A new study suggests countries that use large amounts of high fructose corn syrup in their food may be helping to fuel the global epidemic of type 2 diabetes. Researchers from the University of Oxford and the University of Southern California (USC) found a 20% higher proportion of the population have diabetes in countries with high use of the food sweetener compared to countries that do not use it.

The findings, published online first in the journal Global Public Health on 27 November, also reveal that the link between high fructose corn syrup (HFCS) and the “significantly increased prevalence of diabetes” is independent of the total use of sugar and levels of obesity.

Co-author Stanley Ulijaszek, Director of the Institute of Social and Cultural Anthropology at the University of Oxford, says in a statement their analysis shows “an ecological relationship that suggests there are potential risks in consuming high levels of high-fructose corn syrup”.

Ordinary table sugar is made of sucrose, which comes from sugar cane or sugar beets. Sucrose contains equal amounts of fructose and glucose, but HFCS has more fructose. This makes HFCS much sweeter, which helps stabilize processed foods.

Food companies also use HFCS to improve the appearance of certain processed foods such as baked goods because it produces a more consistent browning.

Ulijaszek says:

“Many people regard fructose as a healthy natural sugar from fruit, and that’s true. Natural fructose found in fruit for example, is fine: the 10 g or so of fructose in an apple is probably released slowly because of the fibre within the apple and because the fructose is inside the cells of the apple.”

But, he goes on to explain, “there is evidence that the body struggles to metabolize large amounts of fructose that does not come from fruit, and there is a risk for type 2 diabetes“, because “fructose and sucrose are not metabolically equivalent”.

For their study, Ulijaszek and colleagues analyzed data on high fructose corn syrup (HFCS) availability in 42 countries and find that 8% of people in countries with a higher use of the food sweetener have type 2 diabetes compared with only 6.7% in countries that do not use it.

At 25 kg or 55 lbs of of HFCS per year, the US has the highest consumption of HFCS per head, followed by Hungary at 16 kg or 46 lbs per head.

Canada, Slovakia, Bulgaria, Belgium, Argentina, Korea, Japan and Mexico also have relatively high per head consumption of HFCS.

The UK on the other hand, at under 0.5 kg, or around 1.1 lbs per head, was among countries with much lower levels of HFCS consumption.

“This research suggests that high fructose corn syrup can increase the risk of type 2 diabetes, which is one of the most common causes of death in the world today,” says Ulijaszek.

Lead author Michael Goran, professor of preventive medicine at the Keck School of Medicine at USC, says:

“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.”

Ulijaszek says:

“Most populations have an almost insatiable appetite for sweet foods, but regrettably our metabolism has not evolved sufficiently to be able to process the fructose from high fructose corn syrup in the quantities that some people are consuming it.”

“Although this syrup can be found in many of our processed foods and drinks, this varies enormously from country to country,” he adds.

The US is the single largest consumer of HFCS. By the end of the last century, 40% of all caloric sweeteners were HFCS, which was also the most frequently used sweetener in soft drinks in the US.

They researchers note that since restrictions on exporting HFCS from the US to Mexico were lifted in 2008, exports have gone up “exponentially”.

They also found HFCS use varies widely in the European Union and suggest this could be because while the EU sets trade quotas for HFCS, some countries, like Sweden and the UK don’t use their full quota, and other countries, like Hungary and Slovakia, buy extra quota from countries that don’t use them.

The researchers call for better labeling of fructose and HFCS content in foods and beverages.

In another recent study in the International Journal of Obesity, researchers concluded that the the obesity epidemic is not due to HFCS consumption.

Written by Catharine Paddock PhD