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.