Is high fructose corn syrup worse than sugar?

Not a week goes by in the media without stories about potential health problems associated with high fructose corn syrup (HFCS). From brands like Yoplait to Heinz and Hunt’s, consumers are asking for the removal of the ingredient from products and companies are responding.

However, what do you really know about HFCS? Is it the main culprit when it comes to weight gain and metabolic problems or is there more to the story? In order to tackle this subject, let’s first look at HFCS and sugar at the molecular level.

Up close and personal: HFCS and sugar

Time for a little biochemistry: The kind of HFCS used in packaged foods and soda goes by the names HFCS 55 and HFCS 42. In the 55 variant, 55% of molecules are fructose and 42% are glucose. For HFCS 42, the breakdown is 42% fructose and 53% glucose. Both fructose and glucose are basic, simple forms of carbohydrates.

At the molecular level, high fructose corn syrup and sugar are nearly identical Click To Tweet

Why did I provide that molecular breakdown? Sucrose or sugar often replaces HFCS when brands swap ingredients and guess what? It has a 1:1 ratio of glucose to fructose, meaning that 50% of the molecules are fructose and 50% are glucose. At the molecular level, HFCS and sugar are nearly identical.

sucrose
This image shows the molecular layout of sucrose or sugar. 50% of it is fructose and 50% is glucose, making it a near mirror molecular image of high fructose corn syrup.

Research roundup: HFCS vs. sugar

Given that HFCS and sugar have a very similar glucose-to-fructose ratio, what does the nutritional literature have to say about the health effects of HFCS?

According to a 2008 study, “Sucrose and HFCS do not have substantially different short-term endocrine/metabolic effects.” Even when looking at other critical factors like appetite- and fat-related hormones, no difference has been found between sugar and HFCS.

A 2012 study that put subjects on a reduced-calorie diet noted that both the HFCS and sugar group lost similar amounts of weight and body fat, leading researchers to conclude the type of sugar in the diet was of no significance.

All these results are similar to a 2007 critical review in Food Science and Nutrition, which summed up its research saying, “The currently available evidence is insufficient to implicate HFCS per se as a causal factor in the overweight and obesity problem in the United States.”

The real nutritional culprit: excess carbohydrates

It may seem like I’m letting HFCS and sugar off the hook, but I’m not. What’s important to realize is that they’re both carbohydrates and because of their connection to “sweetness,” they shift the conversation away from something people need to be more aware of when it comes to their diet: too many carbohydrates elevates blood sugar.

Note how sugar consumption ramped up  in the early '70s. While sweetener choice has changed with time, one aspect has remained constant: Americans are eating more simple carbohydrates.
Note how sugar consumption ramped up in the early ’70s. While sweetener choice has changed with time, one aspect has remained constant: Americans are eating more simple carbohydrates. Image source: Austin G. Davis-Richardson (Wikipedia)

A diet composed of too many insulin-spiking carbohydrates has been implicated in the following health problems:

Too many insulin-spiking carbohydrates may lead to heart disease, diabetes and macular degeneration Click To Tweet

Making healthier choices

Elimination of foods containing HFCS is a great start to revamping one’s diet as HFCS is typically found in processed foods that contain artificial ingredients, little nutrient density, low fiber counts and hydrogenated vegetable oils.

But don’t be misled: eating the same amount of a food that uses sugar or a similar sweetener in the place of HFCS won’t lead to significant improvements in your health.

Instead, shop the perimeter of the grocery store, stocking up on fibrous fruits and vegetables like berries, avocados and broccoli, and protein sources like wild-caught salmon and grass-fed beef. It’s all about increasing the nutrient density of your food choices and being a more aware consumer.

Reviewed by Kristen Kizer, R.D.

Decoding type 2 diabetes

Type 2 diabetes is the most common form of diabetes. The disease often develops in stages, starting as prediabetes or insulin resistance. People with prediabetes have elevated blood glucose (sugar), but it isn’t high enough to be classified as diabetes.

Diabetics tend to have too much glucose circulating in their blood, which, if left unregulated, can lead to blindness, heart attacks, stroke, nerve damage, amputations and even death. Unlike type 1 diabetes, people with type 2 diabetes can still make insulin, but they develop insulin resistance. That means that the body doesn’t properly use the insulin hormone that the pancreas produces, which leads to it making more insulin.

Insulin helps the cells absorb glucose so that they can use it for energy. As the process of producing more and more insulin continues, the pancreas is unable to meet the demand as the blood glucose levels remains too high and type 2 diabetes occurs. In some instances, the cells that produce the insulin become severely impaired or destroyed and the diabetic requires insulin to help regulate blood glucose.

Blood Glucose 101

With medication and monitoring, diabetics attempt a delicate balancing act to keep their blood glucose within the normal range. If their blood glucose is too low, it can lead to injuries, coma and even death. The symptoms of low blood glucose happen quickly and can include symptoms such as shakiness, confusion, unconsciousness or dizziness. If their blood glucose is too high, then its more devastating effects usually occur over prolonged periods of time, but immediate symptoms include excessive thirst and frequent urination.

Below are the target blood glucose levels for diabetics:

  • Fasting: 70–120 mg/dl
  • After meals (1-2 hours): Less than 140 mg/dl

Are you at risk?

According to the American Diabetes Association, 25.8 million Americans have diabetes. Of that number, there are 7 million people with the disease who are undiagnosed. In addition, there are a staggering 79 million people with prediabetes.

7 million Americans live with undiagnosed type 2 diabetes Click To Tweet

If this trend continues, by 2050, 1 in 3 Americans will have diabetes. One of the biggest contributing factors is the rise in obesity. If you have one or more of the following risk factors, talk to your doctor about testing and prevention:

  • Age 45 or older
  • Overweight
  • Physically inactive
  • High blood pressure or cholesterol
  • Parent or sibling with type 2 diabetes
  • Had gestational diabetes
  • Have prediabetes
  • African-American, Alaska Native, Native American, Asian-American, Hispanic or Pacific Islander
  • Have polycystic ovary syndrome
  • Dark velvety hyper pigmented skin around the neck or armpits

Take control

If you suspect that you have diabetes, schedule a doctor’s appointment to check your blood glucose and to test your hemoglobin A1c, which will give you an idea of your blood glucose levels over the last three months.

To asses your diabetes risk, have your blood glucose and hemoglobin A1c tested Click To Tweet

“You also want to ask your doctor to check your cholesterol and blood pressure, as these risk factors many times cluster together, especially in overweight individuals,” said Dr. Manisha Chandalia, an endocrinologist at Houston Methodist San Jacinto Hospital.

If you have diabetes, check your blood regularly and consider enrolling in the Houston Methodist Diabetes Education Program.

Type-2-diabetes-infographic

Reviewed by Dr. Manisha Chandalia