A Backgrounder on Fructose

By Stephen Rampley

THE CONSUMPTION OF FRUCTOSE in the United States has increased

significantly since 1970. Between 1970 and 1997 the average intake
increased from 64 grams/day to 81 grams/day, a gain of 26%. But what is
fructose? Isn't it just another sugar? Why has there been so much
attention paid to the possible role of fructose in the spread of overweight
and obesity? Does too much fructose upset the balance of hormones like
insulin and leptin which help regulate metabolism and appetite? What is
high fructose corn syrup (HFCS)? Why is there so much of it in our food?
Is HFCS a factor in the obesity epidemic? These are some of the questions
I will try to answer.

Fructose is a simple sugar like glucose and galactose.

Fructose is a "simple" sugar or monosaccharide, as distinguished from

disaccharides (containing two monosaccharide) and polysaccharides
(containing more than two monosaccharides). The main monosaccharides
in the human diet are glucose, fructose, and galactose--the simple sugar
most prevalent in milk and dairy products.

Most people think of sugar as the white granules that we spoon out of a
sugar bowl. This type of sugar is a disaccharide called sucrose, which
contains 50% glucose and 50% fructose. Until the HFCS process was
perfected in the 1970s, sucrose was our primary dietary source of
fructose. Fructose is also contained in honey, berries, melons, tree fruits,
and in some vegetables such as beets, sweet potatoes, onions and
parsnips.

Fructose is metabolized differently than glucose and has a low-

glycemic index.

One of the main difference between fructose and glucose is how our
bodies use them for fuel. Almost every cell in the body can absorb glucose
and break it down for energy, but not all cells can absorb fructose. Cells in
the pancreas, for example, don't respond to fructose, which is why many
experts believe that fructose doesn't stimulate the production of insulin.
Most of the fructose we eat goes to the liver, where it undergoes a lengthy
conversion to glucose for storage as glycogen or for general use
throughout the body.

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Because fructose takes longer to break down into energy it has a lower
glycemic index than glucose--the measure of how fast glucose builds up in
the bloodstream. In some cases this can be a good thing. Physicians will
sometimes recommend fructose for patients with diabetes, but its benefits
must be balanced against the fact that fructose is more lipogenic (fat-
producing) than glucose: when the liver break downs fructose it produces
byproducts that form fat molecules--not something you want to have
happen in a patient who may already be overweight or obese.

Fructose is pretty much ignored by cells in the pancreas, the organ

responsible for secreting insulin into the bloodstream when blood sugar
increases. Insulin, you may recall, is a hormone that spreads throughout
the body and informs cells that there is glucose available and that they
should start taking it inside for energy. Insulin also helps tell the brain
when it's time to stop eating.

Fructose doesn't stimulate insulin and leptin secretion.

It makes perfect sense that fructose not stimulate insulin production. After
all, it's fructose not glucose. It takes a while for the liver to turn fructose
into glucose, so there's no point in notifying the cells until the glucose is
actually waiting outside. In the meantime, though, we don't have insulin
to help us curb our appetite. Also, fructose does not stimulate the
production of leptin, another hormone that helps regulate weight and
appetite. Studies on human subjects have shown that high fructose diets
cause an increase in "ad libitum energy intake," (a fancy phrase for
"eating") as well as weight gain. As a 2002 article from the Department of
Nutrition at the University of California, Davis put it: "One explanation for
this observation could be that fructose ingestion did not increase the
production of 2 hormones, insulin and leptin, that have key roles in the
long-term regulation of food intake and energy expenditure."

High fructose diets may increase insulin resistance.

The research on the effects of fructose on insulin in human beings is

limited, but a 1980 study found that while high-glucose feeding did not
result in an appreciable drop in insulin sensitivity, but that high-fructose
feeding did. Insulin sensitivity is the ability of cells to respond to the
presence of insulin; when cells become too resistant to insulin they don't
get the message to open up and let glucose inside. This is the condition
known as Type-II diabetes.

High Fructose Corn Syrup (HFCS) is a processed mixture of the

monosaccharides fructose and glucose. The HFCS that goes into ice
cream, frozen desserts and soft drinks is 55% fructose / 45% glucose;

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there is also a 42% fructose mixture which is used in "light" processed
foods. As a comparison, the disaccharide sucrose--our familiar white-
grained "table" sugar-- is half fructose and half glucose. As we shall see,
there doesn't seem to be much difference between sucrose and HFCS,
until you consider what they cost to produce. HFCS is relatively cheap.

High fructose corn syrup is made from corn starch.

The corn that eventually becomes HFCS is different than the sweet corn-
on-the-cob that we enjoy in mid-summer. Technically, in the United States,
it's called "yellow #2 dent corn" (it has a small dent at the end of every
kernel) and according to government regulations must weigh a minimum
of 54 pounds per bushel. Corn accounts for more than 90 percent of the
total value of feed grains produced in the U.S. There are 80 million acres
of land planted in corn--that's an area a little larger than New Mexico, but
a little smaller than Montana. Iowa, Illinois, Nebraska and Illinois are the
top corn-producing states.

Corn destined for HFCS is cleaned and put into large stainless steel tanks
where it is softened for up to 40 hours with an acidic mixture of water and
sulfur dioxide. Then it's ground and centrifuged to separate the germ from
the rest of the kernel. The corn germ is heated and further processed to
obtain corn oil for food products and soap. The remaining slurry,
comprised of starch, protein and fiber, goes through another set of
grinding mills. The fiber is removed to become animal feed or bran fiber
for cereals, and the starch and protein are separated by another set of
centrifuges and filters. The protein, called gluten, will become animal
feed. The starch is dried and will become various food products and
building materials, but the majority of the starch will usually be converted
into corn sweeteners, including HFCS.

HFCS is cheap and plentiful because of oil, artificial fertilizer and

government economic policy.

Corn is a subsidized crop. The U.S. government used to pay farmers not to
grow corn when there was too much of it on the market, but an
unexpected shortfall in the 1970s leading to higher meat prices and a lot
of angry voters, convinced Washington to change its policy. Instead of
paying farmers not to grow corn, the government would now encourage
them to grow as much as they could--with a guarantee that the
government would make good any financial loss they might occur if prices
fell because of a weak market.

Corn needs nitrogen, phosphorus, potassium and other minerals in order

to grow. In modern agriculture these chemicals are supplied by artificial
fertilizer, which is made in a high-energy process requiring fossil fuels--

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primarily natural gas. When the price of natural gas goes up--as it usually
does in line with the price of gasoline--so does the cost of fertilizer. On
May 2, 2006 CBS news reported that the price of fertilizer has increased
48% in the past three years. But for most of the years that HFCS has been
made oil and natural gas have been relatively inexpensive commodities in
the United States. We've been able to produce an enormous amount of
HFCS at very little cost.

Nutrition labels tell us how much sugar there is in a food, but they don't
tell us what kinds of sugar. We know that since the 1980s carbonated soft
drink manufacturers have used high fructose corn syrup (HFCS) almost
exclusively, rather than more expensive sweeteners like sucrose, but that
could change if the cost of producing HFCS becomes too high. Beyond the
label, food manufacturers seem to prefer the "and/or" method of listing
sweetening ingredients. A product's sugar content might be HFCS
"and/or" sucrose or another sweetener. The result is that it's difficult to
say with absolute certainty how much fructose we're getting when we eat
a food containing "sugar." But if there is any significance to the relative
amounts of glucose, galactose, fructose and other monosaccharides in our
diet then we really need to know.

HFCS may or may not be sweeter than sucrose.

Some research has shown that HFCS-42 (42% fructose, 53% glucose, 5%
other) is up to 1.16 times sweeter than sucrose (50% fructose, 50%
glucose). HFCS-55 (55% fructose, 42% glucose, 3% other) might be up to
1.28 times sweeter. Fructose by itself is about 1.7 times sweeter than
sucrose. Glucose is only 74% as sweet, and galactose--the simple sugar
found in milk and other dairy products--weighs in at 33% the sweetness of
sucrose. So the number of calories contained in the "total sugars" of a
food doesn't tell us precisely how sweet that food will be.

You might be wondering how HFCS-42, which contains only 42% fructose,
could be sweeter than sucrose, which contains 50% fructose. This is
because the fructose and glucose in sucrose are chemically "bound"
(sucrose is a disaccharide) while they are unconnected or "free" in HFCS.
Our taste buds seem to know the difference. You should also know that
the corn industry disputes much of the research and claims that HFCS-55
is equivalent to sucrose and HFCS-42 is less sweet. Other sources claim
that HFCS-42 is equivalent to sucrose and HFCS-55 slightly sweeter. Don't
expect the confusion to disappear anytime soon.

Actually, the story is a bit more complicated. Experts talk about "taste
profile" rather than simply "sweetness" or any other single taste
characteristic. The creation of foods and beverages with appealing taste
profiles is an art. The flavorist's palette of sweetness includes fructose,

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maltose, dextrose, HFCS 45 and 55, sucrose, and the increasing number of
artificial sweeteners. For example, the aftertaste of an artificial sweetener
like sucralose or aspartame can be reduced by adding fructose from
processed fruit juice concentrates. According to an officer with American
Fruit Processors (AFP) "you can add 10 to 20 calories and get a good taste
profile and low-carb designation. The benefit of fructose is there is no
immediate effect on blood sugar, as it takes time to be converted to
glucose in the body." Again, when a product's list of ingredients says
"natural and artificial sweeteners" we really don't know which of the more
than 20 available sweeteners are being used.

Fructose is the sugar of ripe fruit and honey, foods that were available
from the very beginning of human history. Studies indicate that our love
of sweet foods is "hard-wired" into our brains. Our ancestors couldn't pass
up a fruit tree or bee hive without gorging themselves. They didn't feel
guilty because they really didn't have to worry about gaining weight. As
roaming hunter-gatherers they were expending energy continuously, and it
wasn't every day that they came across a fruit tree or bee hive. From an
evolutionary perspective it made sense that we humans should crave
fructose and that our bodies break it down in a unique way. Fructose is
very sweet, but it doesn't trigger the hormonal response of insulin and
leptin which signal satiety. Fructose metabolism also tends to produce
triacylglycerols, which can end up being stored as fat. Everything seems
designed to keep us consuming fructose for as long as possible and to
pack its energy away for future use.

Fructose consumption has increased since 1970 while sucrose

consumption has decreased. Free fructose has dramatically
increased.

Total fructose consumption has increased approximately 30% between

1970 and 2000. "Total fructose" includes free, "unbound" fructose in fruit
juice or high-fructose corn syrup (HFCS) and the "bound" fructose in the
disaccharide sucrose (table sugar). Most of this increase in attributable to
HFCS consumption, which increased greater than 100 fold during the same
period. The more expensive sucrose decreased by about 50%. Today we
consume about equal amounts of sucrose and HFCS. Since fructose is
"free" in HFCS and chemically "bound" in sucrose, free fructose in our diet
has skyrocketed. We also know that fructose from fruit juice is being used
more and more to smooth out the taste profile of foods flavored with
artificial sweeteners like aspartame.

Much of what has been written about fructose is controversial. The

sweetener business is huge and self-protective. It is also increasingly
fragmented: there are corn interests, cane sugar interests, artificial
sweetener interests, and even oil and energy interests. The rapid rise of

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high-fructose corn syrup (HFCS) would not have been possible without
fertilizers made with natural gas. The U.S. government has also played an
important role by encouraging farmers to produce as much corn as
possible and making good their losses in a falling markets. The net,
provable result of all these factors is that the amount of fructose we
consume has increased by 30% over the past thirty-five years. It's
doubtful that, until recently, anyone bothered to ask what effects this
might have on public health. And by the time anyone did bother to ask,
private interests had hardened.

It would be wonderful if we lived in a world where smart, unbiased

professionals could analyze health issues, reach conclusions, and affect
public policy without undue pressure from the private sector. That world
will probably never exist. No one seriously argues that we don't have a
problem with overweight and obesity. But we don't seem to have a means
to attack the problem collectively. Instead, we must all fend for ourselves.
So, in the absence of definitive, uncontested data about fructose, here are
some modest recommendations:

Be careful of all foods with added sugars. If they are heavy in free fructose
(and you might not be able to tell from reading the nutritional label and
packaging) they might compromise your body's natural mechanism for
telling you that you've had enough to eat. Also, fructose metabolism may
produce triacylglycerols that become stored as fa

Don't be afraid of eating fruit just because it contains fructose. You'd have
to eat three small apples to get the same amount of fructose in a soft
drink, but the total sugar in the soft drink would be almost four times as
much--and without the fiber and vitamins.

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