High Fructose Corn Syrup: A Sweetener with a Bad Rap!

High Fructose Corn Syrup: A Sweetener with a Bad Rap!

Brooke Douglas is back with her monthly nutrition advice for DrPullen.com   This month she shoots down yet one more myth, that high fructose corn syrup is somehow worse than sucrose, a.k.a. table sugar, as a sweetener in foods.  We get fat as a country because we eat too much and exercise too little, not because of this wicked ingredient hidden in our foods.  If you want to read more from Brooke, visit Nutrition Authority, and call her if you need personal nutrition guidance.

Why does High Fructose Corn Syrup spook ‘health-conscious’ eaters, parents and nutritionists alike?
By Brooke Douglas, RD, CD

If you have listened to the mainstream media you may have been misinformed. HFCS has been labeled “the Devil‟s candy,” a “sinister invention,” and “bad for you, crud.”

But is it really all that bad?

Simply stated, the answer is “NO.” Actually, most people fail to realize that HFCS is composed of the exact same sugar combination found in table sugar and honey (fructose and glucose) in virtually the exact same ratios. The name “high fructose corn syrup” simply distinguishes it from other forms of corn syrup, meaning it isn‟t any higher in fructose than sugar is. I say it was a bad name choice; maybe they should have named it, “Bob?” Regardless, many credible studies have been published clearing up a lot of the misinformation on HFCS. The American Medical Association concluded, “There is no difference in how the body metabolizes high fructose corn syrup, table sugar or honey. They are indistinguishable once they reach the bloodstream. High fructose syrup does not appear to contribute to obesity more than other caloric sweeteners.”
As a derivative of corn, this alternative sweetener was created in the late 1960‟s in order to be used in foods and beverages because of the many benefits it offers. HFCS is what makes our ‘moist’ breakfast and energy bars moist. It keeps food fresh, enhances fruit and spice flavors, retains moisture in bran cereals, maintains consistent flavors in beverages and keeps ingredients evenly dispersed in condiments. Over the last 30 years it has become a hard-to-avoid staple of the American diet. HFCS provides the sweet zing in everything from Coke, Pepsi and Snapple iced tea to Dannon yogurt and Chips Ahoy cookies. It also lurks in unexpected places, like Ritz crackers, Wonder bread, Wishbone ranch dressing and Campbell‟s tomato soup.

The news media and a myriad of web sites and blogs continue to mistakenly report that obesity and diabetes rates have climbed at a remarkably similar rate to that of HFCS consumption. Yet, the nutrition science community reports that if the consumption of HFCS has increased in America, then so has all the other food categories. In other words, we are eating more, 24% more total food intake to be exact. We are not eating disproportionately more HFCS; we are eating more of everything! HFCS can only contribute to weight gain when it is eaten as excessive calories, regardless of the food source. Replacing HFCS with sugar, in our processed foods, will not reduce obesity or improve health.

In fact, many parts of the world, including Australia, Mexico and Europe, have an obesity epidemic and rising rates of diabetes despite having little or no HFCS in their food and beverage supply. This supports findings by the U.S. Centers for Disease Control and the
American Diabetes Association that the cause of increasing rates of obesity and diabetes in America is not HFCS. Rather, inactivity and excessive calories, from whatever source, promotes weight gain and therefore, diabetes

Dr. Walter Willett, current chairman of the nutrition department of the Harvard School of Public Health stated “If there was no high fructose corn syrup in our food supply, I don’t think we would see a change in anything important. I think there is an overreaction to HFCS. There is no credible evidence to support the idea that high-fructose corn syrup is somehow responsible for the increasing trend of obesity and diabetes in America.”

Unfortunately, some people have found it easier to look for one single ingredient to blame, like high fructose corn syrup, for all of America‟s weight gain woes. Even former critics of HFCS have dispelled myths and distanced themselves from earlier speculation about the sweetener‟s link to obesity in a comprehensive scientific review published in the December 2008 American Journal of Clinical Nutrition.

Respectfully, to all the “naturalists” out there, the real science does not support the bad rap! Whether it is mercury concerns or ADHD theories, the science does not support singling out this one sweetener. Besides it takes our focus off the larger nutrition picture. „moderation not deprivation” AND spend less time sedentary! The small, smart choices we can make each day to promote good health quickly become good lifestyle habits!

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I Like Unna Boots

I Like Unna Boots

I have to say that I really like Unna boots as therapy for veinous stasis ulcers.  I have no idea why they are called Unna boots.  If anyone knows, let me know.  I couldn’t find anything on-line to explain the name.  It’s an odd name for a really simple old-fashioned treatment that’s about as low tech as you can get.  Technically an Unna boot is an inelastic compression wrap, basically a cotton bandage impregnated with zinc oxide that hardens after application, and forms a sort of boot.  They are easy to apply and help with the pain and swelling usually associated with veinous stasis ulcers.  They are often quite effective in getting ulcers that don’t seem to be healing very well otherwise to start to heal.  In a recent article in American Family Physician by Collins and Serai compression therapy of stasis ulcers is considered to be the standard of care, and a Cochrane Review in 2009 concludes that veinous ulcers heal more quickly with compression than without.

All this is good, but I think I really like Unna boots because it is one of the times where as a family physician I get to use a hands-on therapy that really works.  It also just feels good to apply the cool, soothing bandage to the patient’s leg and see them feel better almost immediately.   In addition it’s a treatment where I see the patient weekly, and when it works well we see regular, fairly steady improvement.  Almost always patients are really happy with this treatment, though it usually takes far more visits that they would like.

If you liked that try this:

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What if All Americans Had at Least Catastrophic Health Care Coverage by Dr. Pullen on July 23rd, 2010

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Generic Lipitor – Coming Soon

Generic Lipitor – Coming Soon

Hang on for real savings.  Coming in July 2011 is the expiration of the patent on Lipitor (generic name atorvastatin), the highest gross sales drug in the world.  Lipitor, by Pfizer, was still the top gross selling drug in the US despite competition since simvastatin became a generic option. We all were ecstatic when Zocor, now generic simvastatin, lost its patent last year.  Prior generic statins, including lovastatin and pravastatin just were not as potent as simvastatin (see table below). Lipitor and Crestor are the two currently available statins that are more potent that simvastatin.  Currently both are expensive branded drugs.  Lots of physicians have kept some patients on Lipitor or Crestor (#14 in gross US sales in 2009) even after simvastatin became available, because their increased potency allowed patients to get to their goal LDL.  Once generic atorvastatin is available, it is likely to dominate the statin prescription market.   I anticipate that generic atorvastatin will quickly become the market leader in the statin prescriptions.  Simvastatin is a great drug, but recent evidence suggests that at higher doses needed to approach the LDL lowering efficacy of atorvastatin, it has a higher incidence of myalgias and hepatic dysfunction.  In patients with extremely high cholesterol, with desired reductions of LDL cholesterol in the 50% range, atorvastatin will be extremely popular once it becomes affordable.  It will also be popular in patients who need more modest LDL reduction; it will just be used at lower doses in those patients.  See the table below with statin doses, average LDL reduction expected, and current costs:

Drug Name Anticipated LDL Reduction Cost on Costco Online/ 30 days
Pravastatin 10 mg 18-25% $5.90 *
Pravastation 20 mg 23-29% $5.90 *
Pravastatin 40 mg 26-34% $10.54
Lovastatin 20 mg 24-27% $5.90*
Lovastatin 40 mg 31% $11.75
Simvastatin 10 mg 26-33% $$5.90
Simvastatin 20 mg 30-40% $5.90
Simvastatin 40 mg 35-45% $5.90
Simvastatin 80 mg 35-48% $7.31
Lipitor (atorvastatin) 10 mg 34-38% $98.87
Lipitor 20 mg 42-46% $139.96
Lipitor 40 mg 47-51% $139.96
Lipitor 80 mg 46-54% $139.96
Crestor 10 mg 43-50% $127.52
Crestor 20 mg 52-55% $127.52
Crestor 40 mg 52-57% $127.52

      *Also on $4./ month at several discount pharmacies.                                                                                                                          

The annual potential for cost savings after next year from this generic alone can be in the range of >$5 billion for the US alone, and <$1500./ per patient if atorvastatin pricing approximates simvastatin pricing after it goes generic.  Let’s celebrate the little bits of good news as they come along.

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