The debate over the health effects of high fructose corn syrup (HFCS) have been going on for decades.
On one side you have the food manufacturers who state that HFCS is "… metabolized at about the same rate (as other sugars) and are indistinguishable by the body." On the other hand there is an increasingly large body of research demonstrating that high fructose corn syrup may contribute to insulin resistance, impaired glucose tolerance, hypertriglyceridemia and high blood pressure.
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Differing interpretations of the medical data have led to a certain level of confusion on the benefit/safety of high fructose corn syrup.
HFCS is composed of two sugars, fructose and glucose. HFCS is often used as a food additive because of its sweetness and government subsidized cost.
Although fructose and glucose occur naturally in fruits, berries, root vegetables, agave and honey, HFCS is made by enzymatic ally converting some of the glucose in cornstarch into fructose. Regular sugar and HFCS account for most of the sugar consumed in the U.S.
Both fructose and glucose in HFCS are absorbed into the body through the intestine. From the intestine, the sugars are then transported to the liver.
This is where fructose and glucose differ in their metabolism. Glucose passes directly through the liver and is used by any cell in the body. Fructose on the other hand stays in the liver and is converted into fats called triglycerides.
Higher levels of triglycerides in the blood are linked to an increased risk of coronary artery disease, heart attack and stroke. In addition, elevated triglyceride levels are a marker for insulin resistance, diabetes and possibly high blood pressure.
One very interesting area of medical research is the effect of a diet that is high in fructose on the type of bacteria growing in the bowels. "Good" bacteria secrete a number of compounds that promote health. In an environment that is rich in fructose, these "good" bacteria are not as prominent as other, possibly more pathogenic bacteria.
There are two problems with HFCS: quantity in our diet and bioavailability.
The amount of sugar, in general in our diet has increased dramatically over the past 30 to 40 years. Although eating complex sugars in a plant-based diet can be quite healthy, when 45 to 60 percent of daily caloric intake is processed sugar, the health suffers mightily.
Fortunately, the annual intake of HFCS has been gradually decreasing since 1999. Still, the average American consumes almost 22 pounds of HFCS annually.
Another problem with HFCS is that it is absorbed more rapidly than complex sugars, leading to increased peak insulin levels and possibly contributing to insulin resistance, diabetes, heart disease and obesity.
We need to limit HFCS in our diet. Eating fruits and vegetables, containing complex carbohydrates, are a better health choice than HFCS. However, not everything "natural" is healthy.
Agave syrup is about 90 fructose -- almost twice as much fructose as HFCS. HFCS itself is not "bad" but it is added to many processed foods and 22 pounds of HFCS per year is just not healthy.
• Patrick B. Massey, MD, PH.D., is medical director for complementary and alternative medicine at Alexian Brothers Hospital Network and president of ALT-MED Medical and Physical Therapy, 1544 Nerge Road, Elk Grove Village. His website is www.alt-med.org.