John Howell Column

Published 12:00 am Friday, March 26, 2010

Poor lifestyle choices add tremendous cost to U. S. health care

Among ideas sparingly mentioned during the ongoing health care reform rage is how much our lifestyle choices affect its cost. Obesity alone accounts for 10 percent of the cost of health care in this country.

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That figure comes from Cleveland Clinic CEO Delos Cosgrove in a recent Fortune magazine interview. Cleveland Clinic has been held up as an example of best practices during the months of debate, consistently delivering a high caliber of health care to its patients at costs well below the national average.

Read the interview at

Cosgrove named smoking, diet and lack of exercise as the cause of 40 percent of the nation’s premature deaths and as factors in 70 percent of the chronic diseases — emphysema, heart disease and such — that account for 75 percent of health care cost.

The Cleveland Clinic CEO also said that U. S. health care gets unfavorable comparison in the international community because high rates of murder and traffic accidents skew the data. The article did not suggest how much the nation’s longevity would be increased if victims of murder and traffic fatalities were factored out. It did set me to thinking about whether the high rates of both might reflect societal lifestyle choices.

Then this week came the report of a U.S. Public Health Service-sponsored study conducted at Princeton Neuroscience Institute which seems to indicate that some lifestyle choices get made for us.

They compared weight gain in rats with one group subjected to long-term consumption of high-fructose corn syrup and the other to similar consumption of table sugar. To oversimplify the findings, “The rats in the Princeton Study became obese by drinking high-fructose corn syrup, but not by drinking sucrose,” according to a report of the study on the Princeton University web site.

Publication of the study results set off an exchange of claims and counterclaims from a number of sources in the blogosphere including, predictably, from the Corn Refiners Association, which cited “gross errors” in the methodology.

“‘High fructose corn syrup and sucrose are exactly the same,’” University of California, San Francisco pediatric neuroendoctrinonologist Dr. Robert Lustig told Science Cafe, a UCSF web magazine. “‘They’re equally bad. They’re both poison in high doses,’” Lustig continued, noting the increase in American fructose consumption from 15 to 75 grams per day during the last century.

(While fructose is a component of both sucrose and high-fructose corn syrup, the latter is a less-expensive mixture, according to the article at Most in the blogosphere exchange, with the exception of the Corn Refiners Association, seem to agree that fructose screws up the brain’s ability to tell the mouth when to stop eating.

Which means that — some lifestyle choices can get confusing. But, recalling the Cleveland Clinic CEO’s observations, some are pretty obvious: No tobacco, good food and much less of it, more exercise.