Thought Leadership in Action

First introduced to the food and beverage industry in the 1970s, high-fructose corn syrup (HFCS) is a liquid sweetener that’s used as an alternative to common table sugar in hundreds of mass-produced foods and beverages in the United States.

The corn-based sweetener is commonly included in numerous brands of sodas and juices, as well as many candies and mass-produced snack foods. But HFCS is also frequently an ingredient in boxed foods, breads, condiments and salad dressings — many of which are not marketed as sweet foods.

Concerns about the health impact of the sweetener have been around for nearly two decades, peaking in 2004 when a landmark study prompted many scientists and medical professionals to link America’s obesity epidemic to high intake of HFCS.

U.S. consumption of HFCS began to decline steadily around that time, falling to 41.4 pounds per capita annually by 2016, down about a third from the peak rate in 2002. Recognizing that trend, food and beverage companies have increasingly found success marketing their products as not containing HFCS, but within the medical science community, there is far from a consensus over whether the liquid sweetener is any worse for your health than ordinary table sugar.

“It's been a highly debatable topic in the nutrition field for quite some time,” says Jenn Fillenworth, a registered dietitian and chef from Grand Rapids, Michigan, who generally encourages people to avoid HFCS in their diet.

Here’s a closer look at the ongoing research and debate over the health impacts of HFCS.

Health Concerns

HFCS is derived from corn starch. When corn starch is broken down into individual glucose molecules, the end product is corn syrup, which is essentially 100 percent glucose. To create HFCS, enzymes are added to corn syrup to convert a portion of the glucose to a different simple sugar called fructose. Different formulations of HFCS contain different amounts of fructose, but the U.S. Food and Drug Administration says most are either 42 percent or 55 percent fructose.

U.S. food manufacturers have turned to HFCS to sweeten products in part because government subsidies have made it cheaper than table sugar. It’s also highly stable and does not mask the flavors of most products. As the consumption of HFCS has risen, so has the amount of medical research involving the sweetener. Fillenworth says research in recent years has linked the consumption of HFCS with type 2 diabetes and nonalcoholic fatty liver disease since HFCS is metabolized in the liver. However, she says it’s not entirely clear whether those impacts differ from the consumption of ordinary sugar.

“Overall, foods with added sugar have become widely consumed and more popular than ever so it is difficult to determine from a research standpoint if HFCS is causing the increase in these diseases or if it's just increased table sugar in general,” Fillenworth says. “I think given that the product is highly processed and there are many unknowns from a disease standpoint, I recommend people stick to regular sugar, but of course using it sparingly.”

The Big Picture

Sangeeta Pradhan, a registered dietitian and certified diabetes educator based in Framingham, Massachusetts, says consumers should look at HFCS as they would any other sweetener, including sucrose (common table sugar), because they are structurally and metabolically similar. She says many concerns over HFCS are often overblown and should be viewed with a skeptical scientific eye.

“It’s important to step back and look at the big picture,” she says. “We have a tendency to idolize or demonize isolated nutrients such as HFCS, when in reality it’s dietary patterns that count, not isolated nutrients.”

Pradhan points to research that indicates that it wasn’t just the increase of high-fructose corn syrup consumption between the 1970s and 1990s that caused obesity to spike, but rather the rise in all nutrients, including all sugars, that may have contributed to the issue. She also notes that data shows Americans have become increasingly sedentary over the past several decades.

“There have been some folks who have been linking high-fructose corn syrup as the cause for the obesity epidemic,” she says. “That is not true, because it’s multi-factorial.” She notes that while consumption of HFCS has dropped somewhat in the past decade, the obesity epidemic has not declined in equal measure.

Still, that doesn’t mean that consumers should ignore the amount of HFCS they allow in their diet. Pradhan says there is evidence the sweetener, like other sugars can cause increased triglycerides, a form of fat in the blood that can negatively affect heart health, as well as insulin resistance and nonalcoholic fatty liver disease.

“Evidence from human subject research does show that consumption of high-fructose corn syrup is associated with obesity and metabolic disorders, but the studies found consistently very little evidence that it differs uniquely from sucrose and other nutritive sweeteners in metabolic effects,” she says. “All added sugars in the diet will have the same effect.”

Pradhan encourages consumers to follow the American Heart Association’s recommendation for limiting added sugars to no more than half of your daily allowance of discretionary calories. For most American women, that’s no more than 100 calories per day, or about 6 teaspoons of sugar. For men, it’s 150 calories per day, or about 9 teaspoons. The AHA recommendations focus on all added sugars, without singling out any particular varieties such as high-fructose corn syrup.