You have probably heard of high fructose corn syrup (HFCS), a sweetener that is increasingly replacing beet and cane sugar. Doubts about the adverse health effects of HFCS have been voiced for at least the last decade, but now new research has shown strong and clear links between its consumption and rates of diabetes.

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HFCS is added to just about every manufactured food product, including soft drinks, salad dressings, ketchup, jams, sauces, ice cream, bread, cakes and confectionery. A low-fat, fruit-flavoured yoghurt could harbour 10 teaspoons of HFCS in one pot, while a can of soft drink may contain as much as 13 teaspoons. Luckily, though, the use of HFCS in the UK is still well behind that in America. While the average person in the UK consumes around half a kilogram of HFCS a year, people in the US eat 50 times as much – a massive 25 kg a year on average!

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Now, in a major study at the University of Southern California, researchers have found that countries that use large amounts of HFCS in their food supply have a 20 per cent higher prevalence of type 2 diabetes than countries that use no HFCS. This association is independent of total sugar consumption or the prevalence of obesity, showing that it really is the HFCS that is doing the damage. This new research refutes the arguments of the food industry that HFCS is basically no different from ordinary table sugar since both contain sucrose and fructose.

The authors of the new study believe that the higher incidence of diabetes is driven by the greater amounts of fructose in foods and beverages made with HFCS. And there is no way to be sure just how much fructose you are consuming in these products. While the standard form of HFCS for sweetening beverages is 55 per cent fructose (and 45 per cent glucose), some US-produced soft drinks, including the big name colas, have been found to contain 20 per cent more fructose than expected, showing that manufacturers are in fact using HFCS with around 65 per cent fructose content. In addition, the actual sugar content of some drinks may be up to 28 per cent more than is declared on the product label.

Fruit sugar is anything but a healthy alternative

So, what is it about fructose that makes it so much more dangerous than normal sugar? For years, fructose was seen as “natural fruit sugar” and a healthy alternative to sucrose. It was (and on some websites still is) even recommended for diabetics since, unlike glucose, it does not provoke an insulin response or cause a rise in blood sugar levels. That is because fructose is chemically quite different from glucose and behaves very differently in the body.

Unlike glucose, fructose is not moved into body cells as a source of energy. Instead, it is transported directly to the liver, where its metabolism promotes the production of uric acid. High levels of uric acid in turn lead to insulin resistance and high blood pressure and impair the function of the endothelial cells lining the arteries, so promoting the accumulation of cholesterol plaque. Uric acid also causes impaired liver function and non-alcoholic fatty liver disease. Fructose is also metabolised to xylulose-5-phosphate, which stimulates the production of fat-producing enzymes. So, single-handedly, high fructose consumption causes all the characteristic features of metabolic syndrome: insulin resistance, high blood pressure, furred up arteries, a fatty liver and excess body fat.

In a recent study, volunteers drank beverages sweetened with either glucose or fructose, providing 25 per cent of their daily energy requirements, for a period of 10 weeks. The results showed that consumption of fructose, but not glucose, increased blood levels of uric acid, activity of the enzyme GGT (gamma-glutamyl transpeptidase), an indicator of liver dysfunction, and production of a protein called RBP-4, associated with increased insulin resistance. Visceral fat and levels of blood fats also increased in those consuming fructose, but not with glucose.

The lesson we can take from these studies is that, whether or not we have diabetes, we would all do well to:

  • Cut down our intake of ordinary table sugar (sucrose) as far as possible;
  • Shun sweet fruit juices that have a high concentration of natural fructose;
  • Avoid like the plague anything that contains HFCS (often labelled as “glucose-fructose syrup” in the UK)

The fructose in whole, unadulterated fruits is less of a problem, since it is naturally present with fibre, which slows down its absorption, and with the vitamins, minerals and other natural compounds that mitigate its effects in the body. Even so, it is wise to stick to the more sharp tasting, low-GL fruits such as berries and avoid the very sweet ones like pineapples, mangos and bananas.

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Janice Martin is a professional journalist who loves to cover education, politics and social sciences. She is also a media influencer with 3 million followers.