Bioidentical Hormones 101 
The Book, by Jeffrey Dach MD

Chapter 46. Selling Sickness in the Lobby, Fast Food in Hospitals

Section Twelve: Is Your Food Making You Sick?

Fast Food in Hospitals Jeffrey Dach MDChapter 46.

Selling Sickness in the Lobby, Fast Food in Hospitals

Dr. Peter Cram reported in JAMA (Journal of the American Medical Association) that forty per cent of hospitals have fast food in the lobby.(3)   While you might consider this an outrage, the hospital probably considers it business as usual.  Your hospital banned cigarette smoking long ago,(47)  yet still sends the message that fast food is healthy for you.  In reality, fast food is unhealthy and leads to chronic diseases and new revenue for the hospital.  For the hospital accounting department, looking at the bottom line, this is a good thing.  Financial consideration, rather than the health of the community, is the deciding factor.  Untrained in medical nutrition, hospital accountants may not understand that fast food causes obesity, metabolic syndrome, insulin resistant diabetes, hypertension and accelerated cardiovascular disease. (1-7)

Left Image, Would this hospital sell Burger King? 1914 Photo of German hospital, courtesy of Wikimedia commons.

Fast Food Causes Chronic Disease

Michael Pollen, a journalist and author of "In Defense of Food", and "Food Rules" says in a New York Times Editorial:  

Fast food causes chronic disease, and there’s lots of money to be made selling fast food, and then treating the diseases that fast food causes. One of the leading products of the American food industry has become patients for the American health care industry". (8)

Fast Food, Obesity and Chronic Disease - What is the Evidence ?

You might ask, what is the evidence that fast food causes obesity and chronic disease? For starters, a 2004 study published in Lancet found that eating Fast Food causes weight gain and insulin resistance. (29-30)  The authors say, “fast foods contain large amounts of partially hydrogenated oils, and this class of fatty acids can cause insulin resistance and increase risk of type 2 diabetes.”  Fast food also contains large amounts of highly refined starchy food and added sugars linked to increase risk for diabetes and obesity.  The national obesity epidemic has been rising at parallel rates with refined sugar consumption, mostly in the form of high fructose corn syrup (HFCS). The average American consumes 70 pounds a year of refined sugar.

Health Risks of Sugar Consumption - HFCS

Ignoring for the moment the hydrogenated vegetable oils in fast food which are an enormous health risk, let's focus on the sweeteners, the high fructose corn syrup used in fast food and soft drinks.  The evidence linking massive amounts of sugar consumption to chronic disease is overwhelming. (9-27)  High Fructose Corn Syrup is our preferred sweetener, refined from government subsidized corn and used for processed foods.  HFCS is cheaper and sweeter than regular table sugar (sucrose), and it prolongs shelf life. High Fructose corn syrup is a 4.5 BILLION dollar industry, with our annual sugar consumption at 73.5 lbs per person.  Now, that’s a lot of sugar!

Refined Sugar - Sucrose – This is an Addictive Drug

Some scientists say that refined table sugar (sucrose) is not food, and should be reclassified as a drug capable of producing craving, withdrawal effects and addiction.(44)   A 2002 Princeton study showed addictive behaviors in rats given intermittent high sugar intake.(46)   A 2008 report in NeuroScience examines the evidence for addiction associated with intermittent excess sugar intake.(45)  The scientific evidence of sugar addiction is summarized nicely by Kathleen DesMaisons, Ph.D., author of “ The Sugar Addict’s Total Recovery Program”, and “Potatoes Not Prozac”.  Her program, called Radiant Recovery, is dedicated to helping people overcome sugar addition. (43)

HFCS- Comparing Fructose to Glucose

Chemically speaking, HFCS is a mixture of 55% fructose and 45% glucose, a ratio intended to mimic common table sugar, called sucrose. Sucrose is a simple molecule made of one fructose and one glucose molecule, so the corn industry can say that sucrose and HFCS are the same stuff.  Of course this is partially true, but there is a difference.   Firstly, HFCS has 10% more fructose than table sugar.  Secondly the fructose in HFCS is absorbed into the bloodstream more rapidly, since the body must first cleave apart sucrose with enzymatic digestion, after which, the liberated fructose can be absorbed into the bloodstream.  Once absorbed, fructose and glucose are metabolized quite differently. 

IV Glucose is OK, IV Fructose is NOT OK.

Intravenous glucose is commonly given to patients in the hospital to sustain life.  There is no IV fructose in the bag, because IV fructose is dangerous to your health. (48)

Warning – Fructose

Intravenous (IV) fructose is dangerous to your health and never given as an IV medication.  On the other hand, IV glucose is routinely given in the hospital as a safe nutrient.

Health Risks of Fructose in Fast Food Sodas

In small amounts, fructose has always been a healthy part of human diet in fruits and vegetables.  However, large amounts of fructose pose a serious health risk.  Unlike glucose, fructose cannot be used by the body.  Instead, it must be processed in the liver where it is uncontrollably converted into fat particles, triglycerides and atherogenic lipids.  This causes insulin resistant diabetes, hypertension and cardiovascular disease.  Thus, fructose is considered more dangerous and harmful than plain old glucose.  Fructose also causes abnormal lipid panels in obese kids, who may then be given statin drugs.  Wouldn't it make more sense to cut out the fructose instead?(9-27)

One in Five Teens have High Cholesterol

A recent CDC report raises alarms about increasing teen obesity and high cholesterol found in 20% of kids.(27)  The CDC report went on to recommend that doctors adhere to guidelines calling for statin drugs for kids with high cholesterol.

Doctor, Surely You Must Be Joking ?- Statins for Kids?

In 1998, the American Academy of Pediatrics convened a Committee on Nutrition to discuss "Cholesterol in Childhood” which published guidelines for treating kids with statin drugs for high cholesterol. (28)  The guidelines were revised in 2008 by Dr. Stephen R. Daniels,  causing a national uproar.(29)  Apparently, Daniels and co-authors had undisclosed ties to Merck, maker of statin drug Mevacor™. (30) The problem with cholesterol guidelines for kids is absence of any medical data showing benefit from statin drugs in this age group.  Alternatively, we have plenty of evidence that statin drugs cause harmful adverse side effects, especially considering a child starting a statin drug is committed to 40 years of drug treatment.  Articles such as, “Storm Over Statins”, promptly appeared in the media and medical literature raising opposition and creating backlash against the guidelines for statin drugs for kids.(33-35)  In view of what we know about Fast Food causing teen obesity and abnormal lipid panels, it would seem the height of absurdity to give kids statin drugs, rather than address the fast food and soda pop diets.(38-40)

Fecal Contamination of Soda Fountains

Another problem with fast food in the lobby, is fecal contamination of soda fountains, reported in the Jan 2010 issue of the International Journal of Food Microbiology.(41-42)   Take Action ! Make a copy this article and give it to your local congressman, or hospital board member.

For references and links, see my web site:

References for Chapter 46. Selling Sickness in the Lobby, Fast Food in Hospitals

PEDIATRICS Vol. 118 No. 6 December 2006  Marketing Fast Food: Impact of Fast Food Restaurants in Children’s Hospitals, Hannah B. Sahud, MD et al.

Prevalence and Type of Brand Name Fast Food at Academic-affiliated Hospitals. J Am Board of Fam Med 19:526-527 (2006) Lenard I. Lesser, MD

Vol. 287 No. 22, June 12, 2002 JAMA by Peter Cram, MD Fast Food Franchises in Hospitals  

The Perils of Ignoring History: Big Tobacco Played Dirty and Millions Died. How Similar Is Big Food? KELLY D. BROWNELL and KENNETH E. WARNER

Row over Fatty Grub in Hospitals, The Sun UK. By EMMA MORTON, 13 Jan 2010.

Daily Mail, UK, NHS pays patients to lose weight - while opening fast food branches IN hospitals
By Sara Nelson  13th January 2010

CMAJ July 29, 2008; 179 (3). Frying up hospital cafeteria food , Yoni Freedhoff and Rob Stevenson

Big Food vs. Big Insurance By MICHAEL POLLAN  September 9, 2009  NY Times.

Curr Opin Lipidol. 2009 Dec 2. Soft drink consumption and obesity: it is all about fructose. Bray GA.

American Journal of Clinical Nutrition, Vol. 79, No. 4, 537-543, April 2004. Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity.  George A Bray et al.

(11) Morbidity and Mortality Weekly Report (MMWR). Prevalence of Abnormal Lipid Levels Among Youths, United States, 1999-2006. January 22, 2010 / 59(02);29-33

J Clin Invest. 2009 May 1; 119(5): 1322–1334.  2009 April 20. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans by Kimber L. Stanhope et al.

Fructose, insulin resistance, and metabolic dyslipidemia Heather Basciano , Lisa Federico  and Khosrow Adeli.  Nutrition & Metabolism 2005, 2:5

Br J Nutr. 2008 Nov;100(5):947-52. Consumption of fructose-sweetened beverages for 10 weeks increases postprandial triacylglycerol and apolipoprotein-B concentrations in overweight and obese women. Swarbrick MM et al.

Hypertension, Vol 10, 512-516,  Fructose-induced insulin resistance and hypertension in rats
IS Hwang, H Ho, BB Hoffman and GM Reaven

JAMA. 2004;292:927-934, Sugar-Sweetened Beverages, Weight Gain, and Incidence of Type 2 Diabetes in Young and Middle-Aged Women by Matthias B. Schulze et al.

Corn Syrup, Is it Really Just Like Sugar? January 30, 2009 by Kitchen Table Medicine

The Double Danger of High Fructose Corn Syrup  Written by Bill Sanda    2004-Feb-19  

LE Magazine December 2008 Metabolic Danger of High-Fructose Corn Syrup By Dana Flavin, MS, MD, PHD

December 13, 2009 Child diabetes blamed on food sweetener, Times Online.

Corn syrup removed from SFUSD chocolate milk, SF Gate.

The Double Dangers of High Fructose Corn Syrup    By Bill Sanda, BS, MBA

Dark Sugar The decline and fall of high-fructose corn syrup. By Daniel Engber. April 28, 2009

(24) Michael Pollen, Food Rules.

Eating at Fast-food Restaurants More than Twice Per Week is Associated with More Weight Gain and Insulin Resistance in Otherwise Healthy Young Adults. NIH Gov News.

Fast-food Habits, Weight Gain, and Insulin Resistance (The CARDIA Study): 15-Year Prospective Analysis”. Mark Pereira et al. Lancet. 2005 Jan 1-7;365(9453):36-42.

Prevalence of Abnormal Lipid Levels Among Youths --- United States, 1999--2006
Weekly January 22, 2010 / 59(02);29-33 MM Weekly Report (MMWR) CDC

PEDIATRICS Vol. 101 No. 1 January 1998, pp. 141-147 Cholesterol in Childhood Committee on Nutrition

PEDIATRICS Vol. 122 No. 1 July 2008, pp. 198-208.  Lipid Screening and Cardiovascular Health in Childhood, Stephen R. Daniels, MD, PhD, Frank R. Greer, MD and the Committee on Nutrition

Pediatrics Fails to Disclose Industry Ties in Lipid Guide for Kids. 

CDC: 1 in 5 teens has cholesterol problems. Now what? By Sarah Klein, January 22, 2010  CNN News

PEDIATRICS Vol. 122 No. 4 October 2008, pp. 904-905 LETTER TO THE EDITOR An Assessment of the New Lipid Screening Guidelines Michael J. Steiner, MD Wallace D. Brown, MD 

Volume 359:1309-1312  September 25, 2008  Number 13 NEJM   Storm over Statins — The Controversy Surrounding Pharmacologic Treatment of Children, Sarah de Ferranti, M.D., M.P.H., and David S. Ludwig, M.D., Ph.D.

July 08, 2008 Is it for real? Cholesterol screening in toddlers and statins from elementary school age?

8-Year-Olds on Statins? A New Plan Quickly Bites Back, by Tara Parker-Pope Jul 8, 2008 NYTimes

One-fifth of U.S. teens have unhealthy cholesterol.Reuters News.

Should We Test Teens for High Cholesterol?  American Teens May Be at Risk for Problems Once Associated Only With Middle Age By JOHN GEVERJan. 22, 2010 MedPage Today Senior Editor

For Kids With High Cholesterol, Change Diet, Exercise Before Drugs January 22, 2010 By Nadja Popovich

Saturday, January 23, 2010 More Business for Big Pharma.
Statins for Kids?Dr. Michael J. Breus 10-Day Boot Camp for a Healthier Lifestyle. Huffington Post.

Soda fountains contained fecal bacteria, study found By Madison Park, CNN January 8, 2010 6:35 p.m. EST

(42)  Int J Food Microbiol. 2010 Jan 31;137(1):61-6.
Beverages obtained from soda fountain machines in the U.S. contain microorganisms, including coliform bacteria . Amy S. White, Renee D. Godard, Carolyn Belling Department of Biology, Hollins University,

The scientific evidence of sugar addiction, Kathleen DesMaisons, Ph.D. is the best selling author of Potatoes Not Prozac, The Sugar Addict’s Total Recovery Program, Your Last Diet, Little Sugar Addicts and Your Body Speaks.

The Reclassification of Sugar as a Drug - Marie-Hélène Lyle: The Reclassification of Sugar as a Drug. Lethbridge Undergraduate Research Journal. 2006. Volume 1 N 1.

Neurosci Biobehav Rev. 2008; 32(1): 20–39. Published online 2007 May 18.
Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake - Nicole M. Avena, Pedro Rada, and Bartley G. Hoebel*

Obes Res. 2002 Jun;10(6):478-88. Evidence that intermittent, excessive sugar intake causes endogenous opioid dependence. Colantuoni C et al.

(47) Smoking Bans in US Hospitals Results of a National Survey. JAMA. 1995;274(6):488-491. Daniel R. Longo, ScD; Ross C. Brownson, PhD; Robin L. Kruse, PhD

(48) Lancet. 1972 Dec 23;2(7791):1354-7.Dangers of intravenous fructose.Woods HF, Alberti KG.

Author Jeffrey Dach MD

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