Eat Well to Be Well: The unsugar-coated truth about high fructose corn syrup

For a substance that’s been in our food supply since the 1970s, it wasn’t until 2004 that it came under intense scrutiny when an article titled “Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity” popped the tab off its relative obscurity. Ever since, high-fructose corn syrup has ridden a not-so-sugary-sweet tidal wave of bitter criticism.

“It seems American food culture is at a real crossroads, because consumers are finding out more and more about the dangers of many of the ingredients in our food, especially processed foods,” said Dr. David Samadi, chairman of urology and chief of robotic surgery at Lenox Hill Hospital in New York City. “The laundry list of ingredients on the back of these packages is incredibly alarming. High fructose corn syrup is one of the most concerning ingredients, and countless studies have shown the effect it can have on the body, especially if highly consumed in one’s diet.”

What is the truth on high-fructose corn syrup? Is it as bad as for our health as some say; why is it in our food supply; what foods contain it; and can it be reduced?

History on high fructose corn syrup

Before the birth of high fructose corn syrup (HFCS), sucrose, which comes from sugar cane or sugar beets, had been used for centuries to sweeten our food. In 1970, the most common sweetener in the United States was sucrose. The carbohydrate sucrose, also known as table sugar, is a disaccharide composed of two monosaccharides – glucose and fructose.

Food manufacturers, however, had issues with sucrose as it posed some technological problems: it tends to break down in acid, changing the sweetness and flavor characteristics of a product; because it’s a granule, it has to be dissolved in water before using; and sugar cane is typically grown in regions near the equator where there’s more climate and political instability, causing fluctuation in the availability and price of sugar.

This is where HFCS made its appearance. As early as the 1950s, work was being done to develop a liquid sweetener alternative to sucrose for use in many foods and beverages. HFCS is made from corn – an enzyme is added to corn starch to break the bonds between glucose molecules. What results is corn syrup that is treated to increase the fructose content, and then mixed with glucose with the outcome being HFCS.

Food manufacturers embraced HFCS, using it in place of sucrose for several reasons:

It’s cheap and the price is stable. It comes from a reliable, plentiful crop grown in the U.S. – corn. Because it’s a syrup, it’s more ready-to-use than sucrose which has to be dissolved first. It’s stable in acidic foods and beverages, making foods taste better, and gives superior browning to baked goods. And it helps foods stay fresh, protecting them from effects of temperature variations, and allows for a soft texture in foods.

Composition of high fructose corn syrup

The composition of HFCS is nearly identical to sucrose. Sucrose is 50 percent glucose and 50 percent fructose, with the glucose and fructose being linked together. HFCS is a mixture of glucose and fructose also, however, the glucose and fructose are separated; when added to beverages the chemical composition is 45 percent glucose and 55 percent fructose, whereas HFCS added to food is 58 percent glucose and 42 percent fructose. It should be noted that HFCS is only available to food manufacturers and is not the same as corn syrup that can be bought by consumers. Corn syrup is 100 percent glucose.

Food and beverages containing HFCS

The abundant growth of HFCS in our food supply over the years was no less than phenomenal. HFCS catapulted by more than 1,000 percent between 1970 and 1990, surpassing the consumption of any other food in the American diet. It now represents more than 40 percent of the caloric sweeteners added to food and beverages.

Here are foods that often contain HFCS:

  • Breakfast cereals
  • Soft drinks
  • Sports drinks
  • Sweetened fruit drinks
  • Breads
  • Donuts, other pastries
  • Candy bars
  • Condiments such as ketchup, chili sauce, salad dressings and BBQ sauces
  • Store bought cookies and cakes
  • Cereal, granola, and energy bars
  • Crackers
  • Sweetened yogurts
  • Whipped topping
  • Ice cream
  • Canned relishes such as pickles, pickle relish, cranberry sauce
  • Jams, jellies and syrups like maple, chocolate and caramel

How bad is high fructose corn syrup for our health?

The catalyst that began the ranting on reducing HFCS was the 2004 article in the American Journal of Clinical Nutrition suggesting that HFCS was a significant cause of the obesity epidemic in America. But is that true? And are there any other health-related conditions that HFCS may play a role in?

To sort out fact from fiction, it helps to understand how both glucose and fructose are absorbed and utilized. Both are absorbed through the small intestine but then they differ. As glucose enters into the bloodstream, blood glucose levels rise, causing the hormone insulin to be released from the pancreas. Insulin helps get glucose out of the blood stream and into muscle and fat cells where it is stored as glycogen. Fructose, on the other hand, once it passes through the small intestine, is picked up by the liver and does not raise blood glucose or insulin levels. But if a person is consuming high amounts of fructose, it’s converted into a substance called acetyl CoA which can build up in the liver, increasing the formation of fats of triglycerides and very low density lipoproteins. However, since fructose is rarely eaten by itself and almost always is associated with similar amounts of glucose in food, neither of the above condition dominates the other.

“This common sweetener added to sodas, fruit-flavored drinks, cookies, breakfast cereals and salad dressings has been linked to unwanted weight gain, Type 2 Diabetes, metabolic syndrome and high triglyceride levels,” Dr. Samadi said. “All of these factors can lead to obesity, cancer, dementia, as well as liver failure.”

Here’s a look at health conditions HFCS has been blamed for and whether there is any merit or not:

Weight gain and obesity – As much as we might want to blame HFCS for the increase in obesity in this country, various studies do not conclusively point the finger at just HFCS. Even if all HFCS was taken out of the food supply, it would simply be replaced either with another type of added sweetener such as table sugar (sucrose), corn syrup or brown sugar. All of these added sweeteners are carbohydrates (including HFCS) and all provide 4 calories per gram. If you consume too much of any of these sweeteners, you will most likely gain weight. There is nothing inherently unique about HFCS that makes it more likely to produce weight gain, except for the fact that it became so pervasive in our food supply over the years, when consumption and portion size of these foods increased.

Blood glucose and Type 2 Diabetes – Whether you’re consuming a food or beverage sweetened with HFCS or table sugar, the glucose in both will increase blood sugar while fructose has no effect on it. Several studies have found no significant difference in blood glucose levels after consumption of either HFCS or table sugar, meaning they both had the same effect on blood glucose levels.

Appetite – There are mixed reviews on whether HFCS does indeed have an effect on appetite. One study showed when giving participants identical amounts of a drink containing either fructose or glucose, there was a difference in how appetite was affected. The hypothalamus in the brain helps regulate hunger, which involves various hormones such as insulin, leptin and ghrelin. Participants whose brains were scanned after drinking glucose showed suppression in the area of the brain involving reward and desire for food, leading to a feeling of satiety and feeling full. Those drinking fructose did not have any changes in suppression and instead had a small increase, failing to trigger a feeling of fullness, which could lead to overeating.

Other studies have looked at table sugar and HFCS, both of which contain glucose and fructose, and the effect on appetite, but there was no evidence of any difference between the two. This is most likely due to the glucose and fructose being consumed together and not apart.

Triglyceride levels – There is strong indication that increased consumption of both HFCS and sucrose does lead to elevated triglyceride levels. But it’s the fructose in both HFCS and table sugar that seems to be the culprit. Remember, in table sugar or sucrose, glucose and fructose are bound together whereas in HFCS, they are separated. When a person consumes foods with sucrose, the glucose and fructose have to be separated when broken down, requiring an extra step before being utilized. Glucose is being used mainly for energy or stored as glycogen. With HFCS, because glucose and fructose are already separated, fructose is absorbed right away by the liver.

Dr. Samadi warned, “In April, a significant study from the University of California reported that an excess consumption of HFCS is linked to an increased risk of heart disease. Researchers concluded that sweetened drinks, especially soda, accounted for 25 percent of total calorie intake for the day. This is highly concerning.”

Our diets composed of excess fructose, due to HFCS and other sugars containing fructose, leads to the excess fructose being used to produce fat, thus increasing triglyceride levels. This most likely significantly plays a role in the development of coronary artery disease, along with visceral fat in the abdominal area, which can lead to metabolic syndrome.

Nonalcoholic Fatty Liver Disease affects 20-30 percent of the adult population. This can progress to nonalcoholic steatohepatitis, which is a fatty liver with hepatitis. Evidence has suggested an association between added sugars (HFCS) in soft drinks and risk factors for nonalcoholic fatty liver diseases, which are obesity, type 2 diabetes, insulin resistance and hypertriglyceridemia.

“Scientist are still debating whether or not the body metabolizes HFCS in the same way it does regular white, granulated sugar,” Dr. Samadi said. “However, a diet high in sweetened drinks is not giving the body any important nutrients it requires for producing energy.”

Advice on consumption of HFCS – The best advice is to greatly limit consumption of HFCS along with all added sugars. Here are steps to follow to help accomplish this:

Read ingredient lists. Ingredients are listed in order of predominance by weight so if HFCS is listed as one of the first ingredients, stay away from the food. Look for these words, all which indicate a type of sugar:

  • High fructose corn syrup
  • Sugar
  • Any word ending in – “ose” means it’s a type of sugar – sucrose, maltose, dextrose, fructose, glucose, lactose
  • Cane juice
  • Corn syrup
  • Brown sugar
  • Barley malt
  • Fruit juice concentrate
  • Dextrin
  • Maltodextrin
  • Molasses
  • Honey

Dilute fruit juices with water to reduce sugar and HFCS. Replace soft drinks with water.

“I recommend treating soda as a dessert, something that should be enjoyed sparingly, not as a routine component of your diet,” advised Dr. Samadi. “Substituting soda for water is a great way to increase hydration. If you are craving soda, I recommend getting the smallest size can. Bottles of soda are nearly three times the size of the original 8-ounce serving size. Furthermore, by choosing a smaller container you are more likely to be satisfied by your snack then if you choose to drink only a proportion of a larger bottle.”

Replace foods containing HFCS with healthier vegetables, fruits, nuts or dairy products.

The American Heart Association recommends no more than 100 calories a day or 6 teaspoons of sugar for women. For men, no more than 150 calories a day or 9 teaspoons.

Eat more foods with natural sugars – fruits, vegetables, low-fat dairy products. Even though containing some sugar, they will also contain various vitamins, minerals, fiber and phytochemicals which are good for your health.

The truth on HFCS is that it needs to be limited as much as possible by all of us. Become educated on foods that contain it and replace them with healthier options. Change your approach towards food – this is your first line of defense in keeping healthy. The more we eat foods containing HFCS, the more we harm our health and there’s nothing sugar-coated about that.


Cheryl's-Headshot-2015-80x1Cheryl Mussatto MS, RD, LD, is a registered dietitian and an adjunct professor at Allen Community College, Burlingame, where she teaches Basic Nutrition, and at Butler County Community College, Council Grove, where she teaches Therapeutic Nutrition. She is also a certified health and wellness coach. She writes Eat Well to Be Well, a column about health and nutrition, and is also a blog contributor for Dr. David Samadi at www.samadimd.com. Contact her at [email protected].


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