Conquering Diabetes...

Michael Dansinger, MD is here to provide hope, inspiration, and knowledge for people with type 2 diabetes or prediabetes who want to conquer their disease and reclaim their health.

High-Fructose Corn Syrup
The human race is genetically designed to love sweet foods. For 99 percent of human existence, this love of sweetness was crucially important for survival, because it drove us to seek and eat fruit. Now, in modern times, our love for sweetness has backfired and has helped accelerate the epidemics of obesity, type 2 diabetes, and heart disease.

Many or even most foods in the supermarket have some sugar added, including breads, cereals, yogurts, processed meats, soups and condiments. Added sugar comes in many possible forms, including granulated white sugar (from sugar cane or beets), brown sugar, honey, molasses, maple syrup, brown rice syrup, corn syrup and high-fructose corn syrup. Adding sweetness to processed foods and beverages makes them taste better and more profitable, especially when high-fructose corn syrup is used.

High-fructose corn syrup has become especially popular in the US during the past 50 years, now accounting for nearly half of the total sugar intake. Reasons include subsidies on corn, tariffs on imported sugar, and cost-effective methods for manufacturing this sweetener. Corn is milled into cornstarch, which is then converted by enzymes to corn syrup consisting primarily of glucose, followed by further enzymatic conversion and additional steps resulting in a syrup that typically contains 55 percent fructose and about 45 percent glucose.

The nutritional biological effects of high-fructose corn syrup would not be expected to significantly differ from other common forms of sugar, such as granulated sugar or honey, because they each result in approximately equal amounts of fructose and glucose in the gastrointestinal tract and bloodstream. Once digested, the body can’t tell the difference. The glucose portion raises the blood glucose levels directly, and the fructose portion goes to the liver where it is converted to glucose. An important component of the negative health effects of excess sugar results from the necessary conversion of fructose to glucose by the liver, which can damage the liver cells (similar to alcoholic liver damage). Too much sugar is unhealthy, regardless of the form it takes prior to consumption.

High-fructose corn syrup has become increasingly frowned upon by those fighting obesity, diabetes and heart disease because it is such a common source of sugar. It has become a symbol, or “marker” of unhealthy processed foods. As a general concept, anyone who can stop eating foods with high-fructose corn syrup will probably improve one’s health. Not just by reducing sugar intake, but because foods that contain high-fructose corn syrup tend to have other unhealthy ingredients and lots of excess calories.

Similarly, simply replacing high-fructose corn syrup with alternative forms of sugar, such as honey, granulated sugar, brown rice syrup, etc. would not necessarily make those foods significantly healthier, but it would raise the cost somewhat. A number of large grocery store chains that specialize in healthier foods have excluded foods with high-fructose corn syrup, but do offer similar foods with equal amounts of sugar derived from beets, sugar cane, rice, etc.

The Corn Refiners Association, a trade association comprised of major players in the high-fructose corn syrup industry, has been fighting back against the gathering public rejection of high-fructose corn syrup. In 2008, they launched a public relations campaign called “Changing the Conversation about High Fructose Corn Syrup” with television commercials emphasizing that the sweetener is made from corn, has the same calories as sugar, is okay to eat in moderation, and has no artificial ingredients.

The Corn Refiners Association has also been in the news lately because they petitioned the FDA to allow them to use the term “Corn Sugar” instead. The reasons are obvious. The results are pending.

All this reminds me of the way tobacco companies hired public relations firms in the 1960’s to fight back against growing public rejection of cigarette smoking. The major players in the tobacco industry banded together and developed strategies to sway public opinion toward a more favorable view on cigarettes. The strategies included raising controversy about the scientific evidence documenting adverse health effects of their product, making the product seem “natural,” and stating it was fine in moderation.

In the case of cigarettes, such strategies provided the rationale or justification that helped smokers avoid trying to quit. In the case of high-fructose corn syrup, such strategies will help those who love the sweetness it adds to food to avoid trying to cut back. “Corn sugar is just like other kind of sugar” is just the justification people need to keep on eating just as much sugar/corn sugar/high fructose-corn syrup as ever.

This is a sorry state, because it is a reminder that public relations campaigns and food advertising have so much influence on the amount of unhealthy food and beverages consumed by the public. As we look back with regret, we know that adding ineffective “filters” to cigarettes revived the tobacco industry by fooling smokers into thinking the filters made the cigarettes safer. It would be sad to learn someday that changing the name to “corn sugar” effectively fooled the general public into thinking this unhealthy industrial sweetener is benign.

I’d like to see the general public continue to rise up against not just high-fructose corn syrup, but against the types of foods that have significant amounts of added sugar in general. We know added sugar is unhealthy. Let’s not let public relations campaigns distract us from solving the public health crises the next generations are counting on us to address in our time.

- Michael Dansinger, MD