August 31, 2011
If you buy a can of Coca-Cola in Mexico, you may notice some differences from its US counterpart. The taste may be a little less sweet and the price relatively more.
The reason is that Mexican Coca-Cola is made with real sugar fresh from the sugar cane and only minimally processed before reaching your glass. American Coca-Cola is sweetened with the super sweet, inexpensive high fructose corn syrup (HFCS). You may have heard media reports warning of the health dangers of HFCS, but it turns out that HFCS may not be much worse for you than sugar or other added sweeteners.
HFCS syrup first made its debut into the American food supply around 1970 when it accounted for about 0.5% of total sweetener use. It is produced when corn syrup undergoes processing to convert glucose to fructose. By the mid 2000s, almost half of all sweetened foods were sweetened with HFCS. So HFCS makes up a large proportion of added sweeteners in beverages and processed and packaged foods, including many canned foods, cereals, baked goods, desserts, flavored and sweetened dairy products, candy, and fast food.
Two forms of HFCS are used in the US food supply: HFCS-55 and HFCS-42. HFCS-55, which is found mostly in carbonated beverages, is made of 55% fructose, 41% glucose, and 4% glucose polymers. HFCS-42 is found mostly in processed foods and contains slightly less fructose at 42% fructose, 53% glucose, and 5% glucose polymers.
Food manufacturers prefer fructose to pure sugar (which is comprised of the sugar, sucrose) due to its cheap cost. This is in large part thanks to corn subsidies and other policies aimed at increasing corn production and leading to corn prices 25-30% below the cost of production. Plus, high tariffs on imported sugar cane make sweetening with the all-natural stuff costly.
After publication of several animal studies and human studies of marginal quality showing that HFCS may contribute to obesity, insulin resistance and diabetes, and decreased feelings of fullness after consumption, health advocates and the media became alarmed that HFCS may contribute to negative health outcomes, including the surge in obesity. But the animal studies were flawed. For example, the levels of HFCS provided to those animals (around 4g/kg) was much more than a human could reasonably consume making those studies mostly invalid in trying to draw parallels to human consumption. And many of the human studies were poorly conducted and biased.
Recent large-scale human studies have not shown increased risk of overweight, obesity, or metabolic disorders like diabetes when HFCS is consumed in reasonable amounts. However, the number of long-term, high-quality controlled studies is limited. Still, the Expert Panel Centre on Food Nutrition and Agricultural Policy supported that fructose does not contribute to overweight and obesity any differently than other caloric sweeteners. They also added that fructose consumed in typical quantities (<50g per day) has no impact on health, but that very high levels of fructose consumption (>100g per day) may increase triglyceride levels immediately afterwards. (The average person consuming a typical American diet gets about 15-20g of fructose per day.) Elevated triglyceride levels are associated with increased risk of heart disease and stroke. Most people do not consume anywhere near 100g of HFCS per day.
This is not to say that a person can eat all the HFCS he/she wants without risk of ill consequence. Rather, HFCS probably doesn’t increase health risk more than sugar or other sweeteners. But the typical American still consumes about 10% of daily calories from added sugars. That’s about an extra 200 calories per day of ‘empty calories,’ which provide minimal nutritional value. Add it up and the typical American eats about 20 pounds worth of added sugar over the course of a year.
Anyone trying to lose or control their weight, curb risk of insulin resistance or diabetes should aim to minimize consumption of HFCS as well as other added sugars, including sucrose (table sugar) and other caloric sweeteners.
As you carefully scan ingredient lists, you’ll soon find that it doesn’t matter whether you drink Mexican Coca-Cola or American Coca-Cola – trying to cut added sugars in the diet is a major challenge. Without large scale policies in place to reduce the added sugars – including HFCS – in the current food supply, millions of Americans will continue to struggle with obesity.
By Natalie Digate Muth
Natalie Digate Muth, MD, MPH, RD, FAAPNatalie Digate Muth, MD, MPH, RD, FAAP is the Healthcare Solutions Director for the American Council on Exercise, a board-certified pediatrician and Fellow of the American Academy of Pediatrics, a Diplomat of the American Board of Obesity Medicine, registered dietitian and board-certified specialist in sports dietetics, and ACE-certified health coach. She is the author of "Eat Your Vegetables" and Other Mistakes Parents Make: Redefining How to Raise Healthy Eaters" and the upcoming textbook "Sports Nutrition for Health Professionals". She has been ACE certified since 1998.