We’ve walked through multiple exhibit halls at diabetes conferences in recent months, and seen hundreds of displays for products ans services meant to serve or help the diabetes community — everything from medical devices, blood strips and supplies to non-profit charities and food products that people with diabetes might care about.
Some “controversial” exhibitors definitely caught our eye, such as a cinnamon water extract product that’s supposedly a dietary supplement to help blood sugar control (really?), and of course, the much-buzzed-about High Fructose Corn Syrup booth that appeared at the AADE Annual Meeting expo this year. This sparked a lot of anger in the diabetes community, with a fellow blogger even launching an “HFCS-Free Day” protest scheduled for this Saturday, Aug. 25 (more on that below).
Aftermath: the AADE 2012 Exhibit Hall
The big issue for us was: how the heck did the Corn Refiner’s Association get in the door to exhibit at a diabetes education conference?!
Clearly, long before these conferences start and the expo halls fill up, someone has the task of reviewing all the potential exhibitors and deciding who’s allowed in.
We felt it was high time to take a look at the criteria used by the leading national diabetes organizations to make these decisions.
What we learned is that not every organization/conference has the same rules for vendors, and in fact, they have radically different views on this issue. Read on to learn more…
AADE’s Viewpoint
To understand their criteria, we went straight to the AADE’s exhibitor rules posted online. This document specifies that participation in their exhibit halls “is limited to manufacturers and suppliers of products and services used in the education and care of diabetes.”
So how does High Fructose Corn Syrup fit into that definition? We asked AADE director of communications Diana Pihos.
“Our goal is to provide a forum for companies and organizations to inform the diabetes healthcare community through their research and/or their products and services and to allow the healthcare professionals in attendance to form their own judgments,” Pihos offered as an AADE statement, noting that the organization also seeks attendee feedback to inform future decisions.
She explained the process: an exhibits team reviews each vendor application, and the organization “reserves the right to accept, reject or condition acceptance based on AADE’s sole discretion, for any reason, which need not be disclosed to the applicant.”
Although some applications have been rejected over the years, those cases are confidential and therefore the AADE declines to elaborate.
“All food-related products play a role in diabetes care. Whether and how to advise patients about consuming certain products is for the healthcare professional to decide… (The Annual Meeting) is a forum for the exchange of information. Being an exhibitor does not imply an endorsement,” Pihos added.
So that’s why the HFCS folks were allowed in, and why others that may be controversial are generally OK to
o.
But what our community seems to take issue with in particular is the Corn Refiners Association touting “scientific evidence” of the health value of HFCS, in the form of “Sweetener Studies.” To learn more about the protest, check out D-Mom Leighann Calentine’s initiative, “HFCS-Free Day.” She’s asking everyone to boycott products with HFCS that day, and post about on Facebook and Twitter.
The Corn Lobby’s POV
Dr. John White, a nutritional biochemist who serves as a consultant for the Corn Refiners Association and other clients, staffs the HFCS booth at various conferences. He said the AADE is the only diabetes-focused event they present at. He sees all different kinds of reactions from attendees, from those who disagree with their very presence and dispute HFCS itself, to those who “appreciate the opportunity to learn more.”
“I don’t think there’s a conflict in being there,” White said. “People need the information, (because) what people eat… what diabetics eat… is very important. We’re not there to sell more HFCS, but to educate people so they’re not providing the wrong information to clients. There’s nothing evil about it.”
White pushed the talking points about HFCS being interchangeable with regular sugar and that, like everything in the food world, it’s fine in moderation. When pressed on how moderation is possible when HFCS seems to be in so many products, White insisted that was an exaggeration — rather it’s simply a “perception that it’s in everything.”
I bit my tongue, knowing that most of the labels I read every day contain HFCS and it’s indeed very difficult to avoid this product when grocery shopping. But why argue with professional lobbyists? The science isn’t something I’m all too familiar with, so I didn’t feel equipped to argue anyway. Turns out, White sees their presence at the AADE conference as a chance for HFCS to redeem itself, and clear the bad rap it’s gotten in the press.
“There’s a growing awareness, and the black eye that (HFCS) had is beginning to clear up,” White said. “Scientifically this is the case, but it’s about communicating that science to everyone.”
ADA Draws the Line
Despite the “educational” aspect echoed by the AADE and HFCS-promoters, the ADA takes a different approach to this kind of controversial booth, and we give them kudos for standing on principal with regard to the “healthy eating” message.
They do not allow the Corn Refiners Association to be present at the big ADA annual conference (!), which most recently this June featured 171 exhibitors.
Stephanie A. Dunbar, a registered dietitian who serves as the ADA’s director of Nutrition and Medical Affairs, takes the lead on reviewing exhibitor information. She said the Corn Refiners Association asked the ADA to exhibit a few years ago, but the organization didn’t allow it.
“Considering their product is HFCS, I didn’t think it made sense,” she said. “Just like we wouldn’t allow a company to exhibit regular soda.”
Just like AADE, the ADA has a disclaimer on its exhibitor rules stating that the organization “reserves the right to restrict or deny any booth assignment that would compromise the integrity or desirability of the exhibition.” Only they seem to be exercising it more aggressively.
Dunbar tells us that food-specific product exhibit guidelines were first implemented by ADA in 2004 and last revised in 2008. The guidelines prohibit acceptance of revenue for “foods or beverages without significant nutritional value that could be perceived by the general public as either unhealthy or inconsistent with the Association’s Clinical Practice Recommendations.”
As an organization, the ADA took a financial hit when it stopped accepting advertising and exhibits for things like sugar-free cookies and other similar low-nutrient-dense foods.
“We felt it was important to promote foods that reinforced our health messaging for managing diabetes and also preventing type 2 diabetes,” she said. “It is difficult to encourage people to eat fruit for dessert instead of cookies or cakes, and then have an advertisement on the next page or a booth around the corner. I think we live in an environment where making a healthy choice is not usually the easy one, so we need to avoid mixed messages.”
Any new product submitted for potential exhibit goes to the science and medical department for review, she said. An example of something in the ”not allowed” category would be a 100% white-flour-based bread; only if it has half the grains as whole wheat would it be allowed. So no Wonderbread, ay?
“There are some gray areas with some of the newer products that are coming out such as nutrition bars and shakes,” Dunbar said. “When in doubt, I have a small committee of health professional volunteers and I get their opinion. Based on their feedback, a decision is made.”
AACE, CWD and Other Orgs
The American Association of Clinical Endocrinologists (AACE) had about 83 exhibitors at its most recent conference in May, and Matthew Marcial, the director of Meetings & Event Services, told the ‘Mine they haven’t had any cases where vendors have been turned away. He surprised us by saying they’ve not had any controversial booths or issues that needed more review. The organization’s conference guidelines for exhibitors can be found here.
For Children With Diabetes, founder and D-Dad Jeff Hitchcock says it’s pretty simple: any product presented in the exhibitor’s space must have science to support its use in the management of type 1 diabetes.
“So that means no vitamin vendors, no sock vendors, etc., and – at least at this time – no diabetes alert dogs, because for now there is no good science,” he said. “We also do not accept companies that are not singularly focused on diabetes care, so no religious organizations, which you can find at ADA and AADE.”
And then there’s the Academy of Nutrition and Dietetics (formerly the American Dietetics Association) that hosts the annual Food and Nutrition Conference and Expo each fall. While we couldn’t reach the exhibit coordinator to talk about their policies and past reviews, an exhibitor list for the 2011 conference shows more than 300 exhibitors in food products, food delivery equipment, baking and cooking products, food management, nutrition assessment tools, and computer programs — including the Corn Refiners Association. Their policy and guidelines are listed here. These guys are all about FOOD, rather than diabetes, however, so perhaps we might not expect them to uphold the same ethics with regards to sugary products.
Your Bottom Line?
In the end, this is a touchy issue to argue. On the one hand, AADE makes a strong point about emphasizing education and individual choice, regardless of what some might think or believe about controversial products like HFCS.
On the other hand, their allowing HFCS in the door when even ADA deems this product to be “without significant nutritional value” seems like a real compromise of ethics. And yes, it at least appears to be some kind of endorsement by AADE, the very group of healthcare professionals closest to diabetes patients (!)
What do you all think? Should controversial products like HFCS be checked at the door, or allowed in for “learning purposes” so conference attendees can “make up their own minds”?
Its likely directly related to MONEY. The vendors pay the bills for the venue ….. Tells you something about the organizations
The corn syrup booth also started some good conversations – likely on site as well…..
Hi MikeH,
Something to consider. The most common sugar is sucrose and what most individuals refer to as table sugar. Sucrose is a disaccharide, or double sugar, being composed of one molecule of glucose linked to one molecule of fructose. Has it been demonstrated whether there is a difference between an all glucose diet verses an all frutose diet?? Most individuals purchase “sugar”, table sugar and give no thought to the product. Yes, since we as diabetics measure the “glucose” in our blood stream we are more responsive to the term. What we eat, how much we eat does come into play in the management of our diabetes. Hope this hels and as always have a great day.
Dan
To individuals who are informed, a booth from the HFCS folks would just make them laugh, but some people are not as well informed. They may believe that if HFCS has a booth at a diabetic convention, it must be fine for consumption. I’m disappointed that more organizations don’t value integrity over money. Every day I run into people who are misinformed about some aspect of diabetes and/or nutrition. What I want for my fellow diabetics of all stripes is clear information and consistent, accurate nutritional information.
I would really appreciate an organization where the process for inclusion was completely open and public, that is: if a vendor is approved or refused, the reason is stated publicly. That openness should be a requisite for their being considered at all. I think then that these PR attempts to defend the undefendable would get no traction, and rightly so.
I agree with Doug, I’m sure this is tied to money. To our advantage, this did give us an opportunity for discussion. But, I think it’s pretty sad that we live in a country that has sold the health of it’s citizens out for profit. Europe has banned HFCS to protect it’s citizens and the only reason we haven’t is money.
So those of us who are more informed than the average consumer have a responsibility to our fellow citizens. We can choose to ban HCFS from our lives entirely. It’s NOT hard, I’ve done it, and if you stick to the “health” section of your grocery you’ll avoid it almost entirely as you read labels. Better yet, stick to the produce section and you’ll avoid HCFS and added sugars-which are almost just as bad and added in everything as well. The company’s live for profit so if we deny them that as consumers, we are protecting those who don’t have the information, ourselves and our families, and getting the market to make us what we do want.
I can’t understand why so many people who are informed don’t stand up for their values in a way that actually counts-such as what we purchase. That’s just about the only real agent for change we have left these days so let’s use it
Awesome piece of journalism. Thanks for the many insights to chew on. This is a multi re-read post for sure. You win a beer at Founders brewery if your ever in my town, and a HFCS free snack. lol. Thanks for reporting Mike!!!!!
Mike – Great post. You’re raising good discussion and thinking about the conflicts of interest that our diabetes organizations must consider.
As a T1 that lives with a hypoglycemia alert dog it saddens me that some in our community remain so skeptical about the legitimate service these dogs give so as to ban them (as vendors) from their community gatherings.
Good scientific proof takes big money. There isn’t and probably never will be sufficient economic incentive to motivate an organization to finance a real scientific study to prove or disprove a dog’s ability to give valid low blood glucose alerts.
In the meantime I’m grateful for the many alerts that my dog gives me each and every day. I am very much a person that believes in hard science and am often not persuaded by the many “cures” and “treatments” that some promoters push. But when my dog wakes me up from a deep sleep ten minutes before my CGM buzzes a low alarm, then my confidence in the validity of diabetes alert dogs soars.
I know many in our community are sympathetic with the idea of diabetes alert dogs. I hope that over the years, the skeptical holdouts will start to understand and believe in the validity of this service!
I have to echo Tim’s comment above. An exhibit like this, while laughable, is relatively harmless to those who do their homework and know the score, nutritionally speaking. But for many others, whether they be new diabetics just starting up the learning curve or simply casual observers, the mere presence of HFCS in an exhibition of this type can’t help but imply that it’s a worthwhile dietary component. Bad news.
After all, this is not a conference about food in general; It’s an event produced primarily by and for those whose job it is to teach diabetics how to manage their disease. This exhibit doesn’t need to say anything. Simply by existing, it sends the wrong message.
@Terry – I think Jeff Hitchcock’s point is that when you stand on strict principles, you sometimes have to make tough choices. In other words, he’d probably *love* to let the alert dogs folks into his Expos, but if the rule is that ALL exhibitors must have science behind their offerings, he has to stick to that standard.
btw, some researchers are working very hard to gather scientific evidence of the benefit of medical alert dogs. We just a post & video on this topic, here:
http://www.diabetesmine.com/2012/07/talking-hypo-alert-caninesin-the-dogs-days-of-summer.html
Wow, I’m pretty impressed that the Corn Refiners care enough to bring their story to the diabetic population. Oh, that’s right, they want to sell stuff to EVERYONE, even those of us with metabolic challenges.
Mike, thanks for drawing attention to these issues.
We, people with diabetes, can’t eat whatever we want, especially not HFCS… or any other sugars that raise glucose more rapidly than our insulin can counter the effect. Just my 2 cents.
“All food-related products play a role in diabetes care. Whether and how to advise patients about consuming certain products is for the healthcare professional to decide… (The Annual Meeting) is a forum for the exchange of information. Being an exhibitor does not imply an endorsement,” Pihos added.
I suggest that if you ever meet a healthcare professional who advises consumption of HCFS (even in moderation), you run away – fast. As for the endorsement issue – the AADE may not give HFCS an official seal of approval, but allowing a booth in the expo does imply an endorsement. And unless the booth appears with a large skull-and-crossbones poster, its presence undermines the entire concept of diabetes education. And the comment “All food-related products play a role in diabetes care,” is ridiculous, and a weak defense.
All that said, HCFS isn’t the only villain out there. Table sugar is processed too and has been associated with obesity, CVD, etc.
It’s funny to me that the ADA supposedly wants to focus on healthy eating. When we went to an ADA Exhibition, there were extremely long lines of people waiting to pick up their free junkfood (labled as being for diabetics) from the grocery stores’ gigantic “booths”. They took up one entire end of the hall. Most of the people in line were grossly overweight already and certainly could use some education on proper food choices, rather than buying boxed, processed junk.
i have diabetes type I and when i consume a product that has hfcs it takes twice the amount of insulin to control my levels as regular sugar. i have avoided hfcs at all costs due to that fact. anyone who says it’s the same is sadly mistaken.
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As a T2, I like it when the right organizations can charge a vendor fee at these great shows. Now all we have to is train the rest of us to stay away from them, and point them out. Then give the money to research, find the cure, especially for the kids.
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