New study released on High Fructose Corn Syrup and Diabetes

Public release date: 27-Nov-2012
Contact: Leslie Ridgeway lridgewa@usc.edu
323-442-2823

University of Southern California - Health Sciences USC, Oxford researchers find high fructose corn syrup-global prevalence of diabetes link International analysis finds that countries using high fructose corn syrup in their food supply have a 20 percent higher prevalence of type 2 diabetes

LOS ANGELES AND OXFORD, U.K.— A new study by University of Southern California (USC) and University of Oxford researchers indicates that large amounts of high fructose corn syrup (HFCS) found in national food supplies across the world may be one explanation for the rising global epidemic of type 2 diabetes and resulting higher health care costs.

The study reports that countries that use HFCS in their food supply had a 20 percent higher prevalence of diabetes than countries that did not use HFCS. The analysis also revealed that HFCS's association with the "significantly increased prevalence of diabetes" occurred independent of total sugar intake and obesity levels.

The article, "High Fructose Corn Syrup and Diabetes Prevalence: A Global Perspective," is published in the journal Global Public Health.

"HFCS appears to pose a serious public health problem on a global scale," said principal study author Michael I. Goran, professor of preventive medicine, director of the Childhood Obesity Research Center and co-director of the Diabetes and Obesity Research Institute at the Keck School of Medicine at USC. "The study adds to a growing body of scientific literature that indicates HFCS consumption may result in negative health consequences distinct from and more deleterious than natural sugar."

The paper reports that out of 42 countries studied, the United States has the highest per capita consumption of HFCS at a rate of 25 kilograms, or 55 pounds, per year. The second highest is Hungary, with an annual rate of 16 kilograms, or 46 pounds, per capita. Canada, Slovakia, Bulgaria, Belgium, Argentina, Korea, Japan and Mexico are also relatively high HFCS consumers. Germany, Poland, Greece, Portugal, Egypt, Finland and Serbia are among the lowest HFCS consumers.

Countries with per capita consumption of less than 0.5 kilogram per year include Australia, China, Denmark, France, India, Ireland, Italy, Sweden, the United Kingdom, and Uruguay. Countries with higher use of HFCS had an average prevalence of type 2 diabetes of 8 percent compared to 6.7 percent in countries not using HFCS.

"This research suggests that HFCS can increase the risk of type 2 diabetes, which is one of the most common causes of death in the world today," said study co-author Professor Stanley Ulijaszek, director of the Institute of Social and Cultural Anthropology at the University of Oxford.

The article proposes that this link is probably driven by higher amounts of fructose in foods and beverages made with HFCS. Fructose and glucose are both found in ordinary sugar (sucrose) in equal amounts, but HFCS has a greater proportion of fructose. The higher fructose content makes HFCS sweeter and provides processed foods with greater stability and better appearance because of the more consistent browning color when foods made with higher fructose are baked.

In a previous related study, the authors found that the fructose content in some U.S.-produced soft drinks, especially the most popular, was about 20 percent higher than expected, suggesting that some manufacturers might be using HFCS with more fructose than previously estimated. Such differences could "potentially be driving up fructose consumption in countries that use HFCS," the researchers said. The study notes the difficulty in determining the actual amount of fructose in foods and beverages made with HFCS because of "a lack of industry disclosure on food labels."

Growing evidence reveals that the body metabolizes fructose differently from glucose. Among other things, fructose metabolism occurs independently of insulin, primarily in the liver where it may be readily converted to fat, which likely contributes to non-alcoholic fatty liver disease, a condition on the rise in Hispanics in the U.S. and Mexico.

"Most populations have an almost insatiable appetite for sweet foods, but regrettably our metabolism has not evolved sufficiently to be able to process the fructose from high fructose corn syrup in the quantities that some people are consuming it," said Ulijaszek. "Although this syrup can be found in many of our processed foods and drinks, this varies enormously from country to country."

The U.S. is the single largest consumer of high fructose corn syrup. By the late 1990s HFCS made up 40 percent of all caloric sweeteners and was the predominant sweetener in soft drinks sold in the U.S. However, since 2008, exports of HFCS from the U.S. to Mexico increased "exponentially" after trade restrictions were removed, the researchers said. They call for updated public health strategies requiring better labeling of fructose and HFCS content in processed foods.

To explain the varying degrees of HFCS consumption in the European Union, the researchers note that trade and agricultural policies set quotas for HFCS production, and while some countries, such as Sweden and the U.K., do not take their assigned quotas, other countries, such as Hungary and Slovakia, are able to purchase extra quotas from countries that do not accept them. The findings of the paper thus have important implications for global trade policies that may affect public health.

"If HFCS is a risk factor for diabetes—one of the world's most serious chronic diseases—then we need to rewrite national dietary guidelines and review agriculture trade polices," said Tim Lobstein, director of policy for the International Association for the Study of Obesity. "HFCS will join trans fats and salt as ingredients to avoid, and foods should carry warning labels."

Article cited: Goran, M., Ulijaszek, S. and Ventura, E. (2012). High fructose corn syrup and diabetes prevalence: A global perspective. Global Public Health. Published online Nov. 27, 2012.

Background Information: Sources of data in the ecological analysis include the Global Burden of Metabolic Risk Factors Collaborating Group (BMI), International Diabetes Federation Diabetes Atlas (prevalence) and the FAOSTAT, a statistical

Pumpkin Mushroom Risotto

I threw this recipe together on Orphan Thanksgiving - note to self - you have to remember how much rice expands, I'll be eating risotto for weeks (don't worry I froze the leftovers so I won't expire from food poisoning!!) I have cut the amount I made in half which is a much more manageable amount especially if it will be the main item.

3 cups Arborio Rice
3 cups mushroom stock
3 cups vegetable stock
water (as needed)
8oz crimini mushrooms, sliced
2 cloves garlic, chopped
1 cup chopped sweet onion
2 tablespoons olive oil
1 teaspoon fresh thyme
salt and pepper
1 pint pumpkin puree (unseasoned/unspiced - I had frozen fresh pumpkin puree from some pumpkins I had picked up at the local farm, but you can also get this at the store in a can - you could also substitute butternut squash if you can't find pumpkin)
1/2 pint marscapone cheese (1 cup)

1. Heat the olive oil in a 4-quart stock pot over medium low heat. Add garlic, onions and cook 5 minutes to let them start to get soft, then add mushrooms and cook until mushrooms have lost most of their moisture, about 10 minutes. In a separate pot, heat the broth to simmer.
2. Add pumpkin to the mushrooms and stir for about a minute, then add rice and stir for another minute. Season with pepper (do the salt at the end as the broth might make the dish very salty). Add warm stock by the 1/2 cupful to rice, making sure to stir mixture until broth is completely mixed. You will need add another cup of broth about every 2 minutes until rice has fully bloomed (or is fully soft - no bite to it, this might take 40-50 minutes) so keep your eye and attention on the pot - being sure to scrape the bottom as you are stiring. If you run out of broth start to use warm water but the 1/2 cupful.
3. Once the rice is fully cooked, stir in fresh thyme and marscapone cheese and mix until fully combined, you probably won't need more salt, but if you feel you do, add it now.

Enjoy!

My peeps in the News

Our miracle kid - featured on the news last week!

Adrian Price

White Fish Veracruz-ish Style

You could make this dish with any white fish that you like. I used haddock but if you find barramundi, pollack, cod, sea bass, snapper or tilapia it would work just as well!

4-4oz fillets
2 limes
2 T olive oil
1 medium onion (sweet works best or vidalia), chopped
4 garlic cloves
1-14oz can chopped tomatoes (remember to get a can without added sugars!), drained
1/2 cup green olives, pitted and sliced
1 T capers (optional - I don't really care for capers so I don't use them)
3 jalapenos, (also optional), diced
3 sprigs fresh thyme, leaves removed from stem
3 sprigs fresh oregano, leaves removed from stem
1 cup fresh baby spinach
salt and pepper

1. Preheat oven to 350 degrees.
2. Place fish fillets in a baking dish, drizzle with olive oil and squeeze the juice of the limes over the top, sprinkle with some salt and pepper. Cover dish with foil and place in oven to bake for 7-10 minutes (timing will depend on thickness of fish: if you have fillets that are thin like flounder you may want to cook for only 5 minutes, it they are about 3/4 - 1" thick you want to cook 10-13 minutes)
3. Heat a saute pan on the stove top with a drizzle of olive oil (about 1 teaspoon) over medium heat. Add onion and garlic and let cook until soft about 6-7 minutes.
4. When onion and garlic are soft and fragrant, add tomato, olives, capers and jalapenos (if using) and spinach. Stir to combine and let cook until spinach is starts to wilt. Remove from heat.
5. Remove fish from oven after 10 minutes. Uncover (careful the steam will quickly want to escape and can burn!). Spoon all of the tomato mixture over fish fillets. Sprinkle thyme and oregano over top. Put fish back into oven to cook 3-5 minutes (this depends on how thick your fish is and how close to being cooked it was when you removed from oven).

Enjoy!

Weight of the Nation

For anyone who didn't get to see the HBO special: Weight of the Nation - here is the link, courtesy of Miriam & Lifespan.

Weight of the Nation

It runs about 50 minutes. ENJOY!

Bariatric Surgery Tops the Cleveland Clinic List of Medical Innovations

The Cleveland Clinic (OH) released its yearly list of the top 10 medical innovations for improving patient care. Bariatric Surgery topped the list, not because its new, but because its results have shown that it should be used sooner in the treatment of obesity and not as a last result for comorbidity resolution. Also, for the first time legislation actually made the top 10 cut!

To read more:

Cleveland Clinic News Release