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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.

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:

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).

I’ve been trying to keep track of the legal dispute between the Corn Refiners (representing manufacturers of high fructose corn syrup—HFCS) and the Sugar Association, which represents growers of sugar beets and cane (sucrose).

Recall: HFCS is glucose and fructose separated, whereas sucrose is glucose and fructose stuck together.  Because they are biochemically pretty much the same (enzymes that split sucrose act quickly), they have the same effects in the body.

So the dispute is about market share, not science.

First, the Corn Refiners tried to change the name of HFCS to “corn sugar.”  The FDA turned this down (as well it should).

Then, the Sugar makers sued the Corn Refiners, claiming that the Corn Refiners’ public education marketing campaign was false and misleading because it promoted HFCS as “natural” (It’s not, in my opinion) and nutritionally and metabolically equivalent to other forms of sugar (which it is).

Then, the Corn Refiners countersued on the basis that Sugar lobbying groups are tricking the public into believing that sucrose is healthier than HFCS (it’s not) and trying to create a “health halo” for sucrose (absurd).

As Food Navigator puts it, the two associations are “trading insults.”

While all this is going on, a group called Citizens for Health has filed a petition with FDA to put the concentration of fructose in HFCS on package labels.  HFCS is usually 42% or 55% fructose (it is 50% in sucrose).  These forms of HFCS are considered by FDA to be generally recognized as safe (GRAS).

The petition argues that some products have more fructose—65% or 90%—and should say so.

All sugars should be consumed in small quantities, but fructose especially so.

The Corn Refiners say that Citizens for Health, which sponsors a website called foodidentitytheft.com, is funded by the Sugar Association.

Also in the meantime, a new study says HFCS has nothing whatsoever to do with obesity.  Guess who sponsored the study.

Advice for today: eat less sugar(s), meaning sucrose, glucose, fructose, table sugar, HFCS, corn sugar, and all the other euphemisms food companies use to deflect attention from how much their products contain.

You have to hand it to BPI (Beef Products Inc), the producer of  “Lean Finely Textured Beef (LFTB)”—a.k.a. “pink slime.”  The company deserves a prize for chutzpah (translation: outrageous audacity).

It has just filed a defamation (“veggie libel”) lawsuit for $1.2 billion (!) against an amazing cast of characters:

• ABC News (owned by Disney)
• TV news anchor Diane Sawyer
• ABC correspondent Jim Avila
• ABC correspondent David Kerley
• Gerald Zirnstein , former USDA employee who invented the term “pink slime”
• Carl Custer, former USDA employee
• Kit Foshee, whistleblower former BPI employee

South Dakota, apparently, has a veggie libel law to protect companies making food products from people who say mean things about them (recall: the Texas cattlemen vs. Oprah Winfrey).  Nobody has ever tested the constitutionality of veggie libel laws but I don’t know anyone who thinks they will stand up in court—free speech and all that.

BPI says the company lost 80% of its sales, a loss of $20 million per month, following news broadcasts about “pink slime.”  It had to close three facilities—in Texas, Kansas, and Iowa—and fire 650 workers at those places as well as 85 others at the company’s headquarters in South Dakota.

As I’ve written before, I see the “pink slime” episode as reflecting a lack of transparency in the beef industry and BPI’s efforts to defend its products as an example of power politics in action.

BPI is fighting back, hard.

• It created its own website: Beef is Beef
• It got some congressional representative to get the Congressional Research Service to write a report on the “pink slime” episode.
• And now this lawsuit.

The responses:

ABC News says, “The lawsuit is without merit. We will contest it vigorously.”

Bill Marler, the Seattle attorney who specializes in representing victims of food poisonings, has taken on this case and is representing Custer and Zirnstein.

Marler points out:

• You can buy a lot of Pink Slime for $1.2 billion.
• Someone should have told BPI’s lawyer it is not a great PR move to repeat the same charge that your client is now claiming harmed them in the first place.
• The lawsuit is without merit.
• We intend to defend this bogus, unwarranted and frivolous claim brought by BPI against these two former FSIS public employees.
• We are also contemplating filing a counter-claim against PBI.

Let the charges and countercharges begin!

This one will be almost as much fun to watch as the equally absurd legal squabbles between the Sugar Association and the Corn Refiners Association over what to call High Fructose Corn Syrup.  I’ll do a post on that next week sometime.

While Congress is fussing over the farm bill, Michele Simon’s new report, Food Stamps: Follow the Money, identifies the businesses that most stand to gain from the $72 billion spent last year on SNAP.  This program, formerly known as food stamps, gave 46 million Americans an average of  $134 per month to spend on food in late 2011.

Just as health and anti-obesity advocates are working to bring agricultural policy in line with health policy by getting the farm bill to promote production of healthier foods, they also are looking at ways to encourage SNAP recipients to make healthier food choices.  At present, SNAP recipients have few restrictions on what they can buy with their benefit cards.

In contrast, participants in the Women, Infants, and Children program (WIC), which is not a farm bill program, can only use their benefits to buy foods of high nutritional value.  The idea of requiring SNAP recipients to do the same has split the advocacy community.

Anti-hunger advocates fear that any move to restrict benefits to healthier foods, or even to evaluate the current food choices of SNAP recipients, will make the program vulnerable to attacks and budget cuts.  They strongly oppose such suggestions.

Follow the Money explains some of the politics behind efforts to maintain the status quo:

• Food industry groups such as the American Beverage Association and the Snack Food Association teamed up with anti-hunger groups to oppose health-oriented improvements to SNAP.
• Companies such as Cargill, PepsiCo, and Kroger lobbied Congress on SNAP, while also donating money to America’s top anti- hunger organizations.
• At least 9 states have proposed bills  to make health-oriented improvements to SNAP, but  none have passed, in part  due to opposition from the food industry.
• Coca-Cola, the Corn Refiners of America, and Kraft Foods  all lobbied against a Florida bill that aimed  to disallow SNAP purchases for soda and junk food.
• Nine Walmart Supercenters in Massachusetts received more than $33 million in SNAP dollars in one year.
• Walmart received about half of the billion dollars in SNAP expenditures in Oklahoma over a 2-year period.
• J.P. Morgan Chase holds contracts in 24 states to administer SNAP benefits.
• Banks and other private contractors are reaping significant windfalls from the economic downturn and increasing SNAP participation.

The point here is that banks that administer SNAP have a vested interest in keeping SNAP enrollments high and makers of junk foods have a vested interest in making sure that there are no restrictions on use of benefits.

Another point: data on use of SNAP benefits exist but are either proprietary or not made available.

The report concludes with these recommendations:

• Congress should maintain SNAP funding in this time of need for millions of Americans;
• Congress should require collection and disclosure of SNAP product purchase data, retailer redemptions, and national data on bank fees;
• USDA should evaluate state EBT contracts to determine if banks are taking undue advantage of taxpayer funds.

I’ve not seen this kind of analysis before and this report deserves attention.  At the very least I hope that it will encourage Congress to make sure that the poor get their fair share of SNAP benefits.

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).

Are you puzzled, annoyed, or irritated beyond belief by the word “natural” on food product labels?

FoodNavigator must think so.  It conducted an opinion survey on what to do about marketing foods as “natural”.

FoodNavigator asked: Do we [food companies] need a clearer definition of ‘natural’ for food marketing?

The response options:

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.