Our Mandate for Responsible Food Behaviors: HFCS, Sugar added beverages and Portion Distortion. William Barum

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1 Our Mandate for Responsible Food Behaviors: HFCS, Sugar added beverages and Portion Distortion William Barum 1

2 Presenter Disclosure Information William Barum Our Mandate for Responsible Food Behaviors: HFCS, Sugar added beverages and Portion Distortion FINANCIAL DISCLOSURE: No relevant financial relationship exists 2

3 Cleveland Clinic Mission Statement Cleveland Clinic offers food and nutrition services in order to promote and deliver a state-of-the-art program that results in a positive experience for patients, staff and visitors, supports growth and development, our local economy, healing, recovery, and optimal health in an environment that supports research and development. 3

Sugar-Sweetened Beverage Consumption Energy in liquid form Displacement of more satiating foods High glycemic load Fructose Alteration of taste preferences Sugar Incomplete

dysfunction Increased intake of sugary foods; decreased intake of vegetables, fruits, etc Lower intake of fiber micronutrients, antioxidants and other phytochemicals Increased

4 Sugar-Sweetened Beverage Consumption Energy in liquid form Displacement of more satiating foods High glycemic load Fructose Alteration of taste preferences Sugar Incomplete calorie compensation Passive calorie overconsumption when drinking to satisfy thirst Increased hunger Insulin resistance Postprandial hyperglycemia & hyperinsulinemia B-cell dysfunction Increased intake of sugary foods; decreased intake of vegetables, fruits, etc Lower intake of fiber micronutrients, antioxidants and other phytochemicals Increased energy intake Metabolic Syndrome (low HDLC, high triglyceride, hypertension, hyperglycemia coagulopathy, chronic inflammation) Hyperuricemia Obesity Diabetes CHD Gout Dental caries 4

5 Wellness Building a Comprehensive Culture of Wellness Smash the Ash All Cleveland Clinic Campuses Smoke Free Banned Trans - Fats From all public and patient menus Stopped Hiring Smokers Launched weekly Farmer s Market for employees and Community Launched first class Of Lifestyle 180 participants Launched com Implemented employee biometric collection (ROI over next 3 years) June 2007 May 2008 November 2008 October 2009 July 2010 July 2005 February 2007 September 2007 July 2008 October 2008 September 2009 January 2010 Free Yoga and Weight Watchers Shape Up and GO! Removed SUGAR drinks from all vending & cafeterias Established Wellness Institute and Michael F. Roizen MD as the Country s FIRST Chief Wellness Officer Initiated free memberships to Curves and Cleveland Clinic - owned fitness centers for EHP member employees Linked health plan contribution to wellness program participation 5

6 American Home Grown Tragedy Beaumont-Port Arthur, Texas Obesity rate: 33.8 percent Annual obesity-related costs: $182.8 million Rockford, Illinois Obesity rate: 35.5 percent Annual obesity-related costs: $179.4 million Huntington-Ashland, West Virginia-Kentucky-Ohio Obesity rate: 36 percent Annual obesity-related costs: $146.9 million Binghamton, New York Obesity rate: 37.6 percent Annual obesity-related costs: $131.5 million McAllen-Edinburg-Mission, Texas Obesity rate: 38.8 percent Annual obesity-related costs: $410.9 million 6

7 Weight Management 295,000 LBS Lost Weight Watchers Food Specifications Processes, i.e, Fryers Shape Up & Go Fitness Centers Education Communication Farmer s Markets Vending Machines GO! Foods 7

8 BAGEL 140 calories 3-inch diameter How many calories are in this bagel? 8

9 BAGEL 140 calories 3-inch diameter 350 calories 6-inch diameter Calorie Difference: 210 calories 9

10 Coffee 20 Years Ago Coffee (with whole milk and sugar) Today Mocha Coffee (with steamed whole milk and mocha syrup) 45 calories 8 ounces How many calories are in today's coffee? 10

11 Coffee 20 Years Ago Coffee (with whole milk and sugar) Today Mocha Coffee (with steamed whole milk and mocha syrup) 45 calories 8 ounces 350 calories 16 ounces Calorie Difference: 305 calories 11

12 Muffin 210 calories 1.5 ounces How many calories are in today s muffin? 12

13 Muffin 210 calories 1.5 ounces 500 calories 4 ounces Calorie Difference: 290 calories 13

14 Pepperoni Pizza 500 calories How many calories are in two large slices of today s pizza? 14

15 Pepperoni Pizza 500 calories 850 calories Calorie Difference: 350 calories 15

16 Chicken Stir Fry 435 calories 2 cups How many calories are in today s chicken stir fry? 16

17 Chicken Stir Fry 435 calories 2 cups 865 calories 4 ½ cups Calorie Difference: 430 calories 17

18 Turkey Sandwich 320 calories How many calories are in today s turkey sandwich? 18

19 Turkey Sandwich 320 calories 820 calories Calorie Difference: 500 calories 19

20 Soda 85 Calories 6.5 ounces How many calories are in today s portion? 20

21 Soda 85 Calories 6.5 ounces 250 Calories 20 ounces Calorie Difference: 165 Calories 21

22 Cheesecake 260 calories 3 ounces How many calories are in today s large portion of cheesecake? 22

23 Cheesecake 260 calories 3 ounces 640 calories 7 ounces Calorie Difference: 380 calories 23

Sugar-Sweetened Beverages and Health

Sugar-Sweetened Beverages and Health CIA-Harvard Menus of Change National Leadership Summit June 10, 2014 Cambridge, MA General Session IV Walter C. Willett, MD, DrPH Department of Nutrition Harvard School