This article first appeared in the St. Louis Beacon, May 12, 2011 - Standing outside the Brentwood Whole Foods on a pleasant afternoon, Angie Warfield doesn't pull punches when it comes to how she feels about sweeteners.
"I think sugar is the devil," said the 37-year-old Kirkwood resident. "When it comes to kids, they just get addicted to it. I do, too. If it's out of my diet, I notice a difference."
She said her family avoids soda and tries to steer clear of sugars as much as possible. When she does consume them, she prefers unrefined varieties to table sugar or foods with high-fructose corn syrup.
She said having a child made her more conscious of her family's eating habits.
"The fewer chemicals, the better," she said. "The less manufacturing, the better."
Warfield isn't sure though. "Maybe I'm buying the hype," she adds. "I admit that, too."
Separating hype from fact is difficult for many people when it comes to high-fructose corn syrup. A longtime additive for everything from breads to soft drinks, the substance is derived from maize. It's been a popular substitute for common table sugar for years because of its lower cost and powerful sweetening abilities.
But lately this low-profile ingredient has come under increasing fire by a growing chorus of voices who claim it is less healthful than the traditional white stuff it replaced. Websites have sprung up in opposition to its inclusion in processed foods. Some national brands have pulled it from their products altogether. Hunt's Ketchup dropped the substance, and Pepsi introduced a "throwback" version of their soda using plain sugar instead of corn syrup. Some stores, like Trader Joe's, make sure it's kept out of their store-labeled brands. Meanwhile, a Facebook page advocating the outright prohibition of the substance has nearly 200,000 fans.
Opponents argue that high fructose corn syrup contributes to the nation's obesity epidemic. A Princeton University study found rats gained more fat on HFCS than with sugar.
The corn refiners have launched a pushback in response. On their website, the additive is defended as being little different than table sugar, also called sucrose. Both HFCS and sucrose are a blend of fruit sugar, known as fructose, and the simple sugar glucose. The corn refiners challenge the Princeton study, citing other studies, including research published in the American Journal of Clinical Nutrition, which found that HFCS is no more obesity-promoting than sucrose. That research found few differences in how the two sweeteners are metabolized.
"Because they are nearly compositionally equivalent, the human body cannot tell the difference between high fructose corn syrup and sugar," said the website.
Corn refiners are advocating a name change for their product. "Corn sugar" would be a less confusing and more accurate term, they say.
"High fructose corn syrup is simply a kind of corn sugar. It has the same number of calories as sugar and is handled similarly by the body," according to the HFCS industry website.
The Science of Sweet
The industry has found qualified support in unlikely places. Marion Nestle, the Paulette Goddard professor in the department of nutrition, food studies and public health at New York University, is author of the prominent Food Politics blog. A sometime critic of the food industry, she has pointed out that some of the extra attention the additive has received is largely unwarranted.
"Again, I'm not a fan of HFCS; we would all be healthier if we ate less sugar," she wrote last month, "but from a biochemical standpoint, HFCS and table sugar are pretty much the same. They have similar amounts of glucose and fructose, are digested as quickly and are metabolized the same way."
She writes that it's important to reduce the total amount of sugar in the average American diet, whether from HFCS or sucrose.
Sugar, in any form, contains little nutritional value. It replaces other more nutritious food in everyday diets. Recent studies suggest a link between obesity and increased sugar consumption. But there's no consensus on the "right" amount of sugar in the diet.
On this point many dieticians sound a similar note.
"There is insufficient evidence right now to say that high fructose corn syrup is less healthy than other types of added sweeteners," said Lanette Tanaka, a registered nurse and assistant teaching professor at the University of Missouri-St. Louis. "If you eat too much sugar of any type, that's not a good thing."
She said "inconclusive research" has yielded "mixed results."
Andrea Giancoli, a registered dietician and spokesman for the American Dietetic Association, agrees.
"The overall scientific conclusion is that the general public is consuming too much added sugar in general," she said, "whether it's coming from actual table sugar, high fructose corn syrup, agave honey, no matter what it may be. It's more important to decrease our added sugar intake than it is to be teasing out whether high fructose corn syrup is worse for us than sugar."
She said that ratios of different sugars in high fructose corn syrup and table sugar are similar. She said most soft drinks are made with HFCS that is about 55 percent fructose with glucose making up the rest.
"It's very close to a 50-50 ratio (of fructose and glucose) and that's what sugar is," she said.
In that sense, she believes the label high-fructose corn syrup is something of a misnomer. HFCS can have varying amounts of fructose, as little as 42 percent. That's actually less than table sugar.
However, she notes one recent study, published in the journal Obesity, which alleged that fructose amounts in soft drinks were sometimes higher than standard figures given for HFCS.
She also said some evidence shows higher rates of gas, bloating and diarrhea linked to too much fructose consumption.
"In scientific studies, when people consume drinks that are just sweetened with fructose versus glucose, they have more malabsorption," she said.
Giancoli said that can lead to more fatty deposits in arteries and higher cholesterol. Still, despite its name, HFCS is not pure fructose so the relevance of such findings is unclear.
Giancoli worries the debate may be making a side issue of the real problem. She notes that many who have turned away from HFCS have begun using substitutes like agave, which also contains fructose.
"It's a misguided message that allows people to believe that consuming sugar is OK," she said.
Less is better
The American Medical Association also recommends less sugar generally. The organization's official position on HFCS encourages more research on the matter but says that "at the present time, insufficient evidence exists to specifically restrict use of high fructose corn syrup (HFCS) or other fructose-containing sweeteners in the food supply or to require the use of warning labels."
Lu Ann Swehla, clinical nutrition manager at St. Mary's Health Center, said she neither favors nor opposes HFCS, though she does believe, in general, foods with fewer additives and less processed content are better.
A dietitian for more than a decade and a half, she said she really hasn't seen much uptick in concern over HFCS when she speaks with others.
"You get a handful of patients in a certain period of time (who) ask questions or say that they try to avoid foods that contain it. But I haven't seen an increase in the number of people (who) are concerned," she said.
In that sense, Warfield's views during her shopping trip dovetail with those expressed by the experts. It's a simple enough equation for her.
"Sugar is sugar," she said. "I think if you cut it out, you're better off across the board."
David Baugher is a freelance writer in St. Louis.