty with trying to convince change in behavioral habit. One of their most interesting public health concern examples that had a strong resonance for me was a dilemma experienced by two health researchers on how to approach improving the public’ diet. They argued that if the average person altered their diet by switched from drinking whole milk to 1% milk, the USDA diet recommendations for saturated fat would be attained. The quandary was how to go about eliciting that change in consumer preference. The authors explore different thoughts about public health education and how to market to that change that was needed. They decided the most effective approach was to alter the consumer’s purchasing behavior. “If you want people to change, you don’t ask them to “act healthier.” You say, “Next time you’re in the dairy aisle on the grocery store, reach for a jug of 1% milk instead of whole milk”” (p.13). Drs. Heath tackled the question of change by addressing the choice made when the consumer bought the food item rather than milk-drinking behavior. This may be an answer to decreasing the amount of food bought that contains added sugars. I believe an education approach that is demonstrative in its display as seen below (see Figure 2, page 7) and obvious product labeling, the consumer will alter their purchasing behavior and buy less food items that contain added sugar. We may not drink less soda, for example, but it will be a soda that does not contain calorie-packed added sweeteners.

Figure 2. Advertising healthy? Source: http://www.cdph.ca.gov/programs/cpns/Pages/RethinkYourDrink.aspx

Conclusion: I want to discuss this topic because, as a gout sufferer, I want to have the information I need to make the best choices about what I eat. I have friends, family members, and coworkers that struggle with health concerns including obesity, hypertension, and hyperuricemia. They look to me as an active person and a healthcare professional for advice on diet and exercise. Avoiding HFCS may be the single specific dietary change that could significantly aid in their health and diet goals. This topic is important because our health and wellness is central to our enjoyment of life. Everyone eats food and wants to enjoy a health long life. I believe that the general population has the interest and the right to know about any deleterious effects of any food or medicine that they ingest. The public’s health eclipses any argument for a low cost (in part with federal subsidy) fructose additive to be put into our food. The public has a right to know if they are eating a food item that contains HFCS. The general public needs to hear the call for action more clearly. The industries that are sapping political will with campaign fund donation and muddying the scientific waters with misinformation cannot hide the epidemic rise of diet-related disease. Thus providing a sound argument for the truth about HFCS would be an achievement. The addition of fructose and high-fructose corn syrup (HFCS) in beverages and food items is a studied health-risk phenomenon and the Food and Drug Administration to should alter their position on HFCS and consider product labeling requirements.

References
American Medical Association. (June, 2013). Obesity as a disease. 2013 AMA Annual Meeting Policy Announcement. Retrieved from: http://www.ama-assn.org/ama/pub/news/news/2013/2013-06-18-new-ama-policies-annual-meeting.page
Bray, G., Nielsen, S., & Popkin, B. (2004). Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. The American Journal of Clinical Nutrition. 79:537–43. Retrieved from: http://ajcn.nutrition.org/content/79/4/537.full.pdf
Brownell, K., Farley, T., Willett, W., Popkin, B., Chaloupka, F., Thompson, J., & Ludwig, D. (2009). The public health and economic benefits of taxing sugar-sweetened beverages. New England Journal of Medicine. 361(16):1599–1605.
Duffy, K. & Popkin, B. (2007). Shift in patterns and consumption of beverages between 1965 and 2002, Obesity. 15(11):2739-47. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/18070765
Duffy, K. & Popkin, B. (2008). High-fructose corn syrup: is this what’s for dinner? The American Journal of Clinical Nutrition. 88(6):1722S-1732S. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/19064537
Heath, C. & Heath, D. (2010). Switch: how to change things when they are hard. New York: Broadway Books.
Lin, W., Huang, H. Chan, T, Ciou, S., Lee, C., & Lee, C. (2013). Effects on uric acid, body mass index, and blood pressure in adolescents consuming beverages sweetened with high-fructose corn syrup. International Journal of Obesity. 37(4), 532-539. doi:10.1038/ijo.2012.121
U.S. Food and Drug Administration. (July 22, 2014) High Fructose Corn Syrup: Questions and Answers. U.S. Department of Health and Human Services. Online Publication. Retrieved from http://www.fda.gov/food/ingredientspackaginglabeling /foodadditivesingredients/ucm324856.htm
U.S. Department of Health and Human Services. (October, 2012). Overweight and obesity statistics. National Institutes of Health Publication No. 04–4158. Retrieved from http://win.niddk.nih.gov/publications/PDFs/stat904z.pdf
Uusitupa, M. (2002). Lifestyles matter in the prevention of type 2 diabetes. Diabetes Care. 25(9) 1650-1. Retrieved from http://care.diabetesjournals.org/content/25/9/1650.full
Zhu, Y., Pandya, B., & Choi, H. (2011). Prevalence of gout and hyperuricemia in the U.S. general population. Arthritis and Rheumatism; Published online: July 28, 2011. Retrieved from https://www.rheumatolgy.org/about/newsroom/2011_01_24.asp doi:10.1002/art.30520