Wednesday, July 20, 2011

Leukemia and Lymphoma Society labels Krispy Kreme fundraisers, "heroes"

And maybe they are, but not because they're selling Krispy Kreme doughnuts, but rather because they're trying to support an important cause.

In case you're new to this story, short version was me blogging last week about folks fundraising for Leukemia and Lymphoma research by selling Krispy Kreme doughnuts. What I wondered aloud was whether or not fundraising for healthy causes by selling unhealthy products was the best way to fundraise.

My post caught the eye of Leukemia and Lymphoma Society Public Relations Director Andrea Greif who wrote me an email. Here's what she had to say,

"Your post, “Krispy Kreme for the Cure,” pokes fun at some participants of The Leukemia & Lymphoma Society’s Team In Training (TNT) for using sales of doughnuts as a fundraiser to help advance blood cancer research while they train for a marathon. However, your reference to some studies that allege a connection between obesity and leukemia must be taken seriously.

It is important to note that the recent meta-analyses referred to in your article, concluding that “excess body weight may increase the risk of developing leukemia," were neither randomized nor controlled by any other gold-standard approach.

Obesity does seem to associate with a slightly increased risk of leukemia, but this does not prove any causal link. Clearly, obesity is linked to serious health concerns, including diabetes, and studies have shown that fat stores can affect metabolism of some anti-cancer drugs which may at least partly explain the other leukemia finding you mention.

In any case, doughnuts eaten in moderation, especially by marathoners who need to carbo-load while training and running their races, are not the problem. TNT participants employ many creative methods to take on the challenge of fundraising for the cause, and surely there is no harm done in athletes enjoying the occasional doughnut. TNT participants are heroes in their own right, and are raising money to support the critical work of researchers who are heroes too
Now if you read my post, you'll know I didn't poke fun at anyone, but I suppose that's in the ear of the beholder.

What was interesting to me about Andrea's response is her rationalizations - that doughnuts eaten in moderation by marathoners aren't so bad, and presumably therefore, neither is selling them to raise money for the Leukemia and Lymphoma Society.

So I agree that doughnuts eaten in moderation by anyone aren't so bad, but of course that's not the point.

The point is that organizations who care about health shouldn't be in the business of selling unhealthy products, especially products that may have a link to the condition championed by their organization. The rationale isn't because eating a single doughnut will kill you, the rationale is that elevating the brand and consumption of unhealthy products in the name of a few research dollars isn't a fair trade.

The Leukemia and Lymphoma Society, along with all other health charities, should establish guidelines and rules governing fundraising which in turn would prohibit the sale of junk food, because even if the link to leukemia isn't ultimately found to be causal, junk food's link to a veritable mountain of other chronic disease undoubtedly is.

[Oh, and Andrea, one last thing. While you're right to point out that the gold standard of research are randomized trials, I'm pretty sure we're never going to see a trial that randomly assigns people to gain weight to test the hypothesis that weight is causally linked to leukemia. Instead we're probably going to need to rely on the very types of meta-analyses that you casually toss aside as not being important.

And about carbo-loading, you might want to have a peek here.]

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  1. I can understand Ms. Greif's feelings in trying to defend her cause... it is a good cause and I believe her intentions are in the right place. That being said, I agree with you 100% that an organization ought not promote health with unhealthy food. Regardless of whatever ties there may or may not be between cancer and obesity (of which I am sure there actually are), I don't think it right to say "Well, we're not raising money for THAT health issue so let's ignore the consequences of what we're representing indirectly."

    Health is health.

  2. Alexie7:14 am

    Speaking as someone who's just endured a year of lymphoma treatment, I'd rather money wasn't raised for the cause this way. Because even though weight and my diseas

  3. Anonymous7:15 am

    I know several marathoners and professional athletes and NONE of them carbo-load using donuts! Give me a break! That has got to be the lamest excuse I've ever heard for selling crap. I agree that 1 donut isn't going to kill anyone but that's not the point. If you're trying to raise money for a health related cause, why not do it by promoting good health. Lead by example instead of trying to impress upon readers that marathoners, athletes who care what goes into their bodies, eat deep fried, sugar coated goo as a way to make it through a race.

  4. GREAT response, Dr. someone who has lost both a brother and my father to different forms of leukemia, I admire the Leukemia & Lymphoma Society and have sponsored several friends who have trained with them to run marathons...and I still will. But selling donuts appalls me. Any fundraising done in the name of preventing/treating/curing any disease should not use the sale/promotion of products that not only don't provide any health benefits but do in fact provide empty calories in the form of potentially dangerous and admittedly addictive ingredients (the demon sugar). Here we have a cancer fundraiser called Alex's Lemonade Stand...sorry, but I'm not buying a cup of artificial lemon flavored sugar water to "support" cancer treatment. And I gag every October during "Breast Cancer Awareness Month" when I walk into the supermarket and am greeting with a table piled high with boxes of sugar-filled, artificially colored, chemically preserved pink frosted junk like cookies and cupcakes (of course with the obligatory pink ribbon stuck on them)and all the sheep buying them "for the cure"...when possibly 25 cents of every purchase maybe even makes it to the charity in question and millions of unnecessary, potentially harmful calories make it into the bodies of the consumers. Thanks for addressing this conflict of interest and for countering Ms. Greif's arguments defending the L&L Society's irresponsible, pandering choice of fundraiser.

  5. Yoni, I can certainly understand how someone in your line of work can get a little jaded about such things, but I respectfully disagree with your objection to raising funds for a health cause selling "unhealthy" foods.

    What else should they sell? Let's think about what many consider healthy foods: Yogurt-like substances, FiberOne bars, Nutrigrain bars? How about burgers - depending on your camp these are either one of the healthiest foods on the planet if served bunless, or one of the unhealthiest foods.

    I'm thinking selling carrot sticks is not going to be a very productive fundraiser.

    So, no food items at all? Do we really need another ribbon pin or ridiculous plastic colored bracelet to show support for another cause? (Those bracelets some adults wear 24/7 are a peeve of mine). Or even another hat or t-shirt?

    Krispey Kremes are not inherently unhealthy any more than they are inherently fattening. Bake sales used to be favorite fundraisers now getting banned from schools.

    Someone buying a donut to help a cause is not harming themselves and getting a tasty (well, I'm not a big KK fan) treat. I don't see anything wrong with that.

    If KK donated a million dollars to the cause, should they not accept that because KK is in the business of selling unhealthy food? How about the Ronald McDonald House? Good, no good?

    I guess my point is we need to pick our battles and this one just seems rather more a nit pick to this reader.

  6. Hi CarbSane,

    Respectfully, we will have to disagree.

    Suggesting that there's no other way to fund raise is simply accepting the status quo because it's convenient and because bucking it would take some thought and creativity.

    Off the top of my head with 30 seconds of thought - they could mow lawns, wash windows, clean local parks or organize car washes. They could offer to run in ridiculous clothing (I had a friend run a breast cancer run in a dress), organize silent auctions, or sell locally grown fruits and vegetables. They could sell bandannas, T-shirts, buttons or bumper stickers.

    I'm sure with more time, and the hive mind, the Leukemia and Lymphoma Society ought to be able to provide Team members with at least 100 different non-junk food selling ideas for fundraisers.

    Just because it's easier to sell junk food, doesn't make it wise, right, or smart, and it sure isn't any stretch to go from fundraising with doughnuts, to KFC's infamous Buckets for the Cure.

    Me? I don't think KK's sugar money is something I'd want funding my organization's public health efforts.

  7. Anonymous10:04 am

    krispy kremes are not inherently unhealthy? what redeeming quality do they have nutritionally? i completely understand that as a rare treat if you enjoy the taste, then no, they're not going to kill you. but they are in no way healthy.

  8. Anonymous10:11 am

    Thank you Dr. Freedhoff!
    I completely agree with your stance on this issue. It is so frustrating to see fundraisers, for health causes, at any price to the well being of others. As a teacher, I see this in schools all the time, and think that the word "moderation" is thrown around with out much thought. Eating doughnuts in moderation? Give me a break! It should be 'eating doughnuts rarely, if ever' and not in support of any kind of health related issue! (Even for 'marathoners' - who I guess are immune to the negative health effects of doughnuts?) There are so many clever ways to raise money that don't sacrifice the well being of others.

  9. Anonymous10:19 am

    I'd like Andrea to show us how any fund-raising for the L&L Society has resulted in research that has improved life for afflicted, or has promise to lead to a cure.

    She can't. It's all a huge myth that all this running (and munching) does anything but aid researchers careers.

  10. Theresa11:04 am

    Not to mention a FRACTION of the profit goes to the research! KK is still making MORE money with these extra guilt/feel good sales.

    drugstores who sell wellness items are no longer allowed to sell tobacco products for this very same reason. CONFLICT OF INTEREST!

    To all the people who have suffered with lymphoma I am truly sorry and wish you well. Cheers to you and I'll sooner put that $15.00 directly into the fundraising coffers than into KK's till.

    GREAT comments!

  11. krispy kremes are not inherently unhealthy? what redeeming quality do they have nutritionally?

    This is a different argument. I didn't say they were a nutritious choice, but making the occasional less-than-nutritious choice does not equate to UN-healthy. What is that anyway? I'm not sure -- allergies and intolerance aside -- that any food is inherently unhealthy. An unhealthy food would negatively impact one's health. Show me how the occasional donut does that.

    There are lots of people who believe that flour is unhealthy, that beer is unhealthy, that cream cheese is unhealthy. And yet I remember when my grandmother was in her 60's she ate a slice of pumpernickel bread with cream cheese and a beer for dinner every night. She lived to a ripe old age.

    I appreciate Yoni's viewpoint, but I think it's a nit pick. It's OK to disagree!

    To the person who thinks such fundraisers never help anyone with the disease and just line the pockets of researchers, you need to get a grip. I have no idea about L&L, but all such organizations/charities as a whole tend to have rather poor records as to where their money goes. Too much, often over half, goes to pay the salaries and operating costs for the charity itself. The researchers aren't getting rich off this sort of thing.

  12. Michelle Mercurio2:29 pm

    I love how whenever the talk turns to obesity or unhealthy foods someone invariably needs to whip out their personal anecdotes about 300 lb. great aunt Sally who at junk food and lived to be 85 and was never sick a day in her life. My parents each smoked for over 60 years...neither one ever got emphysema or lung cancer...does that mean cigarettes are not bad for you? Saying that sugar and white flour and artificial ingredients deep fried in lard are not inherently unhealthy and claiming that elite runners eat donuts to carb load for mararthons are the two most asinine things I've heard this week.

  13. Anonymous2:42 pm

    Those researchers have not cured anything, and that's because they are not looking for a cure, but the next drug to market for the pharma co. That's who they work for. And the pharmaco is not looking for a cure either. What?! Slit their own throats?!

    YOU need to get a grip and read some PloS on drug research, marketing and conflict of interest. For a start, then motor on over to CSPINET (just put that into google) and Therapeutics Initiative (ditto google). Read. Learn. Sit down first.

  14. I totally agree with you 100%. I find it very difficult to support fundraisers that are ironically not seeing the picture of the causes of health problems we see today.

  15. Anonymous7:27 pm

    Totally agree. There are lots of other ways to raise money. I worked in a middle school that dared to simply ask for donations- we promised no school sales if donations alone were adequate. Parents exhausted by buying hundreds of dollars worth of junk at the elementary school literally whipped out checkbooks and asked us how much we wanted! It worked! You don't have to compromise your values of the cause is worthy. When people come around selling products for worthy causes, I usually tell them, "I can't eat anything in your catalog. How about cash?" Haven't been turned down yet. BTW- for hypoglycemics, a doughnut IS inherently unhealthy. I'll go from witchy to exhausted in an hour, and be emotionally nuts for the rest of the day, if I eat one.

  16. "The point is that organizations who care about health shouldn't be in the business of selling unhealthy products, especially products that may have a link to the condition championed by their organization" ~ I definitely agree with you, Yoni. Guidelines should be set here because these types of organizations are supposed to be encouraging healthy food choices and lifestyle. Are they really this desperate to jump in the back of the "enemy" just so they could take advantage of its popularity and raise money for their "cause"? These will only result to much confusion especially to the children. It's all about accountability and being responsible.