The high fructose corn syrup industry has launched an intensive advertising campaign intended to counter concerns about products containing the sweetener. The spots begin with an individual offering a beverage or dessert containing high fructose corn syrup (HFCS) to a friend.

The friend declines the offer explaining, “That contains high fructose corn syrup. You know what they say.” Contained in the rejection is a suggestion that the treat would not have been offered if the person cared about the health of her family and friends.

“What do they say?” the first individual asks before proceeding to answer her own question. “That it’s made from corn? That it has no artificial ingredients? That it contains the same number of calories as table sugar? That it’s okay to consume in moderate amounts? That it’s endorsed by the AMA and FDA?”

At that point the friend, stunned and speechless, happily accepts the food or drink.

Each claim made in the advertisement is misleading. It’s not only important to know what the ads say about high fructose corn syrup, but to understand what is being said. It is also important to know what the unidentified “they” in the ads are actually saying.

The first statement in the ads is that high fructose corn syrup is made from corn. True, but so are ethanol and biodiesel fuels. No one is suggesting that those corn derivatives be used as food additives. The fact that HFCS is derived from corn says nothing about the advisability of including it in one’s daily diet.

The assertion that HFCS contains no artificial ingredients is a bit of a stretch. To create HFCS the manufacturers use multiple enzymes to break and rearrange the chemical structure of corn starch. One of the enzymes used, 1-glucose-isomerase does not occur in nature, but is a synthetic chemical. Manufacturers point out that the enzymes simply drive the reactions that convert corn starch to high fructose corn syrup, but the absence of the enzymes in the finished product does not change the fact that HFCS is a substance that occurs nowhere in nature.

The ads then point out that high fructose corn syrup has the same number of calories as table sugar. This is true, but it is hardly a sound argument for including foods and beverages containing HFCS in the daily diet. Both table sugar (sucrose) and HFCS contain 15 calories per teaspoon. The only difference between sucrose and HFCS is the ratio of fructose and glucose in the products. Sucrose (granulated sugar) contains 50 % fructose and 50 % glucose. HFCS consists of 55 % fructose and 45 % glucose. It is therefore safe to assume that they would not only have the same caloric makeup, but that they would have the same effect upon health.

Americans consume massive quantities of soft drinks. Carbonated soft drinks (sodas) contain an average of 150 calories in every 12 ounce serving. Non-carbonated soft drinks (fruit drinks), such as those shown in the ads, contain 180 calories in every 12 ounce glass. Companies produce enough carbonated beverages to allow every man, woman, and child in the United States to drink 557 cans—52.4 gallons—annually. When noncarbonated beverages are added the total consumption rises to 68 gallons a year. This adds up to 85,000 calories. That’s enough for each individual to gain approximately 24 pounds of fat annually.

Soft drinks are currently the largest single source of calories in the U.S. diet. Carbonated and noncarbonated soft drinks account for 13 % of daily calories taken in by teens. It is therefore not surprising that obesity is on the rise. The suggestion that items high in sugar or HFCS should be consumed without considering the health consequences of doing so is patently ridiculous.

The claim that it’s all right to consume moderate amounts of HFCS may be correct, but doing so presents a challenge. Moderation is defined as no more than 32 grams of sweeteners daily. A single serving of fruit punch like that shown in one of the ads contains 48 grams of HFCS – 1 ½ times an entire day’s sugar allowance. Since nearly all packaged foods currently contain HFCS, keeping daily intake at moderate levels is impossible for anyone eating a standard American diet.

The AMA’s stance on HFCS is not accurately reflected in the advertising. It is true that the AMA issued a press release on June 17, 2008 that read in part, “After studying current research, the American Medical Association (AMA) today concluded that high fructose syrup does not appear to contribute more to obesity than other caloric sweeteners.”

The full statement, however, contained a qualifier: “But the AMA calls for further independent research to be done on the health effects of HFCS and other sweeteners.” They went on to recommend that no more than 32 grams of sugar be consumed daily, and concluded with the disclaimer, “Currently, there are few available studies on the health effects of high fructose syrup and most are focused on the short-term effects.”

Basing approval upon a few studies that focused on short-term effects is foolhardy and dangerous. Concerns about consumption of sweeteners including HFCS arise not so much from the immediate effects of doing so, but rather upon the risk of becoming obese or developing conditions like the metabolic syndrome or diabetes mellitus over time.

Read the AMA’s statement once more: “High fructose corn syrup does not appear to contribute more to obesity than other caloric sweeteners.” The conclusion that HFCS does not contribute more to the development of obesity than other caloric sweeteners does not support the inclusion of sweetened foods and beverages in the daily diet.

The statement could have been worded, “High fructose corn syrup is as likely to cause obesity as other caloric sweeteners.” Caloric sweeteners are likely to cause obesity; choosing to use the negative phrase “does not appear to contribute more” simply softens the conclusion. Someone reading that HFCS “does not contribute more to obesity” may conclude that HFCS does not cause obesity, but it is extremely unlikely that anyone reading that HFCS “is as likely to cause obesity” would make that mistake.

The suggestion that HFCS is endorsed by the FDA is similarly flawed. What actually occurred is that one manufacturer obtained permission to claim that HFCS is a “natural” substance. The FDA statement read, “(The FDA) would not object to the use of the term ‘natural’ on a product containing the HFCS produced by the manufacturing process . . .”

The statement referred to the process used by one specific manufacturer who had requested permission to use the term “natural” in relationship to its product. The FDA’s permission was not intended to be a blanket statement covering the entire HFCS industry. The FDA’s original stance remains in effect for other manufacturers. That position is: “The use of synthetic fixing agents in the enzyme preparation, which is then used to produce HFCS, would not be consistent with our . . . policy regarding the use of the term ‘natural’. Consequently, we would object to the use of the term ‘natural’ on a product containing HFCS.”

Even if the FDA grants industry-wide permission to use the “natural” label on products containing HFCS it is clear that the FDA’s definition of “natural” is unnatural. The FDA defines a substance as “natural” if no synthetic substances have been added in the manufacturing process. Thus a substance that is found nowhere in nature is considered “natural” if it is based solely upon materials that occur in nature. Some have pointed out that the FDA would have allowed Dr. Frankenstein to portray his monster as “natural”, since it was created from naturally occurring body parts and naturally generated electricity.

If the ads are misleading, what is it that “they” are saying about the consumption of HFCS? Was the concern expressed by the person rejecting the HFCS product justified, or was the purveyor of the beverage or dessert correct in defending the product?

It is not possible to keep sugar consumption at a moderate level when the daily diet includes foods or beverages that contain concentrated sweeteners such as sucrose and high fructose corn syrup. On the other hand, it is virtually impossible to exceed moderate levels of sugar intake by eating whole fruits and vegetables.

This is because whole fruits contain approximately 1 gram of fructose per serving. Even sweet vegetables such as beets, carrots, and corn typically provide 2 grams or less of sucrose per serving. One would need to consume between 15 and 30 servings of fruits and vegetables daily to exceed the level of sugar intake that is generally considered safe.

In contrast, a single serving of any of the products shown in the HFCS ads contains more sugar than should be consumed in an entire day. The widespread practice of adding sweeteners to foods has had a profound effect upon the level of sugar consumption in the United States.

At the turn of the twentieth century the average American consumed around 5 pounds of sugar each year. In 1942 the American Medical Association’s Council on Foods and Nutrition released the following statement:

“From the health point of view it is desirable especially to have restriction of such use of sugar as is represented by consumption of sweetened carbonated beverages and forms of candy which are of low nutritional value. The Council believes it would be in the interest of the public health for all practical means to be taken to limit consumption of sugar in any form in which it fails to be combined with significant proportions of other foods of high nutritive quality.”

It seems ironic that over sixty years later the AMA is unable to recommend against inclusion of such items in the diet without “additional research on the health effects of HFCS.” In 1942 the annual consumption of soft drinks was approximately 720 ounces, which was equivalent to two standard 6 ½ ounce bottles per week. By the turn of the twenty-first century soda consumption had increased to 6,700 ounces – an average of 10 ½ twenty ounce cans each week.

Today the average annual sugar consumption stands at an astounding 135 pounds per person, having jumped 26 pounds since 1980. Increased serving sizes have played a major role in the rise in sweetener consumption; in the 1990s a twenty ounce bottle replaced the 12 ounce can as the most popular beverage serving size. Drinks like 7-Eleven Stores’ 64 ounce Double Gulp have also contributed to the jump in sugar and HFCS consumption.

Unfortunately, dietary sources of sugar and HFCS are no longer limited to candy and soft drinks.

Eliminating those obvious sources of sugar in the diet will not be enough to keep sugar consumption in a safe range. This is because sweeteners are now hidden in foods like tomato sauce, peanut butter, mayonnaise, salad dressings, and nearly all packaged foods. They are even present in many packages of fresh frozen foods.

As critical as the total amount of sugar consumed is the manner in which it is handled by the body. Fructose taken in the form of an apple, peach, or strawberry is absorbed slowly because it is released gradually from the surrounding pulp. Fructose does not affect insulin production nor does it adversely affect blood glucose levels. In fact, in small quantities such as those found in fruits and vegetables, fructose has been shown to support the body’s ability to handle glucose.

When consumed in high amounts fructose has quite different effects. Without the moderating effect of plant fiber, fructose is absorbed rapidly. This causes it to be delivered in high concentration to the liver, where it is stored as fat. This contributes greatly to the development of insulin resistance, which in turn leads to type 2 diabetes mellitus.

A particularly disturbing characteristic of HFCS is that it does not appear to give the body a sensation of satiety. Research has revealed that two hormones play an important role in appetite control. One is ghrelin. Ghrelin is produced by cells in the stomach. When the stomach is empty, ghrelin production increases and the sensation of hunger rises. Eating a meal typically causes ghrelin production to fall, and hunger pangs to cease.

The second hormone that affects the desire to eat is leptin. Leptin is produced by fat cells. As leptin levels rise, signaling the presence of adequate fat stores, there is normally a decrease in appetite.

Research is showing that the normal appetite response to ghrelin and leptin is blunted when sweeteners including sucrose and HFCS are present in the diet. It appears that while the production of the appetite control hormones is relatively unaffected, the body’s interpretation of the fluctuation in hormone levels is adversely affected. When an individual consumes a food or beverage containing sucrose or HFCS he or she does not experience the same sensation of fullness that would have been triggered by eating foods or drinking beverages that did not contain added sweeteners.

This explains to a great extent why diets containing caloric sweeteners trigger obesity. Those foods and beverages do not satisfy the appetite. In effect, the more sweetened foods and beverages consumed the hungrier the person feels. The presence of a higher number of calories in each serving coupled by the consumption of more servings throughout the day is a recipe for substantial, ongoing weight gain.

As weight increases the tissues of the body become less sensitive to the effects of insulin. This causes insulin levels to rise. Insulin resistance is initially characterized by an increasing waist size due to increased fat deposition around the waist. Biochemical changes also occur, including a rise in fasting blood sugar, a rise in triglycerides, a fall in HDL cholesterol, and a rise in C-reactive protein. In addition, blood pressure rises. These changes are collectively referred to as the metabolic syndrome.

Individuals who are found to have the metabolic syndrome are at increased risk of having a heart attack or another circulatory challenge. Unchecked, the metabolic syndrome will progress to type 2 diabetes.

The risk of becoming obese or developing diabetes should be enough to dissuade people from indulging in foods and beverages high in sugar or HFCS, but there are many other reasons avoid them. Most of the research has been done on sugar, but as I have pointed out, the only difference between sucrose and HFCS is a slightly different ratio of fructose to glucose in the products. I believe it would be foolhardy to suggest that the consumption of HFCS would not produce the same or very similar effects in the body.

Sugar suppresses the immune system, making one more vulnerable to infections. Suppression of the immune system may explain why high sugar intake has been shown to increase the risk of developing cancer. Imbalances in the immune system also make allergic reactions more common and bothersome.

Sugar depletes the body’s supplies of B vitamins. This is because B vitamins are required for the metabolism of sugar in the body. These vitamins are found in unrefined foods, but are absent in refined or manufactured sweeteners like sucrose and HFCS. B vitamin deficiencies impair the activity of the adrenal glands, which are the stress glands of the body. When adrenal activity is compromised, allergies become more bothersome and the ability to handle stress is diminished.

Sugar can impair the absorption of calcium and magnesium, accelerating the development of osteoporosis. It has also been shown to cause deficiencies of trace minerals such as chromium and copper. This compounds the problem of insulin resistance, as chromium deficiencies create a picture that is indistinguishable from type 2 diabetes.

Sugar has been found to increase the acidity of the intestinal tract, increasing the risk of inflammatory bowel disease including Crohn’s disease and ulcerative colitis. Saliva also becomes more acidic. This increases the incidence of tooth decay and diminishes the ability of saliva to protect the esophagus from damage. Absorption of nutrients is impaired when sugar consumption is high.

As sugar molecules bind to protein, a process called glycation, aging accelerates. Tissues become stiffer and more susceptible to injury. Wrinkles become more noticeable. As protein structure is altered regulatory mechanisms within the body become compromised.

I could continue to describe the ways in which caloric sweeteners destroy health, but that would be laboring the point.

Don’t be fooled by the Corn Refiners Association’s advertising campaign. Indulging in foods and beverages containing high fructose corn syrup does not promote health and wellness. HFCS may be no more dangerous than granulated sugar, but neither is it safer. A rifle bullet may inflict no more damage than a bullet shot by a pistol, but when it hits the heart it is just as deadly. A glass of punch sweetened with HFCS may not appear to contribute more to obesity than other caloric sweeteners, but does contribute. That is all they should need to say.