Brandon

Cavinee
11/25/13
HIGH FRUCTOSE CORN SYRUP
LITERATURE REVIEW
NUTRITION 2200

Introduction:
The following literature review is a critical examination of the sweetener high
fructose corn syrup. Although there is a vast number of issues related to high fructose corn
syrup, this review will focus on Sive major points that deal with high fructose corn syrup.
The points that will be addressed are the background of the substance, what is high
fructose corn syrup, the metabolism of fructose, high fructose corn syrup availability, and
health concerns. There are many different types of high fructose corn syrup and they vary
in many ways, this review will discuss the various types of high fructose corn syrups. The
review will focus on the metabolism of fructose due to the fact high fructose corn syrup has
higher fructose levels and the metabolism of this molecule will be necessary to discuss . In
addition there are health concerns that are related to high fructose corn syrup such as
obesity and metabolic damage; this review will discuss these concerns. High fructose corn
syrup is a sweetener that currently has a great deal of debate around it, both sides of the
argument will be discussed.
Background and What Is High Fructose Corn Syrup:
High fructose corn syrup is a liquid sweetener that is used in a great deal of food
products (White, John S. 2008). This sweetener is used as an alternative to sucrose to
enhance Slavor and sweetness of food (White et al., 2010). High fructose corn syrup Sirst
came onto the market in the late 1960s (White, John, S. 2008). This sweetener gained
popularity due to the fact it is stable in acidic foods and beverages (White, John S. 2008).
The liquid nature of this sweetener also made it attractive for food producers, the liquid
nature allows high fructose corn syrup to be pumped from delivery trucks right into storage

and delivery mixing tanks (White, John, S. 2008). Corn is a dependable and readily
available resource, since high fructose corn syrup is derived from corn, the price remains
low and remains readily available (John, White, S. 2008). Another reason this sweeter is so
widely used is the fact fructose is sweeter than sucrose (Bray et al., 2004). In a comparative
study of sweetness where sucrose sweetness levels were set at 100, fructose had a
sweetness of 173 and glucose had a sweetness of 74 (Bray et al., 2004).

When it comes to the composition of high fructose corn syrup there are two major

types, those being HFCS-42 and HFCS-55 (John, White, S. 2008). The corn starch that the
HFCS are made out of is mixed with enzymes to change glucose to fructose (Healy, Amber
M. 2013). About 90 percent of the glucose is converted into fructose by the enzyme
isomerase, which is produced from Streptomyces (McWilliams, 2012, pp. 157). Although
this enzyme can convert almost 90 percent of glucose to fructose, usually only 45 percent to
55 percent of the glucose is converted into fructose (McWilliams, 2012, pp. 157). HFCS-42
is composed of 42 percent sugar and HFCS-55 is composed of 55 percent fructose (John,
White, S. 2008). The remaining ingredients in these sweeteners are free glucose and minor
amounts of bound glucose, a majority being maltose and maltoriose (John White, S 2008).
Studies have shown that HFCS-42 is 1.16 times higher in sweetness than sucrose and
HFCS-55 is 1.28 times higher in sweetness than sucrose (Bray et al., 2004). When referring
to the United States HFCS is found in nearly all foods containing a nutritive sweetener (Bray
et al., 2004). Some foods that contain high fructose corn syrup in are canned fruits, dairy
desserts, soft drinks, fruit drinks, candied fruits, yogurts, baked goods, cereals, and many
jellies (Bray et al., 2004). Although HFCS is found in a vast majority of food products, it is
found in about two thirds of all beverages consumed in the United States (Bray et al., 2004).

Metabolism/Biology of Fructose and High Fructose Corn Syrup:

Most of the fructose consumed in America comes from high fructose corn syrup, so it

is important to understand how fructose is metabolized in the human body (Bray, George A.
2007). Although high fructose corn syrup is not pure fructose it is hypothesized its
consumption can lead to all of the metabolic issues displayed below (Bray et al., 2004).
When fructose from fruit is consumed it is usually accompanied by some sort of Siber which
slows the absorption of the fructose (Healy, Amber M. 2013). High fructose corn syrup is
consumed in higher concentrations and as a liquid so it can get into the bloodstream more
readily (Healy, Amber M. 2013). The need for dietary fructose in the body is obsolete and
when it is consumed by itself it is poorly absorbed by the gastrointestinal tract (Bray,
George A. 2007) Most cells in the human body contain a low level of the Glut-5 transporter,
which is responsible for the uptake of fructose (Bray, George A. 2007). When glucose is
consumed it signals the beta cells of the pancreas to release insulin, fructose on the other
hand does not illicit this metabolic response (Angelopoulos, Theodore J. et al., 2009).
Therefore fructose is not effective in eliciting a postprandial insulin secretions (Teff et al.,
2004).
The higher fructose load from consuming HFCS could lead to higher triglyceride
levels. Fructose, unlike sucrose, is known for its lipogenic potential (Angelopoulos et al.,
2009). When fructose is taken to the liver it is broken down into dihydroxyacetone
phosphate and glyceraldehyde 3- phosphate (Angelopoulos et al., 2009). Dihydroxyacetone
can become the glycerol backbone for the production of triglycerides and glyceraldehyde 3-

phosphate produces acetyl- CoA that is necessary for de novo lipogenesis (Angelopoulos et.
al., 2009). Consuming high fructose corn syrup could possibly lead to higher triglyceride
levels (Bray, et al. 2004)
Another main difference in the metabolism of glucose and fructose is fructose can
raise uric acid levels (Lanaspa et al., 2012). Fructose is metabolized in the liver by
ketohexokinase and this process uses ATP to phosphorylate fructose to fructose-1-
phophate (Lanaspa et al., 2012). Glucose is phosphorylated by hexokinase and has a
negative feedback system that prevents excessive phosphorylation, ketohexokinase causes
fructose to become phosphorylated quickly and this leads to intracellular phosphate
depletion (Lanaspa et al., 2012). The low levels of intracellular phosphate result in the
activation of AMP deaminase, this converts the AMP to IMP, inosine, and eventually to uric
acid (Lanaspa et al., 2012). This causes uric acid to rise in the cell and spill out into
circulating blood (Lanaspa et al., 2012). Therefore fructose has the ability to cause
intracellular phosphate depletion and production of uric acid (Lanaspa et al., 2012).
Although all of the prior information on metabolism holds true for pure fructose, it
is hypothesized that high fructose corn syrup does not cause these problems in metabolism
because the sweetener is not just fructose but half glucose as well (White, John S. 2009).
The most approximate way to measure the metabolic effects of high fructose corn syrup is
to measure the fructose against the sucrose being replaced (White, John S. 2009). In the
limited amount of studies that have measured the metabolic effects of HFCS against the
sucrose it replaced, the studies showed no difference in metabolic markers for obesity or in
satiety (White, John S. 2009). Another study was done that compared 30 percent of total

energy consumed from high fructose corn syrup versus sucrose and there were no
differences in leptin levels, glucose levels, or ghrelin levels (Rippe & Angelopoulos, 2013).
The claims made from Rippe where conSirmed by the work of Stanhope (Rippe &
Angelopoulos, 2013). The study was ran by feeding a group of men three isocaloric meals,
one day feeding them sucrose and the other day HFCS, blood samples were collected after a
24 hour period (Stanhope et al., 2008). The blood results showed that there were no
difference in glucose, leptin, ghrelin, triglycerides, and free fatty acid concentrations when
comparing eating HFCS for a day versus sucrose (Stanhope et al., 2008). This study also
showed that were no difference in plasma triglycerides, cholesterol, LDL concentrations,
HDL concentrations, or baseline and postprandial concentrations (Stanhope et al., 2008).
These results showed that HFCS and sucrose do not have signiSicant short term effects on
endocrine markers in the body (Stanhope, et al., 2008).
Since HFCS is not entirely composed of glucose a study suggested that HFCS does not
have an effect on different blood levels (Melanson et al., 2007). A study was conducted to
test high fructose corn syrup consumption against sucrose to test changes in glucose,
insulin, leptin, ghrelin, and appetite, the study was conducted by feeding two groups three
controlled meals throughout the day, one that contains high fructose corn syrup and one
that contains sucrose (Melanson et al., 2007). The subjects blood was drawn the day after
the subjects consumed the HFCS and sucrose meals (Melanson et al., 2007). The results
showed that the subjects had similar blood levels of glucose, insulin, leptin, ghrelin, and
appetite levels (Melason et al., 2007) It is suggested that HFCS effects the body the same
way as sucrose when measuring for levels of glucose, insulin, leptin, ghrelin, and appetite
(Melnason et al., 2007).

Although not many studies have been conducted comparing HFCS with sucrose, one
study looked to compare the two in regards to the effect on acute metabolic and
hydrodynamic response of healthy individuals (Le et al., 2012). For this study fructose,
glucose, and uric acid levels were tested in individuals, two separate groups were given
either Dr. Pepper that was sweetened with HFCS or Dr. Pepper that was sweetened with
cane sugar (Le et al., 2012). The subjects blood was sampled periodically for six hours after
they ingested either the HFCS or cane sugar (Le et al., 2012). The results showed that when
compared to the Dr. Pepper sweetened with cane sugar, the subjects that consumed HFCS
had higher levels of fructose, glucose, serum uric acid, and systolic blood pressure (Le et al.,
2012). Although there was a difference in systolic blood pressure when consuming HFCS,
the difference was very small (Le et al., 2012). Research needs to be conducted to see if
chronic consumption of HFCS can have an effect on systolic blood pressure (Le et al., 2012).
This is one of the only studies that showed there is a difference in acute metabolic effects
when comparing HFCS and sucrose (Le et al., 2012).

High Fructose Corn Syrup Availability/Intake:

A great deal of the current research on high fructose corn syrup has to do with the
availability of high fructose corn syrup and how this rise has increased fructose intake
among the population. When high fructose corn syrup was Sirst introduced in the 1970s it
accounted for less than one percent of total caloric sweeteners available for consumption in
the United States (Duffy & Popkin, 2008). In 2004 HFCS of any type accounted for 42
percent of all nutritive sweeteners consumed (Duffy & Popkin, 2008) High fructose corn

syrup is found at some degree in almost all beverages; there was a trend of increase per
capita caloric consumption from HFCS between 1991-2004 (Duffy & Popkin, 2008). In
2002 HFCS 55 accounted for 61.2 percent of total HFCS production (Bray et al., 2004 ).
Between 1989 and 2000 the average total caloric intake of HFCS went from 77
calories coming from high fructose corn syrup a day in 1989 to 189 calories of HFCS
consumed a day (Duffy & Popkin, 2008). In 2000 HFCS accounted for nine percent of total
calories consumed per day in America and 16.5 percent of total carbohydrate consumption
among Americans (Duffy & Popkin, 2008). The total amount of added sugars consumed in
the United States grew from 119 pounds per person in 1970 to 142 pounds in 2005 (Wells
& Buzby, 2008). Since the introduction of HFCS the availability has risen to 63.7 pounds per
person in 1999 and availability of sucrose has declined 33 percent (Wells & Buzby, 2008).
Although high fructose corn syrup has risen dramatically in the food chain, studies are
showing that availability of HFCS is beginning to drop off (Wells & Buzby, 2008). With the
rise of popularity in bottled water and diet soft drinks, HFCS availability has dropped to 59
pounds per person in 2005 (Wells & Buzby, 2008). The increased use of sugar alcohols,
artiSicial sweeteners, and bulking agents in foods can also be attributed in the decline of
availability of HFCS (Wells & Buzby, 2008).
Health Concerns:
Obesity:
One major debate around HFCS is if it can lead to obesity. One study showed that the
increase in HFCS consumption just preceded the rise in obesity and these two elements
could be linked (Bray et al., 2004) This same study suggest that the rise in obesity can be

linked to the overconsumption of soft drinks sweetened with HFCS (Bray, et al., 2004). A
ten week trial was conducted on overweight men and woman; they either consumed a
sucrose sweetened drink or an artiSicially Slavored drinks for the ten week period (Raben et
al., 2002). The results showed that the sucrose groups body weight increased and the
artiSicially Slavored sweeteners group body fat decreased (Raben et al., 2002). The
researcher used the results of this study to conclude that the consumption of soda is
causing an increase in obesity (Bray et al., 2004). A study was done to look at the satiety
effects of beverages that contained HFCS versus other drinks (Soenen & Westerterp-
Plantenga, 2007). Subjects were given four different beverages, one containing sucrose,
another group with HFCS, milk, and a diet drink (Soenen & Westerterp-Plantenga, 2007).
The results showed that an increase in satiety did not differ from, a sucrose drink, HFCS
drink, milk, or a diet drink (Sonenen & Westerterp-Plantenga, 2007). Although some
research showed that the increase of HFCS consumption could be linked to obesity, one
study makes the point that HFCS rates hit an all-time high in 1999 and are now declining,
but obesity rates are staying at 33 percent for the population over 20 years of age (White,
John S. 2009) Outside of the United States at South Korea, HFCS has been available since
the 1980s, but obesity rates in this country are low to moderate when they are compared to
the rest of the world (White, John S. 2009). Argentines main sugar consumed is sucrose,
with only small amounts of HFCS being produced, but they have one of the highest obesity
rates in the world (White, John S. 2009). In Mexico HFCS only accounts for 5 percent of
total consumption, but they have much higher obesity rates when compared to America
(White, John S. 2009). This study claimed that it is hard to make a direct link with obesity
being caused from HFCS with this information (White, John S. 2009)

Diabetes:

Diabetes is on the rise in the world and some believe that this can be linked to high
fructose corn syrup (Gorana et al., 2012). One study looked to compare countries using
HFCS versus countries not using HFCS and the prevalence of diabetes (Gorana et al., 2012).
The results showed that countries that use HFCS have a higher percent of people with
diabetes when compared to counties that do not use HFCS (Gorana et al., 2012). The
countries that use HFCS have 20 percent higher prevalence in diabetes than the countries
that do not use HFCS (Gorana et al., 2012). Through these observations one group of
researchers claim HFCS causes obesity (Gorana et al., 2012).
Autism:

One study hypothesis that there is a link between HFCS consumption and autism
(Dufault et al., 2012). One reason the study comes to this conclusion is due to the fact that
when the peak rates of HFCS consumption in California matched the peak rates of autism
growth in California (Dufault et al., 2012). The study also suggest that autism can be linked
to HFCS due to the zinc depleting characteristics of HFCS and food colors found in
processed food (Dufault et al., 2012). Small amounts of mercury can be found in HFCS, due
to the manufacturing process and it is hypothesized that this can be linked to HFCS causing
autism (Dufault et al., 2012). It is stated in this study that the consumption of high fructose
corn syrup when magnesium levels are low can lead to lower calcium and phosphorus
levels (Dufault et al., 2012). The lower levels of calcium and magnesium can increase the
toxic effects of lead (Dufault et al., 2012). The toxic effects of lead can be detrimental to
cognitive and behavioral development in children (Dufault et al., 2012). The study also

notes that autism rates in Italy are close to 0.1 percent and they do not consume as much
HFCS as Americans (Dufault et al., 2012). It is suggested since Americans consume more
HFCS than other countries and have a higher prevalence of Autism there could be a possible
link (Dufault et al., 2012).
Conclusion:

In conclusion when it comes to the composition of high fructose corn syrup the

sweetener is easier to store, transport, and is sweeter than sucrose. The metabolism of
pure fructose can lead to many metabolic disorders such as high triglyceride levels, high
uric acid levels, and fructose does not elicit an insulin response. Some researches
hypothesis that high fructose corn syrup can elicit these metabolic disorders due to the
higher content of fructose in high fructose corn syrup. Some researchers on the other hand
feel that high fructose corn syrup does not cause metabolic problems. The reason behind
this view of HFCS is high fructose corn syrup is not composed solely of fructose; almost half
of the molecule is glucose. There have been multiple studies that showed there is no
metabolic disturbance when comparing high fructose corn syrup with sucrose. The theory
that high fructose corn syrup can lead to metabolic problems is based off the assumption
that high fructose corn syrup increases fructose levels in the body. There is not much or
any conclusive evidence that showed high fructose corn syrup can elicit such a metabolic
response.
Regarding availability of high fructose corn syrup there is no debate that the use and
availability has raised dramatically over the years. There is research showing that the use
of high fructose corn syrup is starting to decline. When it comes to health concerns it is

hypothesized that high fructose corn syrup can be linked to obesity, diabetes, and autism.
In reference to obesity the key evidence is the link between the rise in the use of high
fructose corn syrup and the rise of obesity happening around the same time. There have
been some studies done that showed there is an increase in body fat when consuming
beverages sweetened with high fructose corn syrup. There are also studies that showed
high fructose corn syrup is widely available in other countries yet they still have low levels
of obesity. Also there are counties where the main sweetener used is sucrose and they have
higher obesity rates than Americans. These studies go against the assumption that the rise
in HFCS and the rise in obesity are related. In consideration of the use of high fructose corn
syrup and diabetes there is only one study that hypothesis a link between the two. The
studies premise is based off of data that showed that countries that use higher amounts of
high fructose corn syrup have higher rates of diabetes than countries that do not consume
as much high fructose corn syrup. There is only one study that links autism with the
consumption of high fructose corn syrup. This study suggests that mercury found in high
fructose corn syrup can lead to autism. The study also states that when consuming high
fructose corn syrup when magnesium levels are low can lead to low amounts of calcium in
which can increase the toxic effects of lead. Lead at toxic levels can be attributed to slow
cognitive and behavioral development.
Throughout the review of the current literature of high fructose corn syrup there are
more research and data suggesting that the sweetener is no worse in regards to health than
regular sugar. Although there is more data suggesting the sweeter is not to blame for
current health problems, there is still some researches that suggest high fructose corn
syrup can be attributed to current health problems.

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