Researchers from USC and the University of Oxford say they have found an association between countries that have more high fructose corn syrup in their food supply and those that have higher rates of diabetes.
Countries with higher use of HFCS had an average prevalence of Type 2 diabetes of 8%, compared with 6.7% in countries that don’t use it, according to the research published Tuesday in the journal Global Public Health. Those differences held, the researchers said, after adjustments for body mass index, population and gross domestic product.
“HFCS appears to pose a serious public health problem on a global scale,” Michael Goran, the lead author of the study and a professor of preventive medicine, director of the Childhood Obesity Research Center and co-director of the Diabetes and Obesity Research Institute at the Keck School of Medicine at USC, said in a statement. “The study adds to a growing body of scientific literature that indicates HFCS consumption may result in negative health consequences distinct from and more deleterious than natural sugar.”
The researchers reported that of 42 countries studied, the United States had the highest per capita consumption of HFCS: 55 pounds a year. The second-highest was Hungary, at 46 pounds. Countries that had a per capita annual consumption rate of about a pound or less included Australia, China, Denmark, France, India, Ireland, Italy, Sweden, Britain and Uruguay.
Dr. Robert Lustig, a professor at UC San Francisco and director of the Weight Assessment for Teen and Child Health Program there, noted that the researchers did not show that higher consumption of high fructose corn syrup caused the increase in diabetes, only that there was a link between the two.
The people who have diabetes may or may not be the people who ate the HFCS, said Lustig, who has studied the effects of sweeteners on people for years.
He also said the researchers didn’t assess all aspects of the diet. For instance, other researchers have found an association between processed meat consumption and diabetes, and this study didn’t look at that food.
The study waded into complicated and controversial areas.
Fructose and glucose are found in equal amounts in ordinary sugar, but HFCS has a greater proportion of fructose. That makes it sweeter and provides processed foods with greater stability and better appearance.
In the article, Goran and his colleagues propose that the association is probably driven by higher amounts of fructose in foods and beverages made with HFCS.
Caloric sweeteners, particularly in beverages, have come under scrutiny as scientists, advocates and politicians consider their role in the obesity epidemic. Calories from sugar-sweetened beverages make up 7% of the calories in the average American diet, according to government data. Studies have found that people don't compensate for extra calories consumed in drinks the way they do when they have a cupcake.
“There is already a growing literature linking sugar in beverages with diabetes,” said Barry Popkin, nutrition professor at the University of North Carolina and author of the book “The World Is Fat.” “The main reason they find this finding is that ... it is really sugary beverages" that are the problem.
The American Beverage Assn. said in a statement that there is no evidence that HFCS, which was developed in the 1920s, has any unique risks for diabetes or any other disease.
The trade group noted that “Hungary has a relatively low incidence of diabetes – yet has the second-highest per capita consumption of HFCS. Conversely, countries like Egypt and Malaysia, which have among the highest incidence of diabetes, have low consumption of HFCS.”
“All this paper shows is that there is an association between obesity and diabetes, which is already well known,” the group said.
And the Corn Refiners Assn., representing companies that turn corn into HFCS, was sharply critical.
“This latest article by Dr. Goran is severely flawed, misleading and risks setting off unfounded alarm about a safe and proven food and beverage ingredient,” Audrae Erickson, the association’s president, said in a statement. “There is broad scientific consensus that table sugar and high fructose corn syrup are nutritionally and metabolically equivalent. It is, therefore, highly dubious of Dr. Goran – without any human studies demonstrating a meaningful nutritional difference between high fructose corn syrup and sugar – to point an accusatory finger at one and not the other.”
“The common sense message for consumers to understand is to watch their intake of all extra calories, including all added sugars,” the refiners association said.
The researchers, in their article, noted some difficulties: Their analysis is based on data that was available, not on surveys or measurements they took. It is “extremely challenging to obtain individual estimates of HFCS consumption,” the researchers said, because it is not listed as an ingredient in nutrient databases.
Goran on Tuesday said the refiners’ statement “crossed the line and turned this into a personal attack.... Obviously they have a huge economic stake in this argument for the sale of HFCS.”
“Public health strategies aimed at diabetes prevention should incorporate efforts to limit sugar consumption and provide consumers with better labeling with regard to sugar consumption, especially with regard to fructose and HFCS content,” the researchers wrote in their article.
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