TUESDAY, Nov. 27 (HealthDay News) -- In the United States and
elsewhere, high fructose corn syrup is ubiquitous in soft drinks,
sweet baked goods and many processed foods. But a new study shows
that as a nation's rate of fructose intake rises, so do levels of
type 2 diabetes.
The study cannot prove a cause-and-effect link, but it does
conclude that diabetes prevalence is about 20 percent higher in
countries where use of the sweetener is high, relative to those
where it is not.
The association between high fructose corn syrup intake and
diabetes risk persisted regardless of an individual's overall sugar
intake or obesity status. According to the study authors, that
suggests that there's something special about the sweetener that's
boosting diabetes risk beyond what other sugars would.
"The 20 percent higher prevalence of type 2 diabetes in countries using a lot of high fructose corn syrup was not explained by population differences in terms of obesity [levels]," said study lead author Michael Goran, professor of preventive medicine and director of the Childhood Obesity Research Center at the University of Southern California in Los Angeles.
"So, there's some other factor, maybe several interrelated factors, over and above obesity, that contributes to diabetes," he said. "High fructose corn syrup and the way it is metabolized may very well be one of them," he added.
The findings were published online Nov. 27 in
Global Public Health.
Type 2 diabetes, which is typically tied to obesity, remains one
of the most common causes of death worldwide. According to Goran's
team, nearly 8 percent of people worldwide could be diabetic by
2030. Much of the rise is taking place in the developing world, as
diets shift to more Western fare high in carbohydrates and
But are all sugars created equally? Goran and his team say prior
studies have suggested that fructose follows a different digestive
path than glucose, metabolizing in the liver independently of
insulin. From there, they said, it can readily turn into fat.
In their study, the researchers analyzed data on diabetes
prevalence and body mass index (BMI, a measurement based on height
and weight) collected in 2000, 2004 and 2007 by the Global Burden
of Metabolic Risk Factors Collaborating Group. This information
came from adults over the age of 20 across 199 nations.
The team also collected United Nations data on food consumption
across various countries to assess to what degree various sugars
and cereals were staples of local diets. In the end, Goran's team
was able to get information on high fructose corn syrup intake from
The investigators found that BMI, daily calories and total sugar
intake (including sugars of any kind) were comparable across
countries, regardless of the level of high fructose corn syrup
Still, countries that ranked high in use of the sweetener also
had significantly higher rates of diabetes than countries with
lower rates, Goran's group reported.
Americans were by far the biggest consumers of high fructose
corn syrup, at 55 pounds per person per year. According to the
researchers, beginning in the late 1990s, the sweetener had
comprised about 40 percent of all sugars found in food products in
the United States and it remains the number one sweetener in soft
Hungary came in a distant second (consuming 46 pounds of high
fructose corn syrup per capita annually), followed by Slovakia,
Canada, Bulgaria and Belgium. Countries with the lowest consumption
included India, Slovenia, Latvia, Ireland and Sweden.
Countries in the highest category of intake were found to have
an average type 2 diabetes prevalence of 8 percent, compared with
just 6.7 percent among those in the lowest consumption category,
the team found. That difference equates to roughly a 20 percent
jump in actual number of cases of diabetes, the researchers
Goran stressed that fructose is found in many sources beyond
high fructose corn syrup. "Ordinary sugar also yields fructose, as
it contains glucose and fructose in a 50-50 mix," he said. "But the
less amount of fructose you consume, the better."
Put another way, he said that, "It's a question of the good, the
bad and the ugly, with an apple -- which has about 10 grams of
fructose in it -- being good, the fructose in [table] sugar being
bad, and the fructose in high fructose corn syrup being the
An industry representative condemned the research as "severely
In a statement, Audrae Erickson, president of the Corn Refiners
Association, said that the study cannot prove a cause-and-effect
relationship. "Just because an ingredient is available in a
nation's diet does not mean it is uniquely the cause of a disease,"
she said. Looking at data from the study, she noted that "even
though Japan consumes more high fructose corn syrup every year than
Mexico, the prevalence rates of diabetes in Japan are about half of
Erickson said, "The common sense message for consumers to
understand is to watch their intake of all calories, including all
One nutritionist not connected to either the study or the
industry agreed with that sentiment.
Lona Sandon is a registered dietician and assistant professor of
clinical nutrition at the University of Texas Southwestern Medical
Center at Dallas. She said that, "no matter what the added sugar is
-- honey, agave, sugar, or high fructose corn syrup -- we should
not be consuming it. In fact, honey and agave syrup have higher
levels of fructose than high fructose corn syrup, but people think
they're somehow better for us because they're 'natural.' But all of
these things feed a craving for sweetness, which really is an
acquired taste that we learn to seek out. Like a drug. So we have
to come to reality here, and learn to stop doing that."
There's much more on diabetes at the
American Diabetes Association.
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