Preventive Medicine Column
Dr. David L. Katz
In 2008, following a FDA decision that high fructose corn syrup could be called “natural,” the Corn Refiners Association launched a controversial ad campaign built around the message that its product was fundamentally the same as sugar and thus “fine in moderation.” The effort did not successfully un-sully HFCS’s declining reputation among consumers, so now comes word that the Association has petitioned the FDA to permit a name change to “corn sugar.”
To sort out whether this is good, bad, or in between, we will need to invoke Shakespeare, sheep, and three hands. On the one hand… I would have liked HFCS to be called sugar all along.
One of my major concerns about the ingredient- first devised in the 1950s, refined for commercial use in the 1960s, and appearing in soft drinks as of the 1970s- was that even consumers watching their sugar intake wouldn’t recognize it as sugar. My worries ran deeper: I thought that perhaps the name was willfully chosen as an alias so the product would confound the consumer on guard against sugar. A wolf in sheep’s clothing, in other words. To address this concern, my colleagues and I built precautions about HFCS into our nutrition education program for school children (http://www.davidkatzmd.com/nutritiondetectives.aspx).
High fructose corn syrup indeed has natural origins, but it gets a bit of help from chemists to wind up in its common form. But then again, sugar cubes don’t grow pearly white on trees either, and need a bit of coaxing out of their natural sources.
When corn is milled, corn starch is produced. Corn starch can be converted into corn syrup using enzymes. Corn syrup is naturally rich in glucose. Additional enzymatic steps increase fructose levels. Corn syrup enriched with fructose is then mixed with corn syrup high in glucose to produce the desired ratio of one to the other; some “high” fructose corn syrup preparations are higher in fructose than others.
Why all the bother? Money, primarily. Tariffs in the US raise the price of imported sugar, produced from sugar cane or beets. Subsidies lower the cost of corn, and products derived from corn. HFCS is a cheaper source of sugar than sugar.
But is it just like sugar? The sugar we all know is called sucrose, molecules of glucose and fructose joined together. So there is fructose in table sugar, too; in a one-to-one ratio with glucose. Our bodies have enzymes that break sucrose down into its component parts as we digest it.
Over recent decades, we have witnessed both worsening epidemics of obesity and diabetes, and the introduction of high-fructose corn syrup into more and more processed foods. The temptation to link the two has been strong, and some nutrition experts have done so.
One of the arguments has been that HFCS has different metabolic effects than sugar. In particular, fructose does not trigger an insulin release the way glucose does, and it has also been associated with a lower release of leptin, a hormone that triggers fullness. Thus, the argument goes, HFCS will tend to fill us up less than table sugar, encouraging us to overconsume.
But the most relevant research belies that contention. There are some subtle differences in the metabolism of HFCS and sucrose, but they don’t seem to matter all that much. The net effects on appetite, satiety (fullness), hormones, blood sugar levels, blood insulin levels, and blood lipid levels are very similar in most studies. Gram for gram, differences between HFCS and sugar are just not worth talking about. I suppose water at 215˚ burns more than water at 212˚ if either splashes on you, but who really cares? How much of either splashes on you would matter far more, and that’s how I see the parade of sugars as well.
On the other hand… why the name change now? The answer seems clear enough. Not only have consumers seen past the disguise to find the wolf in sheep’s clothing, they have decided in the process that HFCS is the worst of all wolves. Under the circumstance, being recognized as a wolf like any other would be trading up.
On that third hand, the percolating perception that HFCS is uniquely bad is allowing manufacturers to gain the glow of a halo simply by abandoning it for the sake of sugar. This gives inappropriate credit to what is really a lateral move, and the requested name change might defend against it.
In addition, when asking us all to ponder “what’s in a name,” Shakespeare’s inexperience with modern food packages was on display. Because on that particular real estate, names matter more than he could have known.
For example, jams are generally made from fruit and sugar. But more accurately, they are made from sugar and fruit; ingredients are listed on food packages in order of abundance by law, and sugar routinely comes first. So, a fairly typical apricot preserve will have an ingredient list that begins with sugar, to be followed by apricots, and then whatever else.
But to borrow from the Bard, here’s the rub: some preserves list apricot first, followed by sugar- have an identical nutritional profile to those that list sugar first- yet aren’t breaking the law! Knowing this is a byproduct of my involvement with the NuVal system, which has now assigned a 1-100 score for overall nutritional quality to over 75,000 foods; we have seen identical scores come up for sugar-first and apricot-first jams.
NuVal is seeing past an industry deception, albeit a permissible one. Since sugar can appear on a food label under a number of aliases listed separately, the apricot-first preserve does, indeed, have more apricot than any one of the five sugar aliases on its ingredient list. However, if all of those sugars were simply called sugar and added up, then just like the competing products, this one, too, would be made more from sugar than from apricot. If we called all sugar “sugar,” this particular brand of deception would be decommissioned, as well it should be.
Shakesepeare doubtless knew his roses, but let’s face it- in a world without HFCS, invert sugar, dextrose, maltose, or agave nectar- he was a novice regarding sweet stuff. We, however, live in a world awash in it, so here’s the take-away message: whatever it’s called, look out for it.
Dr. David L. Katz; www.davidkatzmd.com