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From fruit-flavored drinks to energy bars, a huge
array of sweetened 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, 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.
Earlier this month, the World
Health Organization 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.
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.
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. 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. |