http://www.washingtonpost.com/ac2/wp-dyn/A8003-2003Mar10?language=printer

Sweet but Not So Innocent?
High-Fructose Corn Syrup May Act More Like Fat Than Sugar in the Body

By Sally Squires
Washington Post Staff Writer
Tuesday, March 11, 2003; Page HE01

foods and beverages crowds grocery shelves, vending machines,
restaurant menus, school lunches and kitchens. According to the latest
figures from the U.S. Department of Agriculture (USDA), consumption of
various sweeteners, often in calorie-dense foods and drinks, has risen
in the United States from an estimated 113 pounds per person in 1966 to
147 pounds in 2001.

Last week, the World Health Organization (WHO) recommended limiting
intake of added sugars found in food and drink to no more than 10
percent of daily calories, a step the WHO said could help stop the
worldwide rise in obesity that is fueling the growth of such chronic
diseases as type 2 diabetes. The WHO recommendation is far stricter
than any that U.S. groups have produced.

_____On the Web_____

· Dietary Guidelines for Americans
· USDA: Is Intake of Added Sugars Associated With Dietary Quality?

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But increasingly, it's not just the growing consumption of foods with
added sugars that concerns some nutrition experts. What has also
changed during the past four decades, the USDA figures show, is the
type of sweeteners consumed -- a trend that some studies suggest may
help to undermine appetite control and possibly play a role in weight
gain.

In 1966, refined sugar, also known as sucrose, held the No. 1 slot,
accounting for 86 percent of sweeteners used, according to the USDA.
Today, sweeteners made from corn are the leader, racking up $4.5
billion in annual sales and accounting for 55 percent of the sweetener
market. That switch largely reflects the steady growth of high-fructose
corn syrup, which climbed from zero consumption in 1966 to 62.6 pounds
per person in 2001.

While soft drinks and fruit beverages such as lemonade are the leading
products containing high-fructose corn syrup, plenty of other items --
including cookies, gum, jams, jellies and baked goods -- also contain
this syrup. [For more information about which foods contain these and
other added sweeteners, see the Lean Plate Club column on Page F2.]

Made from corn starch, high-fructose corn syrup is a thick liquid that
contains two basic sugar building blocks, fructose and glucose, in
roughly equal amounts. Sucrose, most familiar to consumers as table
sugar, is a larger sugar molecule that breaks down into glucose and
fructose in the intestine during metabolism.

An advantage of high-fructose corn syrup is that it "tastes sweeter
than refined sugar," making it a popular ingredient for food
manufacturers because it enables them to use less, says George A. Bray,
former director of Louisiana State University's Pennington Biomedical
Research Center in Baton Rouge. As a liquid, the syrup is easier to
blend into beverages than refined sugar, according to the National Soft
Drink Association (NSDA). Industry taste tests suggested that consumers
liked food and drink with high-fructose corn syrup as much as refined
beet or cane sugar.

In the 1980s, manufacturing methods improved, prompting a boost in
production of high-fructose corn syrup and a drop in price to just
pennies below that of refined sugar. "While that may not sound like
much to the average consumer, when you consider how many pounds [the
soft drink industry buys], it was millions of dollars if not hundreds
of millions of dollars in savings," says Drew Davis, NSDA's vice
president for federal affairs.

The switch made economic sense and, as Davis notes, "back then, there
was no suggestion that high-fructose corn syrup was metabolized
differently" than other sugars. More recent research suggests, however,
that there may be some unexpected nutritional consequences of using the
syrup. "Fructose is absorbed differently" than other sugars, says Bray.
"It doesn't register in the body metabolically the same way that
glucose does."

For example, consumption of glucose kicks off a cascade of biochemical
reactions. It increases production of insulin by the pancreas, which
enables sugar in the blood to be transported into cells, where it can
be used for energy. It increases production of leptin, a hormone that
helps regulate appetite and fat storage, and it suppresses production
of another hormone made by the stomach, ghrelin, that helps regulate
food intake. It has been theorized that when ghrelin levels drop, as
they do after eating carbohydrates composed of glucose, hunger
declines.

Fructose is a different story. It "appears to behave more like fat with
respect to the hormones involved in body weight regulation," explains
Peter Havel, associate professor of nutrition at the University of
California, Davis. "Fructose doesn't stimulate insulin secretion. It
doesn't increase leptin production or suppress production of ghrelin.
That suggests that consuming a lot of fructose, like consuming too much
fat, could contribute to weight gain." Whether it actually does do this
is not known "because the studies have not been conducted," said Havel.

Another concern is the action of fructose in the liver, where it is
converted into the chemical backbone of trigylcerides more efficiently
than glucose. Like low-density lipoprotein -- the most damaging form of
cholesterol -- elevated levels of trigylcerides are linked to an
increased risk of heart disease. A University of Minnesota study
published in the American Journal of Clinical Nutrition in 2000 found
that in men, but not in women, fructose "produced significantly higher
[blood] levels" than did glucose. The researchers, led by J.P Bantle,
concluded that "diets high in added fructose may be undesirable,
particularly for men."

Other recent research suggests that fructose may alter the magnesium
balance in the body. That could, in turn, accelerate bone loss,
according to a USDA study published in 2000 in the Journal of the
American College of Nutrition.

In November, however, Havel and his colleagues published a review in
the American Journal of Clinical Nutrition that examined evidence from
multiple studies. They concluded that large quantities of fructose from
a variety of sources, including table sugar and high-fructose corn
syrup, induce insulin resistance, impair glucose tolerance, produce
high levels of insulin, boost a dangerous type of fat in the blood and
cause high blood pressure in animals. "The data in humans are less
clear," the team noted.

Others are skeptical that high-fructose corn syrup acts differently in
the body than table sugar. "I don't see it as a particular evil," says
Michael Jacobson, director of the Center for Science in the Public
Interest and a vocal critic of soft drinks, which he dubs "liquid
candy." "It wouldn't make much difference if soft drinks were sweetened
with sucrose [table sugar] or high-fructose corn syrup."

Until scientists sort out the details, many nutrition experts say it
makes sense to not surpass the 10 percent recommendation of the WHO. On
a 2,000-calorie intake, that works out to about 200 calories -- roughly
the amount found in a 16.9-ounce bottle of soda or about eight Chunky
Chips Ahoy cookies or about an three ounces of plain M&M's. (Last year,
the National Academy of Sciences suggested that added sugars should not
exceed 25 percent of daily calories -- about 500 calories on a
2,000-calorie intake.)

"Reducing consumption of added sugars seems reasonable to me," Havel
says, "just as you should not consume too many calories from fat and
you should exercise regularly."

But industry groups urged consumers not to respond by avoiding any one
food ingredient. Audrae Erickson, president of the Corn Refiners
Association, notes that many of the studies used pure fructose rather
than the combination of fructose and glucose found in corn syrup.

"There are many sources for the obesity epidemic," Erickson says.
"There's no one single source of the obesity epidemic or the onslaught
of diabetes in America. But there are many contributing factors and no
scientific link to suggest that high-fructose corn syrup is a
contributing factor."

Erickson says that research published in a 1993 supplement to the
American Journal of Clinical Nutrition suggests that there is no
evidence linking the syrup to the obesity epidemic.

What does play a role, she noted, "is the lack of physical exercise.
You can not discontinue the use of any one food or beverage and expect
tomorrow -- or even in 10 years from now -- to be thin without
increased physical activity."

That's a message being delivered not just by the food and beverage
industries, but also by the U.S. Surgeon General, the National Academy
of Sciences and the WHO, which also urged more physical activity -- an
hour a day of moderate-intensity activity, such as walking -- in its
report last week.·

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TC