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.
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.
- 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.
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