I received a packet of glossy brochures and a small booklet the other day from the Corn Refiners Association, along with a "Dear Doctor" cover letter. The purpose of the mailing was to explain
to me, the doctor, that much of the negative press surrounding high-fructose corn syrup (HFCS) lacks scientific merit, and that this "versatile sweetener" is pretty much the same as sucrose (table sugar).

The cover letter started off: "Because you are a trusted source of information about nutrition…" Flattery is like a foot in the door, so I read on.

The letter was signed by the president of the Corn Refiners Association and also by a cardiologist/professor with a university affiliation. It did not disclose the cardiologist's conflicts of interest, but a Medline search revealed that he has received research funding and consulting fees from PepsiCo, one of the biggest users of HFCS in the world.

The main point of the information packet was that HFCS is nutritionally the same as sucrose. Emphasizing that point was so important that it was stated at least 17 times. As discussed below, HCFS and sucrose are not the same, which might be why so much effort was made to convince doctors otherwise. As a corollary to the main point, the packet sought to dispel the "myth" that "sugar is healthier than HFCS." The use of the word "healthier" is particularly amusing, since almost no one on the planet considers sugar to be a healthy food.

A more appropriate framing of the argument would have been to claim that HFCS is no more likely to give you diabetes, make you fat, raise your triglyceride (blood fat) and uric acid levels, cause nonalcoholic fatty liver disease, or give you stomach aches or diarrhea than sugar is. Where there is a great deal of research that contradicts such claims (as discussed, for example, in my 2005 article in Alternative Medicine Review), at least those would have been claims that could have been debated honestly.

The Corn Refiners Association argues that HFCS and sucrose are pretty much the same because they both consist of about 50 percent fructose and 50 percent glucose. In actuality, HFCS consists of 55 percent fructose and 42 percent glucose, while sucrose consists of 100 percent sucrose (which can be converted by intestinal enzymes into 50 percent fructose and 50 percent glucose).

The difference in fructose-to- glucose ratios in these two sweeteners (1.31:1 versus 1:1) may not be insignificant. Fructose malabsorption is a common cause of gastrointestinal symptoms that mimic irritable bowel syndrome. Fructose malabsorption tends to occur primarily when the fructose concentration of a meal exceeds that of glucose, because glucose enhances the intestinal absorption of fructose. HFCS, which contains fructose in excess of glucose, is much more likely to cause gastrointestinal symptoms than is regular sucrose (table sugar), which is converted to equal parts fructose and glucose.

The fact that HFCS consists mainly of two monosaccharides (single glucose molecules), while sucrose is a disaccharide (two glucose molecules), may also be significant. The absorption of fructose
from sucrose might be considerably slower than the absorption of the free fructose present in HFCS-a possibility supported by studies.

Fructose is the most powerful reducing sugar of all edible sugars. Reducing sugars promote the glycosylation of tissue proteins (the bonding of glucose and protein), which is a factor both in the complications of diabetes and in the aging process. The human body has elaborate mechanisms to prevent serum (blood) fructose concentrations from rising to any great extent, but these mechanisms can be overwhelmed by feeding large quantities of free fructose. Exposure to the large amounts of free fructose that are currently being consumed is unprecedented in human evolution, and there is no reason to believe that humans are equipped to handle this new stressor.

There are still significant gaps in our knowledge regarding the consequences of consuming large amounts of free fructose. According to my reading of the scientific literature, the effects of high fructose corn syrup are somewhere between slightly worse than the effects of table sugar and seriously horrible.

***

Reprinted with permission from Townsend Letter: The Examiner of Alternative Medicine, April 2009, p 83 www.townsendletter.com

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