Vail Daily letter: Sugar vs. fructose |

Vail Daily letter: Sugar vs. fructose

James M. Rippe, M.D.

Dear Dr. Klodas,

I am writing to offer some comments about a statement made in column “Eating By DNA” in the Feb. 26 edition of the Vail Daily.

I agree with 99 percent of what you said and think you offer some very sound and practical advice to people seeking to improve their nutrition. However, I would like to offer a comment related to your statement, “High fructose corn syrup is in every processed item and is not equivalent to sugar”. The area of the metabolism of high fructose corn syrup and sugar (sucrose) that has been one of considerable research interest in my laboratory for the last five years. In fact, your article was forwarded to me by a colleague who knows of this research interest. Please let me offer a few comments and background references in this area I hope you may find useful.

There is wide scientific agreement that there is nothing about high fructose corn syrup that uniquely leads to obesity or other metabolic problems. HFCS is no different from a nutritional or metabolic standpoint than sucrose, honey, or concentrated fruit juices. Research in my laboratory and in others has shown that by every parameter yet measured in human beings, high fructose corn syrup and sucrose are identical. We have shown that high fructose corn syrup and sucrose are identical in terms of short-term energy regulating hormones such as insulin, leptin and ghrelin. They are also identical in terms of blood sugar response, uric acid and triglycerides, as well as appetite and calories consumed at the next meal.

You may be aware that the American Medical Association looked at whether or not there is a unique link between obesity and high fructose corn syrup and after studying this question for over a year, in June 2008, concluded that: “High fructose corn syrup does not contribute to obesity more than other caloric sweeteners.” The American Dietetic Association reached a similar conclusion.

It is not surprising that HFCS and sucrose behave similarly since they are essentially chemically identical. Sucrose is 50 percent glucose and 50 percent fructose. HFCS has two major forms used in food. One is HFCS-55, which is commonly used in soft drinks. This contains 55 percent fructose, 42 percent glucose and 3 percent other sugars. HFCS-42, which is used in some baked goods and other foods, has 42 percent fructose and 58 percent glucose. As a practical matter, sucrose and HFCS are absorbed identically by the human body, have the same sweetness and the same calories. From a nutritional standpoint there is good evidence that HFCS, sucrose, honey and cane sugar are essentially interchangeable from a nutritional point of view.

The issue of whether HFCS is chemically or metabolically different from sucrose or uniquely a cause of obesity or other metabolic abnormalities has been discussed in two recent expert panels related to nutritive sweeteners which have been published in the American Journal of Clinical Nutrition and the Journal of Nutrition. In both instances the expert panels have unanimously concluded that there is no difference between HFCS and sucrose. Even the initial authors who suggested there might be a link between HFCS and obesity, Dr. Bray and Dr. Popkin, have publically retracted this statement recognizing that it is not scientifically correct.

Perhaps Professor Dr. G. Harvey Anderson best summed up this issue in an editorial in the American Journal of Clinical Nutrition when he stated:

“The hypothesis that the replacement of sucrose by HFCS in beverages plays a positive role in obesity is not supported on the basis of its composition, biologic actions, or short-term effects on food intake. Had the hypothesis been phrased in the converse, namely that replacing HFCS with sucrose in beverages would be seen as a solution to the obesity epidemic, its merit would have been seen more clearly. Put simply, a proposal that a return to sucrose-containing beverages would be a credible solution to the obesity epidemic would have been met with outright dismissal.”

For all of these reasons I believe it is fairer to say that high fructose corn syrup and table sugar (sucrose) are metabolically and nutritionally equivalent. This is important for a number of reasons since by singling out high fructose corn syrup as potentially different from sucrose, we may inadvertently give people the sense that it is acceptable or somehow “healthier” to eat table sugar than high fructose corn syrup. This would be a mistake and run counter to a considerable body of scientific information and wide consensus within the scientific research community.

You may not be aware that more sucrose is consumed each year in the United States than HFCS. Worldwide, nine times as much sucrose is consumed as HFCS. In parts of the world such as Mexico, Europe and Australia there is essentially no HFCS consumption and yet all of these areas are in the midst of epidemics of obesity and diabetes.

Thank you for the opportunity to offer these comments. I am delighted to see that a fellow cardiologist is actively involved in helping the public understand key principles related to nutrition. I believe that having knowledgeable physicians, such as yourself, involved in this area can only improve the health and well-being of our country.

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