A new article regarding the health issues of added sugar was recently posted in the Journal of the American Medical Association. In this article,1 Mike Mitka discusses many relevant and timely points – the dangers of excessive sugar consumption are now well-established within the medical literature. The editorial brings much needed attention to the dangers of sugar consumption and its thus far minimal representation in health recommendations. However, one large (sugar-consuming) elephant in the room was not addressed: our hospitals.
As the supposed epicenters of health, many hospitals and cancer centers have banned smoking on their grounds and campuses. These measures are meant to lead by example and convey to patients that smoking has negative health consequences, thus it should not be undertaken at our epicenters of health. This is, of course, regardless of patient behaviors at home. While we cannot control people’s activities, we can at least act as role models to hopefully perpetuate a healthy message.
No such efforts exist for many hospitals with regards to poor food choices, and more specifically snacks and soda, which contain the vast majority of added sugar. As Mr. Mitka states, added sugars increase the risk of inflammation and abdominal fatness; both are closely linked to cancer risk and poorer outcomes. Obesity is now an independent risk factor for metastases and death after breast cancer treatment.2 Newer preclinical data reveal that elevated levels of blood sugar may hinder the ability of cancer treatment to be as effective3 and attempts to lower blood sugar with diet during chemoradiation are occurring at cancer centers across the country.4
Health Issues of Added Sugars – At Our Hospitals
Counter to our recommendations and perhaps logic, many hospitals are actually contributing to the problem. Soda machines are found within cafeterias, vending machines filled with candy are often on each floor, and gift shops contain entire rows of candy. Even meals served to patients contain many of the same ingredients we condemn. Perhaps most egregious, many cancer centers celebrate Breast Cancer Awareness month by paying homage to the sugar gods with pink sugar cookies found adorning most centers and hospitals.
For those physicians that spend significant time counseling patients on diet and exercise to improve treatment outcomes, such efforts are completely derailed when these patients encounter these foods within the same facility where they receive their care. We would counsel patients against smoking and then sell them cigarettes within the hospital? Of course not. So why do we do the same with soda, candy, and other well-established unhealthy foods?
As long as we continue to promote within our hospitals the same foods that we condemn on paper, such recommendations are likely to fall on deaf ears. It is time for hospitals to practice what they preach and do as they say.
Believe it or not, this is actually a picture from the waiting room of a cancer center. The day I took this picture was a sad one.
What can we do to fix this? I would appreciate your thoughts and comments below on what we can do together to change these unhealthy behaviors that continue to perpetuate throughout our hospitals. Awareness is the first step, but we need some changes.
Note: This article is a modification from an original letter to the editor that was submitted to the Journal of the American Medical Association. It was rejected for publication as it was not felt to be of importance for publication within the journal. It is one of many similar articles that I have written that were rejected.
References:
- Mitka M. New Dietary Guidelines Place Added Sugars in the Crosshairs. JAMA. 2016. doi:10.1001/jama.2016.1321.
- Ewertz M, Jensen M-B, Gunnarsdóttir KÁ, et al. Effect of obesity on prognosis after early-stage breast cancer. J Clin Oncol. 2011;29(1):25-31. doi:10.1200/JCO.2010.29.7614.
- Klement RJ, Champ CE. Calories, carbohydrates, and cancer therapy with radiation: exploiting the five R’s through dietary manipulation. Cancer Metastasis Rev. 2014. doi:10.1007/s10555-014-9495-3.
- Champ CE, Palmer JD, Volek JS, et al. Targeting metabolism with a ketogenic diet during the treatment of glioblastoma multiforme. J Neurooncol. 2014;117(1):125-131. doi:10.1007/s11060-014-1362-0.
© 2016 CDR Health and Nutrition, LLC. All Rights Reserved.
Hi Dr. Champ, you know we are with you 100%! We’re trying to work with our hospital to do better. One thing we found is that the food services at most hospitals are contractors, just like what you’d find at university or sports stadium, and usually this contract is overseen by administrative services, a department that has little to do with the medical side of the house other than regulations, building requirements, HR, etc. So just like in all huge institutions, how do we get those who deal with the contracts to interact with those concerned with health to look beyond an financially advantageous contract and see the opportunities in health promotion? Rock on, Dr. Champ. The MaxLove family loves you! 🙂
Thanks Audra and keep up the good work at the Max Love Project!!!! So many layers to get through here, all we can do is keep up the fight!
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I totally agree that hospitals (and other institutions that care for people who can least afford a bad diet) should be role models in encouraging much healthier eating. Perhaps it will take sustained pressure from staff and employees to get administrators to make better policy/contract choices. In the meantime – like cigarettes – maybe some kind of warning or information can be posted on, or near, sources of sodas, candies, and other high-carb foods. It could be a start. I think another small, but important, change could be for health care providers to make it a habit to ask patients what they eat. Every time I take our dog to the vet, the vet asks about her diet. I don’t think I’ve ever had a health care provider ask me about my diet, even gastroenterologists. Thank you for what you do and for your communications. Much appreciated.
while I agree with this in theory, who dictates what warrants a warning label? It will end up being the same government and governing agencies that are in big biz’s pockets, those same sources that put heart healthy labels on cereals and instant quaker oatmeal packets full of sugar and told us to eat Snackwells cookies. Prior to that, we were doing just fine with our food choices as a society. It’s a culture issues not governance, the more we govern our health the worse it becomes…
It’s not just hospitals, although I understand how having this junk food available in places that are supposed to be about healing is a terrible example. Everywhere I go I see junk food being sold, or even handed out free to kids. Went to a parade today, and all the kids were gathering up candy thrown to them, and popsicles were being handed out as well. I look at a lot of people watching the parade (or even in the parage), and a big percentage of them are overweight/obese, even young kids. We are killing ourselves with this junk, and most people don’t seem to care, or want to change. Very sad.
agreed 100%. very frustrating and sad
could not agree more
the not caring part is the hardest to digest