by Marion Nestle

Search results: hfcs.

Oct 6 2015

Two rare industry-funded studies with results that must have disappointed the funders

Consumption of Honey, Sucrose, and High-Fructose Corn Syrup Produces Similar Metabolic Effects in Glucose-Tolerant and -Intolerant Individuals.  Susan K Raatz, LuAnn K Johnson, and Matthew J Picklo.  J. Nutr. 2015; 145:2265-2272 doi:10.3945/jn.115.218016 

  • Conclusions: Daily intake of 50 g carbohydrate from honey, sucrose, or HFCS55 for 14 d resulted in similar effects on measures of glycemia, lipid metabolism, and inflammation. All 3 increased TG [triglyceride] concentrations in both GT [glucose tolerant] and IGT [glucose intolerant] individuals and elevated glycemic and inflammatory responses in the latter.
  • Funding: Supported by a grant from the National Honey Board and by the USDA Agricultural Research Service.
  • Comment.  The authors hypothesized that honey would result in improved glycemia and insulin sensitivity compared with sucrose and HFCS.  But they found that their “data do not support the contention that the consumption of honey vs. HFCS or sucrose provides an added health benefit for maintenance of glucose homeostasis and other cardiometabolic outcomes because all 3 sugars evaluated exerted similar metabolic effects.”

Sugar-sweetened beverage consumption and incident hypertension: a systematic review and meta-analysis of prospective cohortsViranda H Jayalath, Russell J de Souza, Vanessa Ha, Arash Mirrahimi, Sonia Blanco-Mejia, Marco Di Buono, Alexandra L Jenkins, Lawrence A Leiter, Thomas MS Wolever, Joseph Beyene, Cyril WC Kendall, David JA Jenkins, and John L Sievenpiper.  Am J Clin Nutr 2015; 102:914-921 doi:10.3945/ajcn.115.107243.

  • Conclusions: SSBs were associated with a modest risk of developing hypertension in 6 cohorts. There is a need for high-quality randomized trials to assess the role of SSBs in the development of hypertension and its complications.
  • Funding: “The Canadian Institutes of Health Research…through the Canada-wide Human Nutrition Trialists’ Network and by the Diet, Digestive Tract, and Disease (3D) Centre, which is funded through the Canada Foundation for Innovation.  The Ministry of Research and Innovation’s Ontario Research Fund provided the infrastructure for the conduct of this project.”  Some of the investigators also received funds from other Canadian government agencies or health associations.  This, therefore is actually an independently funded study.
  • Authors’ funding disclosures: RJdS has received research support from the Calorie Control Council and the Coca-Cola Company…ALJ is a part owner, vice president, and director of research of Glycemic Index Laboratories, Toronto, Canada….JB has received research support from the Calorie Control Council and The Coca-Cola Company…CWCK has received research support from the Calorie Control Council, the Coca-Cola Company (investigator initiated, unrestricted grant), Hain Celestial, Kellogg, Kraft, Loblaw Companies Ltd., Solae, and Unilever…DJAJ has received research grants from Loblaw Companies Ltd., Unilever, the Coca-Cola Company… JLS has received research support from the Calorie Control Council and the Coca-Cola Company…travel funding, speaker fees, or honoraria from the Calorie Control Council, the Canadian Sugar Institute, World Sugar Research Organization, White Wave Foods, Abbott Laboratories, Dairy Farmers of Canada, Dr. Pepper Snapple Group, The Coca-Cola Company, and the Corn Refiners Association….
  • Comment: In this study, a group of investigators, some—but not all— of whom typically receive funding from food companies, participated in a study funded by Canadian government and health agencies.  If nothing else, this study is evidence for the importance of independent funding of nutrition research.

The score, for those of you following this saga, is now 65 studies with results favoring the sponsor to 5 with unfavorable results.  But I will soon be posting another 5 of the former kind.

Nov 27 2012

HFCS v. Diabetes: Correlation does not mean causation.

The latest study on the evils of High Fructose Corn Syrup (HFCS) so annoys the Corn Refiners Association that it broke the study’s embargo.

Reporters were not supposed to write about the study until today, but the Corn Refiners issued a press release yesterday: “Caution: New Study Alleging HFCS-Diabetes Link is Flawed and Misleading.”

The New York Times quickly posted its own pre-embargo account.

Why the fuss?  The study reports that countries with the highest levels of HFCS in their food supplies also have a 20% higher prevalence of diabetes in their populations.  This is a correlation between HFCS and diabetes.  It does not mean that HFCS causes diabetes—an important distinction.

But the authors’ press release (sent to me in an e-mail message) makes it sound like causation.  They say (also see Dr. Goran’s comments added to this post below):

HFCS appears to pose a serious public health problem on a global scale,” said principal study author Michael I. Goran…The study adds to a growing body of scientific literature that indicates HFCS consumption may result in negative health consequences distinct from and more deleterious than natural sugar.

This conclusion is based on their observations that the amounts of other sugars in the food supplies of countries with high and low HFCS are about the same.  But HFCS is a form of sugars that adds to total sugar availability.

The authors obtained information about diabetes and obesity prevalence and HFCS and other dietary factors in the food supply from existing sources of data, all of them questionable.   The data do not distinguish between type 1 and type 2 diabetes, for example, and the two different sources of data on diabetes prevalence give different results.

Inconsistencies abound.  For example, Mexico has more diabetes than does the U.S., but rather low HFCS availability (Mexicans prefer sucrose in their sodas).  Some countries with high diabetes rates report no HFCS availability at all.

As with all correlational studies, something else could be going on that causes HFCS, sugars of all types, and diabetes to increase.

That was the point I was trying to make when I spoke to Stephanie Strom of the New York Times:

 “I think it’s a stretch to say the study shows high-fructose corn syrup has anything special to do with diabetes,” Dr. Nestle said. “Diabetes is a function of development. The more cars, more TVs, more cellphones, more sugar, more meat, more fat, more calories, more obesity, the more diabetes you have.”

She noted that the study “falls right in the middle of the Corn Refiners fight with the Sugar Association,” a reference to the legal war being waged between the two industry groups over the marketing of high-fructose corn syrup.

The Corn Refiners press release quotes its president, Audrae Erickson:

This latest article by Dr. Goran is severely flawed, misleading and risks setting off unfounded alarm about a safe and proven food and beverage ingredient.  There is broad scientific consensus that table sugar and high fructose corn syrup are nutritionally and metabolically equivalent…The bottom line is this is a poorly conducted analysis, based on a well-known statistical fallacy, by a known detractor of HFCS whose previous attack on the ingredient was deeply flawed and roundly criticized.

Whew.

Yes, HFCS is sugar(s)—glucose and fructose.  So is table sugar (sucrose).

But the bottom line goes for both: Everyone would be better off eating less sugar(s).

Addition to post: Dr. Goren wrote two e-mails to me in response.  With his permission, they follow.

Hi Marion,

I saw your comments in the NYT article that was published about our global HFCS paper.

You say that: “Diabetes is a function of development. The more cars, more TVs, more cellphones, more sugar, more meat, more fat, more calories, more obesity, the more diabetes you have.”

I wanted to mention that an often overlooked issue is that obesity is not the only factor contributing to type 2 diabetes and even the causal link between obesity and type 2 diabetes is unknown. Other factors include inflammation, oxidative stress, insulin resistance etc. In the study that was done with my colleague at the University of Oxford, the countries with high and low/zero HFCS were matched for obesity levels as well as total calorie and sugar availability. In essence this allowed us to isolate the effects of HFCS as a contributing factor, independent of obesity and the other factors that you mention that are related to obesity. I agree, as stated in the paper, that the ecological type analysis has its limitations, but in the case of HFCS it provided an opportunity to study its effects at the broader macro level. We did this because it is impossible to evaluate individual levels of HFCS consumption because we don’t know specifically how much is added to food/beverages.

The main critique of our study from the corn refiners association is based on their assertion that fructose and glucose are the same when in fact its textbook knowledge that their metabolic fate/pathways are very different. The CRA now says that sucrose and HFCS are “almost identical”. Almost identical acknowledges that they are different in some way which they are. Its a fact that HFCS-55 has at least 10% more fructose than sucrose and our prior study in which we analyzed popular beverages showed this was on average 20% and in some cases as much as 30% higher fructose. The key question in my mind is whether the additional fructose in HFCS is enough (even if its only 10% higher) to tip the balance towards the negative metabolic effects of fructose on health. This is at the heart of the issue and should be the focus of investigation. Our study, with its accepted limitations, adds to the growing body of evidence that the additional fructose coming from HFCS may indeed be enough to tip this balance.

His second message:

Thanks for responding, and yes, I’d be pleased if you added this to your blog –  – I think this will be a good addition. The question of whether the extra 10% fructose matters is indeed critical.

We also by the way did analyze total sugars versus diabetes in a much larger data set of 200 countries but the reviewers asked for that to be taken out which we did because we also thought the focus on HFCS would be unique. We also did see a clear relationship between total sugar and diabetes – some of that relationship was mediated by obesity but there also was an independent association between total sugars and diabetes. So, I agree – – both obesity and total sugars contribute to diabetes – – but I also believe, as shown in our paper, that HFCS has a separate link, and that this is probably due to the higher fructose content in HFCS.

Also, you mentioned in your blog that the different estimates of diabetes gave different results. That’s not really correct. The estimates of diabetes were different from each other, but regardless of which diabetes estimate we used, we still found a consistent association between HFCS and the 2 prevalence estimates of diabetes as well as fasting glucose. So in essence the results were validated using different prevalence estimates of type 2 diabetes.

Nov 2 2012

Mother Jones: How the industry minimized (and minimizes) the health effects of sugars

One of the great ironies of food politics these days is this: while journalists and scientists are increasingly documenting the health consequences of diets way too high in added sugars, the producers of two forms of those sugars—sucrose and high fructose corn syrup (HFCS)—are doing everything they can to decrease their rivals’ market shares.

Once the election is over, I will write about the ugly legal battles between the producers of sugar cane and beets (sucrose) and the corn refiners who produce HFCS.  But in the meantime, don’t miss the current issue of Mother Jones.

It has just published an investigative report by journalist Gary Taubes and dental health administrator Cristen Kearns Couzens:  Big Sugar’s Sweet Little Lies: How the industry kept scientists from asking: Does sugar kill?

Their report is a detailed account of how the sugar industry manipulated scientists and government officials into overlooking the health problems caused by overconsumption of sugars and instead focusing on overconsumption of dietary fat (both removed from their caloric context, alas).

Their winning campaign, crafted with the help of the prestigious public relations firm Carl Byoir & Associates, had been prompted by a poll showing that consumers had come to see sugar as fattening, and that most doctors suspected it might exacerbate, if not cause, heart disease and diabetes.

With an initial annual budget of nearly $800,000 ($3.4 million today) collected from the makers of Dixie Crystals, Domino, C&H, Great Western, and other sugar brands, the association recruited a stable of medical and nutritional professionals to allay the public’s fears, brought snack and beverage companies into the fold, and bankrolled scientific papers that contributed to a “highly supportive” FDA ruling, which, the Silver Anvil application boasted, made it “unlikely that sugar will be subject to legislative restriction in coming years.”

The report is accompanied by riveting background information, examples of sugar advertisements, and formerly confidential documents:

Much of what’s in this report came as news to me, but is consistent with what I know.  Here, for example, is a comparison of the increasingly complicated and obfuscated sugar recommendations from the Dietary Guidelines for Americans from 1980 through 2010:

  • 1980     Avoid too much sugar.
  • 1985     Avoid too much sugar.
  • 1990     Use sugars only in moderation.
  • 1995     Choose a diet moderate in sugars.
  • 2000    Choose beverages and foods to moderate your intake of sugars.
  • 2005     Choose and prepare foods and beverages with little added sugars or caloric sweeteners, such as amounts suggested by the USDA Food Guide and the DASH eating plan.
  • 2010     Reduce the intake of calories from solid fats and added sugars.

“Avoid too much sugar” is still good advice.
And here’s a photo of a billboard in Guatamala, taken a couple of years ago by anthropologist Emily Yates-Doerr.  If the sugar industry isn’t selling enough sugar here, might as well push it onto people in emerging economies.

Curl up with Mother Jones over the weekend , hopefully one free of hurricanes (I, along with many others, am still waiting for electricity, water, and heat).

May 31 2012

FDA says HFCS is HFCS; it is not corn sugar

Cheers to the FDA.  It just said a firm no to the Corn Refiners’ petition to be allowed to call High Fructose Corn Syrup (HFCS) “corn sugar.”

The FDA’ s rationale:

  • Sugar is solid, dried, and crystallized.  Syrup is liquid.  HFCS is liquid.  Therefore, it is syrup, not sugar.
  • Corn sugar already has a regulatory definition: dextrose (glucose).  HFCS contains fructose as well as glucose.  Therefore, it is not corn sugar.

As I mentioned earlier, I filed comments to the FDA on the Corn Refiners’ petition:

The [Corn Refiners’] website quotes comments I have made to the effect that HFCS is biochemically equivalent to sucrose. It is. But I do not believe that biochemical equivalence is a good reason for the FDA to agree to a name change at this point.

It is highly unlikely that public misunderstanding of nutritional biochemistry and the differential physiological effects of glucose vs. fructose will be addressed and corrected by changing the name of HFCS to corn sugar.

…the name change is not in the public interest. Its only purpose is to further the commercial interests of members of the Corn Refiners, and that is not one the FDA should be concerned about.

I was referring here to the legal and public relations wrangling between the Sugar Association, which represents the growers of cane and beet sugar (sucrose), and the Corn Refiners.

I have complained previously about the in-your-face behavior of the Corn Refiners in attempting to protect its share of the sweetener market: its strange advertisements; its use of my quotes (they told me the quotes are in the public domain and if I don’t like it I can sue them); its aggressive lobbying; its stated intention to use the term “corn sugar” whether the FDA approves it or not.

The Sugar Association’s behavior is not much better.  It has taken the Corn Refiners to court over the naming issue.

I was amused to receive two e-mails this week from its public relations firm complaining about the Corn Refiners’ clumsy PR response to a UCLA  study ostensibly showing that HFCS makes rats “fat and stupid.”  This study, however, did not compare the effects of sucrose and HFCS and its results, even if confirmed, could apply to any source of fructose.

The second e-mail sent links to the FDA’s decision and the Sugar Association’s response.

The FDA’s ruling represents a victory for American consumers,” said Dan Callister, an attorney for the plaintiffs in the ongoing litigation. “It reaffirms what most consumer advocates, health experts and policy officials have been saying all along: only sugar is sugar. HFCS is not sugar. The next step is for the federal court to end the CRA’s misleading propaganda campaign.

Sugars, plural, are sugars.  Sucrose is glucose and fructose.  So is HFCS.

Everyone would be better off eating a lot less of both.

And that brings me to New York City Mayor Michael Bloomberg’s latest attempt to promote the health of his constituents: banning any sugary drink larger than 16 ounces from restaurants, movie theaters, and street carts.

I can’t wait to see how the Beverage Association deals with this one.

Addition June 1: Rosie Mestel of the L.A. Times has an excellent account of this in which she quotes from these comments.  Her story is accompanied by a PR photo from the Corn Refiners Association.  What are these people thinking?

Ad campaign by the Corn Refiners Assn.

Dec 1 2011

Sugar vs. HFCS, continued

The increasingly absurd fight between the Sugar Association and the Corn Refiners Association over what to call High Fructose Corn Syrup (HFCS) seems never to end.

Trade associations representing growers of sugar cane and sugar beets (sucrose–the white stuff on the table) have gone to court to charge that corporate members of the Corn Refiners Association (HFCS) are behind a “conspiracy” deliberately designed to “deceive the public.”  Why?  Because—in an equally absurd move—they want to change the name of HFCS to corn sugar. 

The sucrose-growers lawsuit argues Corn Refiners conspired to engage in false advertising as part of a $50 million campaign to promote HFCS by changing its name to “corn sugar,” thereby implying that HFCS is equivalent to “real” sugar from cane and beet plants.

Oh please.  Sucrose is glucose and fructose linked together.  HFCS is glucose and fructose separated.  Both are sugars (note: plural).  Sucrose is extracted from sugar beets and cane in a series of boiling, extracting, and cleaning steps.  HFCS does the same from corn, but uses one more enzyme so is somewhat less “natural,” but so what?

Both are sugars and empty calories, and everyone would be better off eating less of both.

What’s really at issue here is the encroachment of HFCS into sucrose territory.  Americans used to eat much more sucrose than HFCS.  Now we consume about 60 pounds of each of them a year—way too much of either.

My opinion: the name change is frivolous and so is the lawsuit. 

Both are a waste of time and distract from the real message: eat less sugar(s).

Oct 27 2011

Sugar 1, HFCS 0, at least for the moment

The public relations firm for the Sugar Association, Levick Strategic Communications, sent me a press release celebrating the victory of sugar producers against corn refiners over the question of whether high fructose corn syrup (HFCS) can be renamed “corn sugar.”

A federal judge ruled that the case brought by the Sugar Association against the Corn Refiners can proceed to trial. If you want the details, see the  judge’s “order denying in part and granting in part defendents’ motion to dismiss”, and “order granting defendents’ motion to strike.”

I cannot even begin to tell you how funny I think all this is.

The Sugar Association represents growers of sugar beets and cane.  They produce table sugar—sucrose—a double sugar composed of glucose and fructose linked together.  In the body, sucrose is quickly split to glucose and fructose.

The Corn Refiners represent processors of corn (obviously).  They produce HFCS, a syrup made of glucose and fructose.

From a biological standpoint, glucose and fructose are the same no matter where they come from.  Biochemically, sucrose, glucose, and fructose are all sugars.

HFCS used to be a lot cheaper than sucrose, but what with all the corn used for ethanol, the price gap has narrowed.  As a result, and because HFCS has gotten a bad reputation, companies are dropping it in favor of sucrose.  The Corn Refiners are upset about that and think a name change would help.

The Sugar Association thinks it’s just great that HFCS has a bad reputation and does not want table sugar to be confused with corn sugar.

Both of these trade associations are acting totally in self-interest.  Neither cares at all about public health.  The lawsuit is entirely about corporate profits, not public welfare.

The Sugar Association is famous for protecting a system of quotas and tariffs that transfers money from American consumers to the coffers of sugar producers.  Its aggressive actions in its own self interest are legendary (see, for example, its threatening letter to me when Food Politics came out—this and my reply are posted at the end of the About section).

And I’ve written previously about the Corn Refiners’ consistently bad self-interested behavior.

Both trade associations behave with appalling disregard for the public.

In this case, the public interest is clear: everyone would be healthier eating less table sugar and HFCS.

 

Oct 26 2010

New study: HFCS-sweetened drinks higher in fructose than expected

I’ve been saying for ages that the sugar composition of high fructose corn syrup (HFCS) is no different from that of table sugar (sucrose).

Oops.  A new study in the journal, Obesity, actually measured the amounts and kinds of sugars in 23 kinds of HFCS-sweetened drinks.

The findings are summarized in a fact sheet:

  • The sugar content varied widely from amounts stated on labels.  Some drinks had 15% less sugar than labeled, but others had as much as 30% more.
  • On average, the drinks had 18% more fructose than expected.
  • Several brands of sodas seemed to be made with HFCS that is 65% fructose, not 55%.
  • The average amount of fructose in the drinks was 59%.

The press release points out one other finding.  You know how everyone thinks Mexican Coca-Cola is so much more delicious than American Coke because it is made with table sugar (sucrose), not HFCS?  Oops again.  The investigators could not find any sucrose in the Coke, but did find plenty of glucose and fructose.  This suggests that Mexican Coke is also made with HFCS (or it could also mean that the sucrose had been split into its constituent glucose and fructose).

To review the biochemistry: sucrose is a double sugar of glucose and fructose bonded together.  HFCS is glucose and fructose, separated.  The sucrose bond is quickly split in the intestine and its glucose and fructose are the same as those in HFCS.

The metabolic problems that result from sugar intake are mostly due to the fructose content.  Less is better for health.  More is better for the soft drink industry, however.  Fructose is sweeter than either glucose or sucrose, and sweet is what sells sodas.

At most, HFCS is supposed to be 55% fructose, as compared to the 50% in table sugar.  Most foods and drinks are supposed to be  using HFCS that is 42% fructose.  A percentage of 55 is not much different biologically than 50, which is why the assumption has been that there is no biologically meaningful difference between HFCS and table sugar.   This study, if confirmed, means that this supposition may need some rethinking.

The study names the beverages that contain 65% fructose: Coke, Pepsi, Sprite. It identifies Dr. Pepper, Gatorade, and Arizona Ice Tea as containing close to 60% fructose.

If, in fact, the percentage of fructose is higher than advertised, it’s another good reason to avoid sugar-sweetened beverages.

Addition and possible caution:  I’ve now heard separately from two experts on measuring sugars in beverages who point out serious flaws in the methods used in this study:

  • The results are based on one beverage sample, analyzed once.   Analytical methods invariably produce ranges of values and require multiple samples and analyses.
  • Measuring sugars in beverages is technically challenging and there are several possible methods, some of which give more accurate results than others.  Although the paper says the investigators used standard methods, it does not specify which.
  • The methods used did not seem to detect the small starches or maltose that are always present in HFCS.  If the methods “read” the little starches as fructose, the percentage could easily have been 59 rather than 55.
  • The drinks that contained 65% fructose were bottled drinks, and that is a concern.  The fountain drinks are mixed by the company–McDonald’s or Burger King–and could have been made too concentrated by whoever did the mixing.
  • The failure to find sucrose in Mexican Coca-Cola could be two to two reasons: the Coke is old and the sucrose “inverted” (split into glucose and fructose), or the company used HFCS instead of sucrose.

The bottom line remains the same: it’s best not to eat too much sugar or any kind.

Addition, October 27: Cara Wilking, an attorney with the Public Health Advocacy Institute in Boston, notes that this study raises the possibility that HFCS violates federal prohibitions against:

  • False and misleading food labeling
  • Food adulteration
  • False and misleading advertising

It will be interesting to follow how the lawyers deal with these issues.

Sep 20 2010

One more time: corn sugar chemistry

Thanks to alert reader Glen for pointing out that the FDA already has a regulation for Corn Sugar in the Code of Federal Regulations, under food substances Generally Recognized as Safe (GRAS).  CFR Section 184.1857 reads:

(a) corn sugar (C6H12O6, CAS Reg. No. 50-99-7), commonly called D-glucose or dextrose, is the chemical [alpha]-D-glucopyranose. It occurs as the anhydrous or the monohydrate form and is produced by the complete hydrolysis of corn starch with safe and suitable acids or enzymes, followed by refinement and crystallization from the resulting hydrolysate.

(b) The ingredient meets the specifications of the Food Chemicals Codex, 3d Ed. (1981), pp. 97-98 under the heading “Dextrose….”

(c) In accordance with 184.1(b)(1), the ingredient is used in food with no limitation other than current good manufacturing practice.

The Corn Refiners have just petitioned the FDA to be allowed to use the name Corn Sugar to apply to both glucose/dextrose and High Fructose Corn Syrup (HFCS).  But the existing definition seems to exclude HFCS.  While HFCS is about half glucose, it is also about half fructose, and its manufacture from corn starch requires one more enzyme.

A reminder about sugar chemistry:

  • Glucose is the sugar in blood, and dextrose is the name given to glucose produced from corn but biochemically they are identical.
  • Fructose is the principal sugar in fruit.  In fruit, it raises no issues because it is accompanied by nutrients and fiber.
  • Sucrose is table sugar.  It is a double sugar, containing one part each of glucose (50%) and fructose (50%), chemically bound together.  Enzymes in the intestine quickly and efficiently split sucrose into glucose and fructose, which are absorbed into the body as single sugars.
  • HFCS is made from corn starch.  It contains roughly equivalent amounts of glucose (45 to 58%) and fructose (42 to 55%).

HFCS raises several issues, health and otherwise:

  • Quantity: the U.S. food supply provides to every American (all ages) about 60 pounds of sucrose and another 60 pounds of HFCS each year.  This is way more than is good for health.  Sugars of any kind provide calories but no nutrients.
  • Fructose: increasing evidence suggests that the metabolism of fructose–which differs from that of glucose–is associated with abnormalities.  This means that it is best to reduce intake of fructose from table sugar as well as HFCS.
  • Farm subsidies: these go to large corn producers and have kept down the cost of HFCS relative to that of sucrose.  The use of corn to make ethanol has raised the relative price of HFCS.
  • Genetic modification: Most corn grown in the United States is genetically modified to resist insects or herbicides.

From a health standpoint, it makes no difference whether the sweetener is sucrose or HFCS.

As for agave sugar as a substitute: it can have much higher concentrations of fructose than either sucrose or HFCS but its labels do not give percentages so you have no way to know how much.

Given all this, what’s your guess about what the FDA will decide?

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