Efforts to improve health should be a major part of health care reform. One way of doing this is to promote better diets. People with healthful diets generally need much less health care, and research has continued to identify dietary factors that have major effects on health.
One area where education could have a major impact is with regard to sugar consumption. While everyone knows that large amounts of sugar are not healthful, few are aware the amounts many of us consume can have serious health consequences.
Sugar is now known to be a major factor in the risk for both diabetes and heart disease. In a study of 90,000 nurses, one soft drink (sugar sweetened) per day almost doubled the risk for diabetes. Two soft drinks per day were associated with a 40 percent increase in heart attacks in this same group of nurses.
Sugar is also associated with high blood pressure, gout and pancreatic cancer. High levels of sugar consumption can also result in a chronic low level inflammation of the body. When one consumes sugar during a meal, a substantial fraction of it ends up in the blood as fat in the form of triglycerides, which is a risk factor for heart disease.
Because of the association of sugar with heart disease, the American Heart Association assembled a panel of nine experts to review this topic. As a result, they issued a recommendation this past October that most women consume no more than 100 calories per day in the form of added sugars, and that men consume no more than 150 calories. One 12-ounce can of cola contains 150 calories of sugar. One cup of sweetened fruit yogurt has about 135 calories of added sugar. The recommendation applies only to added sugars. Consumption of fruits is still strongly encouraged.
On average, Americans consume 380 calories of added sugar per day, with the top 20 percent consuming 900 calories of added sugar per day. Based on these rates, major health gains could be achieved if we reduced our consumption of sugar.
Whether the sugar is ordinary table sugar or high fructose corn syrup does not seem to matter. This is because table sugar (sucrose) is rapidly digested into a mixture of 50 percent glucose and 50 percent fructose, while high fructose corn syrup is typically 45 percent glucose and 55 percent fructose.
A proposal to tax soft drinks at the national level was made last spring by group of experts in the area of public health and nutrition. While such a tax appears unlikely to pass anytime soon, this proposal further emphasizes the importance of the sugar issue. Experts now strongly advise diets with limited added sugar, but this information has not yet reached most of the public.
There are a number of ways in which the public could be informed about the hazards of sugar consumption, and be motivated to consume less. One approach would be to include education about sugar in wellness programs. Many people are trying to lose or keep from gaining weight. If they knew that much of the sugar consumed during a meal ends up as fat, they might not include soft drinks with meals.
In another approach, some companies already limit the presence of high sugar foods in vending machines and provide healthful alternatives.
In annual medical exams, alcohol and tobacco consumption are often reviewed. There could also be a review of consumption of soft drinks and other sweetened beverages. Medicine is starting to focus more on the prevention of illness, and this trend should be encouraged.
Consumption of excess sugar is now known to cause diseases that result in high health care costs. It is very much in the interest of employers to encourage their employees to consume less sugar. Those with wellness plans might want to include education on this topic.
There are many other factors in our diets where better education could have major benefits in improving health. This would lower medical costs and also help us to enjoy good health as we age.
John Tjepkema of Orono is a professor emeritus at the University of Maine’s School of Biology and Ecology.