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Diabetes Q&A

Nutritional Pearls: Is High Fructose Corn Syrup Worse Than Sucrose?

Jason is a 29-year old man who is beginning to show signs of prediabetes. When asked about his diet, Jason reports that he drinks several sodas a day, including one to “help him wake up in the morning.”

When you suggest that he switch to coffee or tea in the morning, to avoid consuming so much high fructose corn syrup, he asks, “But is corn syrup really any worse than the sugar I’d put in my coffee?”

How do you advise your patient?
(Answer and discussion on next page)



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Answer: Foods and beverages that contain high fructose corn syrup should be avoided in a healthy diet.

When I give lectures, one of the most frequently asked questions is about high fructose corn syrup (HFCS). Some people say it's "as bad for you as arsenic," while others pooh-pooh all the concern, saying it's no different from sucrose.

For a long time, the peer-reviewed research (as opposed to studies paid for by beverage manufacturers) was divided as to whether HFCS specifically versus excessive sugar intake generally endangered one's health. Current estimates say that the average American adult (age 20-60) consumes about 13% to 14% of their total daily calories in the form of added sugars. (Note: this is distinct from the sugars naturally occurring in foods like fruits.) Worse yet, individuals under the age of 20 appear to consume as much as 16% of their total calories in the form of added sugar.

Some studies correlate that amount of excess sugar consumption to an 18% increase in risk of death from heart disease, but we have yet to see a clear link between HFCS consumption and such concrete risk factors for heart disease as cholesterol scores.

The Research

A new study sheds light on that link. Eighty-five healthy men and women completed a study designed and carried out by researchers from the University of California at Davis.1 The participants were split into 4 groups whose participants were matched with respect to sex, body mass index, cholesterol, and insulin scores—grouping persons of the same gender and similar BMI and test results together.

The participants of each group were assigned to consume a daily drink made with a commercially-available HFCS that provided 4 increasing levels of their total daily calories: 0% of calories (drink made with a calorie-free sweetener), 10% of calories, 17% of calories, and 25% of calories.

The participants moved into the lab for the first 3.5 and last 3.5 days of the study. While there, the participants consumed a standardized diet (along with their assigned beverage), and provided blood and urine samples for testing. For the 12 days in between the first and last stays in the lab, the participants returned to their homes and ate their usual diets, supplemented with their assigned beverage.

The Results

The results showed that those who consumed the drinks containing HFCS saw their triglycerides, LDL cholesterol, and uric acid levels increase: The higher the concentration of HFCS in their assigned beverage, the worse their scores became. This connection held true even when the researchers took into account the amount of weight the participants gained through consuming more calories.

The authors noted that they did not compare HFCS-containing beverages with those sweetened with sucrose alone, so it would be inaccurate to say that sucrose is "better for you" than HFCS. Note: Sucrose, by definition, is a combination of fructose and glucose; in this specific case, sucrose was 55% fructose and 45% glucose.

What’s the Take-Home?

Larger studies are needed, but this certainly cements my position that foods containing HFCS have no place in a healthy diet. At the very least, it's still an indication that the food in question is highly processed and you would do far better to avoid such overly-processed foods. Beverages that contain HFCS shouldn't be consumed by anyone; ditch the sodas and drink water, tea, or coffee instead.

Reference:
Stanhope KL, Medici V, Bremer AA, et al. A dose-response study of consuming high-fructose corn syrup–sweetened beverages on lipid/lipoprotein risk factors for cardiovascular disease in young adults. Am J Clin Nutr. 2015;101:1144-54