Fructose is a monosaccharide (simple sugar), which the body can use for

energy. Because it does not cause blood sugar rise tremendously (has a
low glycemic index), it was once thought that fructose was a good
substitute for sucrose (table sugar). However, the American Diabetes
Association and nutritional experts have changed their minds about this.

Is fructose bad for me?

A small amount of fructose, such as the amount found in most vegetables

and fruits, is not a bad thing. In fact, there is evidence that a little bit may
help your body process glucose properly. However, consuming too much
fructose at once seems to overwhelm the body's capacity to process it. The
diets of our ancestors contained only very small amounts of fructose.
These days, estimates are that about 10% of the modern diet comes from
fructose.

What happens if I consume too much fructose?

Most of the carbohydrates we eat are made up of chains of glucose. When

glucose enters the bloodstream, the body releases insulin to help regulate
it. Fructose, on the other hand, is processed in the liver. To greatly simplify
the situation: When too much fructose enters the liver, the liver can't
process it all fast enough for the body to use as sugar. Instead, it starts
making fats from the fructose and sending them off into the bloodstream as
triglycerides.

Why is this bad?

This is potentially bad for at least three reasons:

 High blood triglycerides are a risk factor for heart disease.

 Fructose ends up circumventing the normal appetite signaling system, so
appetite-regulating hormones aren't triggered--and you're left feeling
unsatisfied. This is probably at least part of the reason why excess
fructose consumption is associated with weight gain.
 There is growing evidence that excess fructose consumption may
facilitate insulin resistance, and eventually type 2 diabetes. However,
some of this effect may be from chemicals in soda which reacts with the
high fructose corn syrup.
What are the major sources of fructose?

The consumption of fructose (corn syrup) has risen considerably in the

general population within recent years. In 1980 the average person ate 39
pounds of fructose and 84 pounds of sucrose. In 1994 the average person
ate 66 pounds of sucrose and 83 pounds of fructose. This 149 pounds is
approximately 19% of the average person's diet.

This increase is due to several factors. There was a decreased use of cane
and beet sugar (sucrose) in processed foods and a wide spread use of
corn syrup due to economics. Corn is much cheaper and twice as sweet as
table sugar. It is absorbed only 40% as quickly as glucose and causes only
a modest rise in blood sugar.

A few years ago the medical community revealed that there was good
news for diabetics. Many people had previously known that table sugar
(sucrose) was not a healthy food for diabetics because it raised their blood
sugar levels above normal.

Since diabetics have a hard time maintaining healthy blood sugar levels,
doctors counseled diabetics not to eat sugar. The new revelation was that
diabetics could eat fructose because fructose did not raise their blood
sugar level extremely high. So far so good, but there is more.

Many doctors were recommending fructose instead of glucose. Today

fructose is not only being used by some diabetics but it is used for a variety
of foods, drinks and confectionery around the world. It is used for candies
for diabetics, desserts for weight watchers, drinks for the sportsman and
jelly for the health conscious.

The medical community recommended it because of a low increase in

glucose in the blood. The scientists did not look at other factors in the body
when a person eats sugar. Let's look at some of these factors now.

Fructose has no enzymes, vitamins, and minerals and robs the body of its
micronutrient treasures in order to assimilate itself for physiological use.
Fructose browns food more readily (Maillard reaction) than with glucose.
This may seem like a good idea, but it is not.

The Maillard reaction, a browning reaction, happens with any sugar. With
fructose it happens seven times faster with than glucose, results in a
decrease in protein quality and a toxicity of protein in the body.

This is due to the loss of amino acid residues and decreased protein
digestibility. Maillard products can inhibit the uptake and metabolism of free
amino acids and other nutrients such as zinc and some advanced Maillard
products have mutagenic and/or carcinogenic properties. The Maillard
reactions between proteins and fructose, glucose, and other sugars may
play a role in aging and in some clinical complications of diabetes.

Research showed that in subjects that had healthy glucose tolerance and
those that had unhealthy glucose tolerance, fructose caused a general
increase in both the total serum cholesterol and in the low density
lipoproteins (LDL) in most of the subjects. This puts a person at risk for
heart disease.

Another study showed that the very low density lipoproteins (VLDL)
increased without an apparent change in high density lipoproteins (HDL).
The VLDL and the LDL should be as low as possible and the HDL should
be as high as possible.

There is a significant increase in the concentration of uric acid that is

dependent on the amount of fructose digested. After glucose no significant
change occurs. An increase in uric acid can be an indicator of heart
disease.

Fructose ingestion in humans results in increases in blood lactic acid,

especially in patients with preexisting acidotic conditions such as diabetes,
postoperative stress, or uremia. The significance to human health is that
extreme elevations cause metabolic acidosis and can result in death.

Fructose is absorbed primarily in the jejunum and metabolized in the liver.

Fructose is converted to fatty acids by the liver at a greater rate than is
glucose. When consumed in excess of dietary glucose, the liver cannot
convert all of the excess of fructose in the system and it may be
malabsorbed. What escapes conversion and being absorbed into the cells
may be thrown out in the urine. Diarrhea can be a consequence.
Fructose interacts with oral contraceptives and elevates insulin levels in
women on "the pill."

Fructose reduced the affinity of insulin for its receptor. This is the first step
for glucose to enter a cell and be metabolized. As a result, the body needs
to pump out more insulin, to handle the same amount of glucose.

Fructose consistently produced higher kidney calcium concentrations than

did glucose in a study with rats. Fructose generally induced greater urinary
concentrations of phosphorus and magnesium and lowered urinary pH
compared with glucose.
The balance of minerals in the body is very important for the function of
vitamins, enzymes and other body function. When the minerals are out of
the right relationship, the body chemistry suffers. The presence of diarrhea
might be the cause of decreased absorption of minerals.

Fructose-fed subjects lose minerals. They had higher fecal excretions of

iron and magnesium than did subjects fed sucrose. Apparent iron,
magnesium, calcium, and zinc balances tended to be more negative during
the fructose feeding period as compared to balances during the sucrose
feeding period.

A study of 25 patients with functional bowel disease showed that

pronounced gastrointestinal distress may be provoked by malabsorption of
small amounts of fructose.

Many times fructose and sorbitol are substituted for glucose in parenteral
nutrition (intervenious feeding, IV). This can have severe consequences
with people with hereditary fructose intolerance, a congenital disorder
affecting one in 21,000. A European doctor declared: "Fructose and sorbitol
containing infusion fluids have no further place in our hospital pharmacies."

There is significant evidence that high sucrose diets may alter intracellular
metabolism, which in turn facilitates accelerated aging through oxidative
damage. Scientists found that the rats given fructose had more undesirable
cross?linking changes in the collagen of their skin than in the other groups.

These changes are also thought to be markers for aging. The scientists say
that it is the fructose molecule in the sucrose, not the glucose, which plays
the larger problem.

Fructose is not metabolized the same as other sugars. Instead of being

converted to glucose which the body uses, it is removed by the liver.
Because it is metabolized by the liver, fructose does not cause the
pancreas to release insulin the way it normally does. Fructose converts to
fat more than any other sugar. This may be one of the reasons Americans
continue to get fatter.

Fructose raises serum triglycerides significantly. As a left-handed sugar,

fructose digestion is very low. For complete internal conversion of fructose
into glucose and acetates, it must rob ATP energy stores from the liver. ,

Fructose inhibits copper metabolism. A deficiency in copper leads to bone

fragility, anemia, defects of the connective tissue, arteries, and bone,
infertility, heart arrhythmias, high cholesterol levels, heart attacks, and an
inability to control blood sugar levels.
It seems that the magnitude of the deleterious effects varies depending on
such factors as age, sex, baseline glucose, insulin, and triglyceride
concentrations, the presence of insulin resistance, and the amount of
dietary fructose consumed.

Some people are more sensitive to fructose. They include hypertensive,

hyperinsulinemic, hypertriglyceridemic, non?insulin dependent diabetic
people, people with functional bowel disease and postmenopausal women.

There is a continuing increase in sugar consumption in the United States.

We now eat 153 pounds of sugar per person per year.

This increase is mostly in the form of fructose. From the research

presented, it seems that this increase is going to have a negative influence
on our health.

Nancy Appleton, Ph.D. is a clinical nutritionist, researcher, lecturer, and

author of Lick the Sugar, Healthy Bones, Heal Yourself With Natural Foods
and the Curse Of Louis Pasteur and her new book Lick the Sugar Habit
Sugar Counter. Her website is www.NancyAppleton.com.
You know how important it is to control the sugar and carbohydrates in your
diet. So you read food labels and listen to your body cues to make sure
you’re getting what you need to stay healthy.

But what happens when a manufacturer disguises sugar as something you

don’t recognize?

Unfortunately, this is not uncommon. In fact, one of the more popular

aliases for sugar today is high fructose corn syrup (HFCS)—a corn-based
sweetener that has been on the market since approximately 1970.

According to a commentary in the April 2004 issue of the American Journal

of Clinical Nutrition, between 1970 and 1990, the consumption of HFCS
increased over 1,000 percent.

“HFCS now represents more than 40 percent of caloric sweeteners added

to foods and beverages and is the sole caloric sweetener in soft drinks in
the United States,” write George A. Bray, Samara Joy Nielsen and Barry M.
Popkin, the authors of the commentary.

HFCS—It’s Here to Stay

Today, food companies use HFCS—a mixture of fructose and glucose—

because it’s inexpensive, easy to transport and keeps foods moist. And
because HFCS is so sweet, it’s cost effective for companies to use small
quantities of HCFS in place of other more expensive sweeteners or
flavorings.

For these reasons and others, HFCS isn’t going away any time soon.

That is why, to best manage diabetes, you need to know what HFCS is and
how to identify it in products.

Understanding Glucose and Fructose

Since HFCS is a blend of glucose and fructose, it’s important to understand
the role each plays in your body. All sugars, indeed all carbohydrates, have
four calories per gram.

But that is just part of the story.

Glucose (dextrose) is a monosaccharide (basically, a simple sugar), which

is the form of sugar that is transported in the blood and is used by the body
for energy. This is what you measure when testing your blood glucose or
blood “sugar.”

Fructose is also a monosaccharide and is often referred to as “fruit sugar,”

because it is the primary carbohydrate in most fruits. It’s also the primary
sugar in honey and half the carbohydrate in sucrose (table sugar).
However, fructose does not stimulate insulin secretion or require insulin to
be transported into cells, as do other carbohydrates.

What It Means to You and Your Diabetes

As a person with diabetes, you know how important it is to control your

blood glucose and insulin levels to avoid complications. So, it would seem
that a lack of glucose and insulin secretion from fructose consumption
would be a good thing.

However, insulin also controls another hormone, leptin, so its release is

necessary.

Leptin tells your body to stop eating when it’s full by signaling the brain to
stop sending hunger signals. Since fructose doesn’t stimulate glucose
levels and insulin release, there’s no increase in leptin levels or feeling of
satiety. This can leave you ripe for unhealthy weight gain.

The Fate of Fructose in the Body

Fructose requires a different metabolic pathway than other carbohydrates

because it basically skips glycolysis (normal carbohydrate metabolism).
Because of this, fructose is an unregulated source of “acetyl CoA,” or the
starting material for fatty acid synthesis. This, coupled with unstimulated
leptin levels, is like opening the flood gates of fat deposition.

Should Fructose Be Eliminated From the Diet?

It’s not that you should eliminate fructose from your diet, but you should be
aware of how much you’re consuming. After all, fructose is the primary
sugar found in fruits, which provide valuable nutrients. In this case, a little
fructose is fine. It becomes a problem only when someone consumes high
levels of fructose or HFCS, which is now present in virtually all commercial
foods (see below).

Check the Food Labels

While there is no way of knowing exactly how much HFCS is in a given

product, you can read the food labels to gauge sugar levels. So, for
example, if HFCS is one of the first ingredients listed (in soft drinks or
syrup, for example), it is safe to assume there’s a lot in the product. If
HFCS is in the products you buy, make sure it is either low on the
ingredient list or that the products list very few total grams of sugar (which
is how HFCS is shown on ingredient labels).

What Does It All Mean?

If HFCS is one of the first ingredients listed on a food label, don’t eat it.
Make a mental list of the worst culprits, such as regular soft drinks and
many highly sweetened breakfast cereals. HFCS alone won’t make you fat,
but when HFCS is high on the ingredient list, the food is not the best
choice. As part of a lifestyle that has many of us eating too much and
moving too little, we’re putting our health at risk if we don’t choose our
foods carefully.

So what’s the answer? It’s easy. Avoid HFCS by reading food labels and
shopping the grocery store’s perimeter: Produce is on one side, seafood,
meat and poultry on another, and dairy products, eggs and bread on the
third. Avoid the center aisles, which are mostly stocked with highly
processed foods.

The more you stick to fresh whole foods and avoid commercial and highly
processed foods, the less HFCS you will consume.

Common Foods High in HFCS

 Regular soft drinks

  Fruit juice and fruit drinks that are not 100 percent juice
 Pancake syrups
 Popsicles
 Fruit-flavored yogurts
 Frozen yogurts
 Ketchup and BBQ sauces
 Jarred and canned pasta sauces
 Canned soups
 Canned fruits (if not in its own juice)
 Breakfast cereals
 Highly sweetened breakfast cereals

Problems Caused by Too Much HFCS

 It can lead to higher caloric intake

 It can lead to an increase in bodyweight
 It fools your body into thinking it’s hungry
 It increases the amount of processed foods you eat, thereby
decreasing your intake of nutrient-dense foods
 It may increase insulin resistance and triglycerides

Data Is Scarce . . . But Telling

Although data on humans is scarce, it does exist.

According to a study published in the October 2002 issue of the American

Journal of Clinical Nutrition, people who consumed 28 percent of their total
calories from sucrose (half the carbohydrate in sucrose is fructose) as
opposed to artificial sweetener had a higher caloric intake, body weight, fat
mass and blood pressure after 10 weeks.

This is no mystery since higher caloric intake leads to greater weight gain.
In the sucrose group, there was an increase of a little more than 400
calories, which would result in an approximate weight gain of almost seven
pounds during the 10-week study if all other factors were constant.
However, there was only about half that weight gain in this group.
Therefore, the authors estimate that 48 percent of the excess energy intake
from sucrose was used for other energy-demanding body processes, such
as lipogenesis (the creation of fat).

To make matters worse, fructose consumption is tied to insulin resistance

in rodents and increased triglyceride secretion (suggesting that it may have
the same effect on humans, too). Considering that type 2 is a common co-
morbidity of overweight and obesity, insulin resistance is common.
Therefore, if fructose does, in fact, have the same insulin-resistant effect in
humans as it does in rodents, individuals would be exacerbating the issue
by consuming too much of it