Richard A. Forshee

A Critical Examination of the Evidence Relating High Fructose Corn Syrup and Weight Gain

The use of high fructose corn syrup (HFCS) has increased over the past several decades in the United States while overweight and obesity rates have risen dramatically. Some scientists hypothesize that HFCS consumption has uniquely contributed to the increasing mean body mass index (BMI) of the U.S. population. The Center for Food, Nutrition, and Agriculture Policy convened an expert panel to discuss the published scientific literature examining the relationship between consumption of HFCS or “soft drinks” (proxy for HFCS) and weight gain. The authors conducted original analysis to address certain gaps in the literature. Evidence from ecological studies linking HFCS consumption with rising BMI rates is unreliable. Evidence from epidemiologic studies and randomized controlled trials is inconclusive. Studies analyzing the differences between HFCS and sucrose consumption and their contributions to weight gain do not exist. HFCS and sucrose have similar monosaccharide compositions and sweetness values. The fructose:glucose (F:G) ratio in the U.S. food supply has not appreciably changed since the introduction of HFCS in the 1960s. It is unclear why HFCS would affect satiety or absorption and metabolism of fructose any differently than would sucrose. Based on the currently available evidence, the expert panel concluded that HFCS does not appear to contribute to overweight and obesity any differently than do other energy sources. Research recommendations were made to improve our understanding of the association of HFCS and weight gain.

Demographics, not beverage consumption, is associated with diet quality

Background Demographic characteristics and beverage choices may affect diet quality. Objective To estimate the independent associations between consumption of food categories of the US Department of Agriculture Food Guide Pyramid, beverage consumption, gender, age, family income, and race/ethnicity with the Healthy Eating Index (HEI). Methods Data from the Continuing Survey of Food Intake by Individuals 1994–96, 1998 were used to develop multiple regression models of demographics and food and beverage consumption regressed on the HEI. Results After adolescence (13–19 years), males consistently had a lower diet quality than females. Young adults (20–29 years) had the poorest diet quality. Family income had a positive association with the HEI. Controlling for income, African-Americans had lower HEI scores than other race/ethnicity groups. Caucasians consumed significantly more milk products than did the other race/ethnicity groups. Consumption of beverages had a weak but positive association with the HEI. Conclusions Family income and race/ethnicity have unique and independent associations with the HEI and dietary patterns.

Changes in Calcium Intake and Association with Beverage Consumption and Demographics: Comparing Data from CSFII 1994–1996, 1998 and NHANES 1999–2002

Background: Consumption of soft drinks has been hypothesized to be negatively associated with calcium intake. However, fortification of some foods and beverages may have affected calcium intake. Objective: The purpose of this study was to examine changes in calcium intake and the association of milk consumption with key beverage consumption and demographic variables using the most current data available. Design: Several techniques were used to describe how age, gender, race/ethnicity, and beverage consumption were associated with milk and calcium intake using the Continuing Survey of Food Intake by Individuals 1994–1996, 1998 (CSFII) and the National Health and Nutrition Examination Survey 1999–2002 (NHANES). Using bivariate and multivariate regression analyses, we examined the independent relationships of total non-beverage energy intake, fluid milk consumption, non-milk beverage consumption, and demographics with calcium intake. Results: During the time period between CSFII and NHANES, milk consumption decreased and RCSD consumption increased among children 6–11 y. Calcium intake was unaffected. Among other age categories, milk consumption either did not change or increased (females 40–59 y), while RCSD consumption increased. Calcium intake either did not change or increased in most age-gender categories, including adolescent females. Fluid milk consumption exhibited the strongest association with calcium intake. Fruit juice consumption was also positively associated with calcium intake in most age-gender categories. Consumption of other beverages, including RCSD, had little or no association with calcium intake. Conclusions: Consumption of low-fat milk should be encouraged, but calcium fortification of certain foods and beverages and calcium supplementation may be needed to further increase calcium intake.

A Risk Analysis Model of the Relationship Between Beverage Consumption from School Vending Machines and Risk of Adolescent Overweight

Risk analysis is a widely used tool to understand problems in food safety policy, but it is seldom applied to nutrition policy. We propose that risk analysis be applied more often to inform debates on nutrition policy, and we conduct a risk assessment of the relationship of regular carbonated soft drink (RCSD) consumption in schools and body mass index (BMI) as a case study. Data for RCSD consumption in schools were drawn from three data sets: the Continuing Survey of Food Intake by Individuals 1994-1996, 1998 (CSFII), the National Health and Nutrition Examination Survey 1999-2000 (NHANES), and the National Family Opinion (NFO) WorldGroup Share of Intake Panel (SIP) study. We used the largest relationship between RCSD and BMI that was published by prospective observational studies to characterize the maximum plausible relationship in our study. Consumption of RCSD in schools was low in all three data sets, ranging from 15 g/day in NFO-SIP to 60 g/day in NHANES. There was no relationship between RCSD consumption from all sources and BMI in either the CSFII or the NHANES data. The risk assessment showed no impact on BMI by removing RCSD consumption in school. These findings suggest that focusing adolescent overweight prevention programs on RCSD in schools will not have a significant impact on BMI.

Innovative regulatory approaches to reduce sodium consumption: could a cap-and-trade system work?

Many regulatory and professional organizations are calling for strict new regulations to reduce sodium consumption on a population basis. New regulations on sodium may have significant public health and economic impacts. This article explores five regulatory options to reduce sodium consumption: 1) maintaining the status quo, 2) improving risk communication and information, 3) revoking generally regarded as safe status of sodium and regulating its use in food products, 4) establishing a sodium tax, and 5) establishing a market-based, cap-and-trade system for sodium that builds on similar approaches in environmental regulatory policy. Cap-and-trade may be a promising regulatory option for sodium and other ingredients.

Associations of Various Family Characteristics and Time Use With Children's Body Mass Index

This study used multiple regression models to estimate associations of various family characteristics and time use with the body mass index (BMI) z-scores of 734 boys and 725 girls aged 5–18y from the Panel Study of Income Dynamics Child Development Supplement 2003. The strongest relationship in the data was between the BMI of the head of household and a childs BMI z-score (p < 0.001). Time spent sleeping, performing sedentary behaviors, and participating in physical activities was not associated with a childs BMI z-score. This suggests that a family-oriented approach to prevent and treat childhood and adolescent overweight is required.

Assessing the Potential Public Health Impacts of Next Generation Foods Derived from Recombinant DNA Technology: A Case Study of Omega-3 Fatty Acids Enhanced Vegetable Oils

We assessed the potential public health impacts of foods derived from recombinant DNA technology that have been modified to have improved nutrient profiles using omega-3-enhanced vegetable oils as an example. Other examples of crops in development include canola plants with increased vitamin C and rice with higher levels of beta-carotene. The change in consumption of omega-3 fatty acids if vegetable oils were replaced with stearidonic acid-enhanced versions was estimated. The results showed that stearidonic acid and gamma-linolenic acid consumption would increase by 5.43 g/d for males and 4.14 g/d for females. The increase in stearidonic acid in eicosapentaenoic acid equivalents was 1.63 g/d for males and 1.24 g/d for females.