In my mailbox today (click to enlarge)
In my mailbox today (click to enlarge)

If you don’t think high-fructose corn syrup is taking an economic hit, read on.
I went to the mailbox today and retrieved a package from the Corn Refiners Association (CRA), the lobbying group for high-fructose corn syrup (HFCS).  It was addressed to me in the same style that all my medical junk mail comes in, so I assume the above group bought a mailing list of primary care physicians from the American Medical Association, which sells such lists.  I tore open the large envelope and looked at the contents, which are all pictured above.  Having done a number of mailings in my lifetime, I’ve got a pretty good handle on what such a mailing costs.  I would reckon that in the volume they purchased, these pieces probably set them back at least a couple of bucks apiece.  Add the postage and the list rental and your probably looking at a couple of million dollars, if not more, to send this thing out to all the primary care docs in the country.
Inside this packet was a load of propaganda about the virtues of HFCS.  And buried in one of the pages was the following statement that was the dead give away as to why this advertising surge:

Consumption of high fructose corn syrup has been dropping in recent years…

Which lets us know why the CRA has also made a couple of TV commercials that have played around the country and are being sent around virally as well.  In case you haven’t seen them, these are presented below.
The main thrust of the ad package sent to me and these video commercials is that HFCS isn’t really any different than sugar.  And, as long as it’s used in moderation, it’s no more harmful than sugar.  Which, of course, is faint praise at best.  But is it true?
Here, for what it’s worth, is my take on the HFCS issue.
There are basically three versions of HFCS: one containing 42% fructose, another containing 55% fructose and one containing 90% fructose.  The most commonly used by far is the second, the one with 55% fructose.  Since sucrose (table sugar) is 50% fructose and 50% glucose, there really isn’t much difference, and most of the studies seem to bear that out.
There is one distinction between sucrose and HFCS, but in the studies I’ve seen, it doesn’t seem to make a big difference.  Sucrose is a disaccharide.  In other words, it is a molecule made of a molecule of fructose hooked to a molecule of glucose.  HFCS is a mix of monosaccharides (single sugar molecules): it has free fructose and free glucose.  You would think that the fructose would absorb better as a monosaccharide since it doesn’t have to be cleaved away from a glucose molecule first.  But, as I say, the majority of studies don’t seem to show any difference between the two in terms of blood sugar levels or metabolic effects.
There are a couple of things that I think are pernicious about HFCS.  First, it is a vastly superior food additive as compared to sucrose above and beyond its sweetening power.  It doesn’t crystallize, it mixes better, it provides more moisture, etc.  And, in this country at least (thanks to subsidies for corn and price supports for sucrose), it is much cheaper to use.  Consequently, HFCS finds its way into many products that contained no sweeteners before the advent of HCFS.  So, since it’s development, we are eating more sweeteners overall because HFCS is in so many things.  Second, the extra grams of fructose (as compared to glucose) don’t really matter all that much in people who don’t eat a lot of sweeteners, but it starts to add up as the sweet content of the diet goes up.
The last statistics I saw showed that the sweetener content of the average American diet was about 22 percent of calories.   If you consider that the average caloric intake is about 2500 kcal, then you can figure that represents roughly 140 grams of sugar per day, which calculates to 70 grams of fructose and 70 grams of glucose if all the sweetener is sucrose or table sugar (which is what it was pre HFCS).  Now, with about 70 percent of the sweetener coming from HFCS, these figures change.  Now the the 55/45 fructose/glucose ratio of HFCS comes into play, and the fructose goes from 70 grams to 75 grams per day – an extra 5 gm.  Does this matter?  Who knows?  But probably not.  However, since I eat no sweeteners throughout the day, someone else has to eat double to keep the averages the same.  And doubling all these figures gives an extra 10 grams of fructose per day.  And if you figure overall sweetener intake has gone up since the advent of HFCS (which it has), then the heavy sweetener users are probably eating an extra 20-30 grams of fructose per day as compared to what they would have eaten 30 years ago.  I suspect an extra 20-30 grams does make a difference.
If kids sit around MacDonald’s and slurp down a couple of Hugos, they could be getting an extra 10 or so grams of fructose right there, which is more than is found in a Paleo kind of diet in a day.  And that’s just the extra fructose as compared to the Hugo being made with sugar instead of HFCS.  It doesn’t count the 102 grams or so of fructose that would be the same if the drink were made with sugar.
Is it any wonder obesity is skyrocketing among teenagers?  As I’ve written in this blog often, I spent a lot of time at MacDonald’s during my teenage years from when I was a Junior in high school on.  But each drink I bought – there was only one size then, and it was tiny compared to the giant drinks of today – cost me an amount that was much higher in today’s dollars than it costs for one of the huge sodas available now.  And I got only one for that amount.  I couldn’t go back for refills.  Unlimited refills are a consequence of the substantially lower price of HFCS as compared to sugar.  Had I had access to unlimited refills, I wouldn’t have done any different than the kids today – I would have drunk one after another.  But I was limited by my pocketbook.
Just to add a little comedy relief to this dreary story of the advertising jihad of the Corn Refiners Association, here is a YouTube parody of the HFCS commercials.


  1. This just exemplifies how we have subordinated the interests of health to business. I’m almost ashamed to be human.

  2. I had never seen any of these spots, but my son just came in here to see what was going on and he said he’s seen them many times.
    Your post, Dr. Eades, is fascinating as usual. But I have one question. The thrust of your argument appears to me to accept the ads’ assumption that table sugar is fine in moderation. As I understand the most significant component of your argument, the problem with HCFS is the 5% surplus of fructose.
    Aren’t you conceding too much? So what if it’s no worse than table sugar. Table sugar itself is not good, even “in moderation.” I would support lobbyists who argue for replacing trans-fats with lard. Should I support lobbyists who argue for replacing HCFS with good-old, natural, table sugar?
    I hope I didn’t leave everyone with this impression. I believe the consumption of sugar is bad whether sucrose or HFCS. I was simply saying that there is a little more of a problem with HFCS as opposed to regular sugar from the additional fructose, but both are terrible and should be consumed as little as possible.
    If we replaced all HFCS with table sugar, the problem would certainly lessen if for no other reason than that table sugar is so much more expensive than HFCS. The cost would probably be too prohibitive to allow unlimited refills on soft drinks at fast food places, which would markedly decrease the amount of fructose consumed as table sugar. So, such a strategy would be good.
    But, as to the question as to which is worse healthwise on a spoonful by spoonful basis, they are both about the same.

  3. Erik, we will be ok as human species. the day will come, dont worry. This is still the greatest nation and country of free. people united will never be defeated! So the more people lead the way, the faster we will have more healthy choices on the shelves! its called free market! But for now, unfortunately there are lot more people to be educated about low carb before things start changing and tide goes in our direction, but it will, no doubt, the truth always has a way to be known somehow. its up to us to keep spreading the word and lead by example!

  4. Erik,
    There are so many things wrong with your comment that I’ll address just one issue because the rest would involve a whole philosophical intervention.
    In your comment you say that there is a conflict between business and health but there is no such conflict when you speak of rational people making rational decisions. Business is the trade of value for value; in my case it’s the value of the insights of Dr. Eades in his books and blog for the value of my dollar. This is where health and business exist harmoniously… no conflict exists here. No matter how much money the corn industry throws at you, will you choose to consume HFCS? I wouldn’t and it sounds like you wouldn’t either. Remember, business is the trade of value for value; how you choose values, and therefore which to trade, is the product of your philosophy. The real villain is not “business” it’s the underlying philosophies that politicians and some businessmen hold. Just don’t forget that here are good businessmen out there, you read one of their blogs. 😉

  5. As usual, I’m the comic relief when there’s any type of profound or philosophical discussion so my only comment is, thank you for providing me with a new factoid. I had to google (my favorite exercise) to discover what a Hugo is. I’ve never eaten fast food and I do remember a pathetic car called the Yugo, but now I know that a Hugo is a 42-ounce drink.
    More than five cups of soda! Perhaps my ignorance explains my mouthful of teeth at 75.
    AAAARRRRGGGGHHHHH!!!!!! I intended to put up a link so that people could go to an article about Hugos in the New York Times, but in my haste to get the post up to get to a meeting, I forgot. It’s all fixed now. Thanks for reminding me.

  6. Dr Eades, your math doesn’t show the actual difference in quantity.
    HFCS doesn’t contain just 5% more fructose than sucrose does i.e. 50% versus 55%. Instead, it contains 22% more fructose. 55% fructose means 45% glucose. The proportion of fructose-to-glucose goes up 22%.
    Consider the fact that fructose doesn’t affect insulin as glucose does. Nor does fructose affect hunger as glucose does. Then we can see how a 22% increase in proportional consumption of fructose can cause an even greater absolute consumption of fructose. Which then leads to even worse problems than sugar itself. Non-fatty liver disease comes to mind.
    Just like sugar the consumption of HFCS drives itself but even more so than sugar.
    If you compare 100 gm of HFCS to 100 gm of sucrose, you get 55 gm of fructose in the former and 50 gm of fructose in the latter, which is 5 gm more fructose in the former. As far as I’m concerned, percentages are irrelevant. Your body doesn’t metabolize percentages, it metabolizes grams of different types of sugars. And in the case of 100 gm of HFCS, it metabolizes an extra 5 gm of fructose.

  7. I think these politico-ag lobby groups are fearing they will have their subsidies cut and are trying to do damage control. But, if government didn’t have the power to wave around money and hand out favors to certain groups, these companies would have to make their case directly to the consumer–and as Dr. Eades points out, their case is rather flimsy.
    This holiday, enjoy your carbs “in moderation” and gorge on fat and protein to excess! Happy Thanksgiving!
    With the makers of HFCS, I’m not sure it’s subsidies they’re worried about. I think that the fall off in consumer purchasing is what’s got them scared. And they’re not really subsidized directly, it’s more of an indirect subsidy. The government maintains price supports on sucrose (thanks to the influence of Big Sugar) keeping the price of table sugar high, which drives food manufacturers to use HFCS (which has no price supports) instead. But if consumers – who are now big time label readers – refuse to buy products containing HFCS, then the makers of these products may either drop the HFCS or switch back to sugar despite its higher cost.
    Here is an earlier post on the cost differential between sugar and HFCS with an interesting interview.

  8. I’m a staunch capitalist. I agree with Erik here. Business is no excuse for poor ethics. Although I’d change the “we” to “they,” and keep it specific to the Corn Syrup lobby for now. Buyer beware is a necessity brought about by the fact that not all sellers can be trusted.

  9. Dr. Eades, have a great Thanksgiving.
    How low carb will it be?
    Not totally low-carb, but pretty low-carb as compared to a traditional Thanksgiving dinner. MD says she is going to post on the whole dinner menu.

  10. Should have expanded my question. Do you have special low carb dishes you will have instead of the usual dressing, etc.? Or does MD make regular stuff this time of year?
    Watch for her post. I don’t know exactly. My job is to eat, not to plan the menu.

  11. I agree that the 5% difference in fructose content of HFCS vs sucrose is probably not significant. I think many people think that the “high fructose” means there’s a lot more fructose than in sucrose, but it refers to the fact that regular corn syrup is 100% glucose.
    One factor you didn’t mention is that fructose is sweeter than sucrose. So because the fructose in HFCS is free, I wonder if they’d use 5% less HFCS than they’d use sucrose, which would even things about.
    However, I agree that the real problem is that the food industry is adding sweeteners to everything they produce, and the low cost of HFCS contributes to this trend. When one doesn’t eat sweet foods, one tastes those things. I can’t stand cold cuts anymore; they’re too sweet. Raw almonds taste sweet. The precooked chickens you can buy at the supermarket taste too sweet. Ham tastes too sweet.
    And finally, I read somewhere that HFCS has some deleterious effects that sucrose doesn’t. Unfortunately, I can’t remember where that paper is, but I think it had to do with oxidation. Glyoxal? Maybe this is it:
    And then, just to complicate things, some people say that the sucrose in sodas is hydrolyzed into its components glucose and fructose: “when a soft drink is sweetened with sucrose, over time the acid in the soft drink will actually hydrolyze sucrose into its glucose and fructose components. In fact, according to Marov and Dowling (1990), at typical storage times and temperatures, more than 90% of the sucrose in soft drinks can be hydrolyzed. Therefore, even if a soft drink is sweetened with sucrose, unbound sucrose and fructose will start to appear immediately and be available to participate in carbonyl forming reactions.”
    The HFCS people aren’t the only ones trying to put a spin on things. I’ve seen ads for “healthy, all-natural” Agave syrup, saying “Contains no HFCS.” True. It’s more than 90% fructose!
    Yep, all true.
    The soft drink study you linked to (here is the actual paper) looked at the contents of methylgloxal in carbonated beverages purchased at various grocery stores. As they put it in the conclusion of the paper:

    In this study, the levels of reactive carbonyl compounds in commercial carbonated soft drinks were found to be astonishingly high. Taking methylglyoxal as an example, the range observed was 23.5–139.5 μg/100 mL which is significantly higher than the reported level of methylglyoxal, 16–21 μg/100 mL in diabetic patients.

    It looks pretty bad for HFCS, but the problem with the study is that the researchers compared soft drinks containing HFCS to diet soft drinks. I suspect that if they had compared soft drinks made with HFCS to those made with sucrose (Coke made in Mexico, for example), they would have found pretty much the same levels of methylglyoxal in both. However, that is sheer speculation on my part. But, since I am a betting man, I would wager on it.

  12. i would like to understand how one concludes the sweetener content of the diet to be so high? Does it include fruit, Does it include substitutes such as Stevia? Anyway, 140 grams, if viewed as being just sugar would be equivalent to 35 teaspoons added to one’s food. If looked at that way no one in their right mind would allow that level of sweetener to enter their diet.
    Wonderful that no sweetener part of your daily diet. What about the protein powder you use; it contains no sweetener? What is the brand?
    No, it doesn’t include sugars from fruits or vegetables. The 140 grams is from caloric sweeteners of all kinds: fructose, glucose, sucrose, corn syrup, HFCS, etc. It doesn’t include artificial sweeteners because those contain no calories (or an insignificant number of calories). In the good old days – pre about 1975 – all the sweetener would be pretty much from one source: table sugar. But now it comes from the numerous choices listed above. Often manufacturers use a number of different sweeteners so that the amount of each one won’t get that ingredient to the top of the list of ingredients on the label and scare consumers away. Again, back in the old days, sugar would have been listed as the first ingredient (and no one would have cared then), whereas now it may be flour listed first with a whole laundry list of sweeteners (including sometimes concentrated fruit juice) listed below.
    We use MRM Whey Protein for our shakes. This product contains no caloric sweeteners. It is sweetened with a little stevia.

  13. Another aspect to consider about fructose, whether it is crystallized fructose or HFCS (fructose is fructose once is inside the body) is that it doesn’t need insulin to get into cells and it provides with ‘raw material’ for fat synthesis. No, no from the fructose molecule itself but from the intermediates that can be used in fat synthesis. So, fructose or food sweetened with fructose may seem a good choice because it doesn’t make our insulin spike… in insulin’s job was just to take care of blood glucose levels, but it’s not. If instead of just fructose, we have a mixture of glucose and fructose as it comes in HFCS, then we’re just getting a double-whammy.
    It just takes a quick search on the scientific literature to find out that one good way to make rats obese is to give them a fructose-based diet. Sure, rats are not humans, but there are also studies that have shown that humans do get other problems as a result of increasing fructose consumption, including hypovitaminosis, hypertension and, as noted, probably obesity. I’m pretty sure that doesn’t show anywhere in that junk mail…
    All true. Fructose is nasty stuff no matter how you look at it.

  14. I suspect I know what your response to this article will be. I thought you might want to know if you don’t already.
    World Health Organization decides the gold standard of scientific evidence is superfluous
    Yes, I knew about it. Scary stuff. I wonder how come no one was willing to rely on this kind of information when thousands of people were going around extolling the virtues of the low-carb diet as they had experienced them. Then the cry was: It’s all anecdotal. Where are the studies? Show us the studies.
    Now that they’ve had the studies rammed down their throats, the standard of scientific acceptability changes. Now a simple observational study that isn’t worth the paper it’s written on can be used to establish causality. Bad, bad stuff.

  15. I saw an Oprah show last night which featured Dr Oz and another guy on various regions where they have most Centerians per given population. Contry like Peru, Georgia, Okinava Island of the Japan made the list. So outside known longivity variables, like meditation, purpose of living, close knitted family and social support, clean air and naturally grown food supply, Dr Oz went on to say that food like beans, tofu and tofu derivitives, such as tofurkey and turkey dogs, prolong life. Oprah refused to taste tofu made caserole, it was funny. Dr Oz insisted she tried a spoonful and she eventually di, but the face said it all. Then Dr Oz went on a ling praise of low fat, relatively vegetarian diet to prevent heart disease. I llike Dr Oz, he seems to be a nice guy on ta surface, but just because he is a thoracic surgeon doesnt make him an expert on longevity, and making generalized conclusions is wrong too. For example I used to be a polar bear, still am at times. I love to go out in the mountains with bunch of other Russian buddies for a New Year, by the way it is the Biggest russian Holiday and we stay there for at least 3 days. We dig few bottles of vodka in the snow, and enjoy Russian banya and semi naked swimming in a local private lake in the Catskill Mountains. There is nothing better then celebrating New Year with your friends at the Mountains. I love to go to Banya ( Russian version of steam room ) where they use fresh oak leafs and beat a crap out of you under 120 degrre and then you get a message to die for all in the sauna. You feel refreshed and reborn. Soon after I and my friends jump into an almost frozen lake for a few seconds. Let me tell you, the energy I feel after that is beyongd words. Even Russian girls jump into action as well. So one New Year I invited my good buddy, who is Italina, per his nagging, long request! He wanted to share the experience of those crazy russian beasts. I warned him that it takes years of experience and body training to do what we do, not guts. But he wanted to be a man in front of his lady and jumped in on the action. Next day, fever, congestion and cauph. He was lucky not to get pneumonia. And he was lucky he drank enouph vodka to keep him warm and relaxed overnihgt. My point is whats fun for russian is a death sentence for german. Just becausue people in japan eat a lot of rice, tofu and miso doesnt mean I need to in order to get the same results. I for one cant stand pineapple, very allergic to it. Becuase the only time I saw pineapple in russia was in a book. So I dont get how doctors can draw a conclusion tha beans and miso diet is excellent for everyone, despite your original place of birth! Dr Eades do you eat miso, it is not very carb loaded, actually quite low carb? Dio you think miso is a healthy food for the rest of us or should we basically try to stick to the diet where we originate form. A lot of scientis beleive that indigenous food is better for us rather then adapting. Or you are a believer that if a food is healthy, unless one allergic, is healthy for everyone and should be broadly recommended? Thanks
    Don’t ever worry that I will beg to go with you on one of your New Year jaunts to the hills and lakes in the Catskills. I’ll be comfortable ensconced cheering on my favorite teams (which are those I’ve decided to bet on) in the various bowl games. No one will beat me savagely with Oak leaves while roasting in a sauna, nor will I leap into a freezing lake. If most of my teams win, however, I, too, will feel refreshed and reborn. And my energy levels will be beyond words.

  16. Those HFCS ads remind me of a funny email that I received a few weeks ago and here is how it went. Sure HFCS comes from corn but that in and of itself is meaningless…
    HEADLINE: New Wonder Supplement Hits the Shelves
    100% fat free! 100% carb free!
    No calories! Revs up metabolism!
    All-natural and organic!
    What is the supplement???

  17. It is probably the wrong lesson to take from this, but the awfulness of fructose makes me feel better about the artificial sweeteners I (probably) eat too much of. I don’t seem to be one of the people who have bad reactions to them.
    I don’t think I’m alone in not knowing what “moderate” sweetener intake would be, either.

  18. Dr Eades your thoughts on this mirror mine exactly. HFCS (the ubiquitous 55% version) is probably very similar metabolically as sucrose is, the problem is that HFCS is used so much more than sugar ever was for all of those reasons you mentioned. Back when sugar was the primary sweetener people were not eating sugar as if it were a food group! It was simply too expensive, and our way of living was very different then (a mother to cook meals of real food, rather than kids going to mcd’s and getting hugos, whatever the heck that is).
    Yep. I honestly don’t know how they can live with themselves, deep down they must have a suspicion this stuff has a major role in obesity and disease – if for no other reason than they proliferate it in every food now.

  19. Trends in Global Sugar Consumption – has some interesting information
    The most significant driver of the consumption of all forms of sugar is economic status. Consumption is low in underdeveloped countries and high in developed countries. India is forecast to become the world leader in per capita sugar consumption. An ominous sign of the benefits of economic development.
    Back in the late 1990s I spent quite a bit of time in the Italian countryside. One of the first things I noticed was that I did not see kids walking around with Slurpees or giant soft drinks. In fact the sight of a kid with any kind of soft drink in their hand was rare. Guess why. A tiny 4 ounce can of Coke cost about $2.00 Canadian. I also did not see any fast food restaurants. But when I got to Venice or Rome the scene like most big cities – sugar everywhere.
    Thanks for the link. You are right about Europeans and soft drinks. The first time we took our kids to Europe was in 1992. At that time a soft drink in Europe ran from $2.00 – $5.00 American when the same soft drinks were selling in the US for $1.99 a six pack.

  20. As a diabetic HFCS, maple syrup, beet/cane sugar, honey etc does not make that much difference – meter says, DON’T. I was more of a bread (my baking)/pasta/rice/potato guy before diagnosis, and unfortunately meter says don’t for all of these too, as well as fruit – and I have a really neat orchard. Oddly as you would know, I can eat a handfull of berries with not much damage to the blood sugars – they are all in the garden too.
    Anyway today I am going to come up with a faux stuffing using cauliflower and a few slices of sprouted grain bread. I’ll report later.
    You are correct about all those ‘natural’ sweeteners. They all raise blood sugar. Everyone should have a glucometer and check themselves after eating something that seems so healthy, a great big apple, for example. it would probably open some eyes. It is great that berries don’t have much effect. Thank God.
    I’ll wait to hear about the stuffing.

  21. Lol, I wont ask you to go to Catskills and go throught that experience. My point exactly, whats good for the goose is not always good for the other one, geeses is it? Or in my and your case, Dr Eades, whats good for a crazy savage Russian living in NYC is not necessarily fun or healthy for a laid back guy in sunny California! Thats why I disagree with Dr Oz to his borad, sweep generalization that miso and beans will make everyone live to 140. But it is quite an experience to get beat up with that fresh oak leaf bunch under hot, swealtering heat! It really does make you want to concur the world, at least for 5 minutes. It makes you a raging beast with so much energy to spare, plus I believe it is good for the skin, may be russina skin, lol, I dont know. But if you are ever in the mood, you shoul at least consider it!
    I am in the mood. I thought about it. The answer is still No.

  22. Cool, HFCS is a “Perfectly Natural!” substance invented thirty-some years ago and manufactured in labs. And there is an amount which won’t harm you, we think. Well, sign me up!
    Disagree with the first poster, though. It’s not up to a gigantic industry to look for reasons to put itself out of business. The current “interests of health” to produce cheaper and more enjoyable low-fat food are being well-served.
    We have to change the “interests of health”.

  23. Dr Eades may be I should ask Dr Feinman to go on one of those trips. I am sure he wont mind! I too feel ensconced, oh God, that word twisted my fingers just writing it, forget about pronouncing it, to be sitting home on New Years eve and watch sport, but my buddies will drag me along on a trip every year. And honesly it is quite fun. They go hunting, I dont. Hate killing anything. I once owned a cat and he used to kill little mices,. it was such a dramatic experience that I never owned another cat. But I do have a German shephard, the most intelligent dog I have ever owned. I will not be able to stop typing if i start talking about my dog. So I am not that wild ans it sounds like, my friends are. I do enjoy skiing on Catskill montains, drinking wine, while sitting outside watching snow go by the fire place. All my friends call me fake Russina, because I dont drink wine and love romance a lot. Hey, whats better then nice bottle of wine, fire roasting meat under the stars with bunch of nice guy, girls talking, playing guitar and having fun?
    Asking Dr. Feinman is a wonderful idea. I’m sure he would be delighted. He doesn’t strike me as the football betting type, so he will probably be free over New Years. Make sure to tell him I suggested that you ask him.

  24. Dr Eades, based on the observations by Vilhjalmur Stefansson, the quantity of protein can remain fixed yet become toxic if the quantity of the accompanying fat (or carbs) is changed. With this in mind, it’s plausible that even though we keep a quantity of fructose fixed we could change its effect merely by changing the quantity of the accompanying glucose.
    If I remember correctly, you mentioned in an earlier post about AGEs that fructose was a much more potent glycating agent than glucose. It follows that in this instance, keeping a constant total quantity of glucose/fructose while changing the proportions will give us inconsistent results. Results more in line with the protein/fat/carbs phenomenon I outlined above. The inconsistency would be caused by the greater potency of fructose as a glycating agent. Yet this is not the only place where fructose and glucose act differently but affect each other.
    In the case of non-alcoholic fatty liver disease, fructose causes an accumulation of triglycerides in the liver while insulin tries to transport and store these triglycerides into fat cells. As we increase fructose and reduce glucose, there is a simultaneous increase in accumulation and decrease in transport and storage. All of this occurs while the total combined quantity of glucose/fructose remains fixed. The result is non-alcoholic fatty liver disease.
    The point is that fructose and glucose work in tandem if not in conjunction and when one is increased while the other is decreased there is a mutual and proportional amplification of their respective behaviors. This is how the 5 extra grams of fructose in HFCS55 is actually an increase of 22%.
    I agree with you pretty much. But the data I’ve seen show that a little fructose, i.e., a few grams per day (the amount we might find in a Paleo type of diet), helps the body better deal with glucose. I’ve never seen anything that indicates that in large amounts the ratio of fructose to glucose matters. High levels of fructose are bad, whether they accompany glucose or not. At least based on everything I’ve read, and I’ll be the first to tell you that I haven’t read everything. If you’ve got a paper on the ratio of the two being important at high levels in terms of amplifying the effects of one another, I would love to see it.

  25. A number of people have asked me what our Thanksgiving dinner is going to be. MD posted on the dinner she is preparing and included recipes. You can find her post here.

  26. “It’s all-natural and comes from corn!” Well, thank goodness they straightened us out on that. I say we load up on all-natural ricin and arsenic, too! Yummy!

  27. Katya
    I am assuming that we absolutely agree on the issue of diet. But I definitely disagree with the fundamentalist ideology of the “Free Market”. The evidence supporting this ideology should be equated to the quality of evidence supporting the “Lipid Hypothesis”.

  28. I thought you and your readers might find these calculations interesting.
    I calculated (assuming the USDA database can be taken as correct) the following for my homemade apple pie, which I plan to make tomorrow. It is somewhat surprising. For each piece,
    71 grams carbs with crust, with sugar
    55 grams carbs with crust, with Splenda instead of sugar
    45 grams carbs without crust, with sugar
    30 grams carbs without crust, with Splenda instead of sugar
    The recipe calls for over a cup of sugar. I usually only use 3/4 of a cup and the values above are for 3/4 cup of sugar because more than that just makes it unappetizingly sweet. Clearly, the majority of the carbs come just from the apples and the crust and not the added sugar. Wow.
    I still plan on doing relatively low carb tomorrow. I don’t think I can keep it below 50 grams but I hope to keep it below 100 because I don’t want to gain back all the weight I lost in the past two weeks! So if I have any of my apple pie, I’ll make it a very small piece and just not eat the crust.
    I look forward to MD’s post on your Thanksgiving menu!
    MD’s post is up. Click here.

  29. Lol. Despite Dr Feinman being an introvert kind of guy, I think getting your body toasted in a hot sauna while getting beat up with a bunch of oak leafs throughout the whole body might bring the beast out of most humble amongst us! By the way, thank you for mentioning football , Dr Eades! I just came to realization that since I amd all my buddies have so much energy after hot sauna and freezing lake dive after that, we might play full tackle football on the snow. That I cant imagine Dr Feinman doing, even though I consider myself a very imaginative and creative fellow. Imagine half naked guy in a winter playing full contact football in the snow. If we do, and I am sure it is totally possible , I will take some pictures. I will tell Dr Feinman you thought it was a good idea for him to try. I will spare him a frozen lake and football part. We will just introduce the basics, hot sauna and leafs beating, lol, I think it is enouph for a beginner!
    I’m sure he’ll love it.

  30. Dr Eades, I have been craving to ask you a question about impulsive eating. I know that it takes ghrelin to signal the brain about 20 to 30 minutes before we are satisfied with food eaten. That is under normal circumstances and applies to normal, and wise people. But what about people, like me? I dont mean abnormal,may be, but in a good way. I mean hyper, emotional and yes at times acting impulsively. At times I eat for the sake of eating my way out of pain or pleasure for that way. it would be a long, and pointless discusssion into the history of binge eating and its causes. I am more intrested in ways to really control it, outside of taping my mouth untill impulse is gone or tie my hands. Once while working in Italian restaurasnt and being on adiet, which in itlsef, wasnt very easy I did something that worked. I would suck on ascorbic acid until my tongue bled. Russian pharmacies on Brighton Beach sell those vit c ascorbic acid in a form of tablets that you can suck on. They taste like semi sweet sour candy. I guess may be for those kids that wouldnt take them otherwse. So I would suck on lots of them and it irritated my tongue mucosa to a point where it was painful to eat for a while. it did work. I wouldnt want to eat and got plenty of vitamin C in the process. But I dont think it was the most effective way to deal with my emotions. Ok, there is another way I knwo which worked for a while, anf that is eating while being naked in front of the mirror. it did work too, but its hard to do it in public, lol! Lately I have been stressed out, juggling two jobs, pre holiday shopping and other things. Traffic in NYC in Holiday alone would make anyone insane and I drive Honda Element with stick. Ok, I did overeat and I know it shows,. I am sorry for writing so much. Dont mean to drift away from the question. So being as experienced as you are in dealing with obese patients, what is the best way not to give in to impulsive eating? Are there any except just conscious eating and self control? Thanks!
    Perhaps you should try some magnesium at bedtime. That often helps with cravings and compulsive eating. Try 300-400 mg at bedtime.

  31. Hi Dr. Eades,
    I really like your blog – I finally added you to my bloglines so I can keep more up-to-date with your posts! I heard you speak a couple years ago at Boulderfest.
    I teach corporate wellness classes around the country. One thing I do in my classes is have people look at actual labels. People are shocked to see there is double and even triple the amount of sugar and HFCS in some juices and yogurt “smoothie” drinks compared to a can of regular soda. Teaching people to actually read the ingredient paragraph and not be pulled in by package marketing is eye opening. Of course, I recommend cooking at home and not eating out of box or package but the reality is my audiences are on the go business people. I think information is power so I try and offer them lots of resources and alternatives to make eating as healthy as possible.
    When I can get my audience to actually read a label and avoid HFCS, trans-fats and artificial sweeteners I feel like they are ahead of the curve. I also find they love this information regarding labels and how sneaky food marketing/politics can be. I find the general public is hungry for this info they just don’t know where to find it!
    I wrote about artificial sweeteners this week in my blog, I run across so many people who drink diet soda because they think it is “healthier.” Ugh, I’m just not a fan of the pink and blue packets! I then followed up with a post about more natural sweeteners (stevia, etc). I stress low sugar as much as possible. I agree with you that the “natural sugars” raise blood sugar/insulin just like the table sugar and HFCS but I’d rather have people using honey, blackstrap molasses, stevia when they want something sweet.
    So many factors to consider regarding this issue from actual physiology, to daily convenience and taste, people’s beliefs, their emotions and food politics/agenda. Thanks for the work you do!
    Thanks for writing. I, too, would prefer people eat stevia than artificial sweeteners, but I don’t know if I would go as far as saying I would rather them eat honey or agave nectar instead of artificial sweeteners. Honey is an invert sugar, which means that it has the same makeup as table sugar but the glucose and fructose aren’t hooked together. Granted, honey contains some healthful substances above and beyond what would be found in an equivalent amount of table sugar, but the metabolic havoc the honey would wreak on one who has metabolic syndrome or diabetes or even just overweight is the same as would be caused by the sugar. And the tiny bit of good stuff in the honey (as compared to that in the sugar) is way overshadowed by the negative metabolic effects. Would I prefer honey to an equivalent amount of sugar? Probably. Would I prefer it to a tiny bit of sucralose with the same sweetening power? Probably not. And as for the agave nectar, it tastes really good and sweetens well, but it’s almost all fructose. Might as well use the 90% HFCS version. I would definitely prefer the sucralose to the agave nectare. But, that’s just me. Others may feel quit differently about it.

  32. In the “Jesus Wept” category: MSN listed the “unhealthiest holiday foods” and how to avoid them. Care to guess what makes a dish “unhealthy” … ? Of course — too much fat! Mashed potatoes are bad if you use whole milk and butter, but okay if you make them with skim milk (yuk!) You wouldn’t want any fat in there to slow down that big blood sugar rush.
    Eat your turkey, but peel away all that fatty skin first. Egg nog? Geez, there’s so much fat in the stuff, you may as well drink a cheeseburger, according the nutritional experts at MSN. Instead, try some pumpkin spice and vanilla in a glass of fat-free milk (double yuk!)
    Yes indeed, nothing puts people in the holiday spirit like a tall, cheery glass of fat-free milk.
    And of course, the article mentions “artery-clogging” saturated fat several times.
    So many idiots, so little time to deal with them. This is doubtless one of the stupider pieces like this I’ve ever seen. It will make my turkey skin taste all that much better tomorrow.
    You’ve inspired me. I may actually set up a ‘Jesus Wept’ category on this blog for just such things as this.

  33. Dr. Eades-
    I can tell Vadim how to control compulsive eating (by the way, I’m Ukrainian and I spent my formative years at the “shvitz”). As I remarked several days ago, I finally did give in and ate huge globe grapes so I’m out of ketosis. And the hunger pangs are debilitating.
    Even for me, with ADHD, lifelong eating disorder, hypersensitivity, a bit of OCD thrown in, you name it, I can still feel totally in control of my eating by eating practically zero carbs. I can play with my hunger and go ten hours or more without a feeling of emptiness. And it’s such a wonderful state to be in, I will NEVER again leave ketosis.
    So, for the next few days, it’ll be zero carb until I’m back burning the proper fuel. There is no food on earth (or in heaven) that feels better than being in ketosis.
    I hope the rains aren’t threatening your home after the fires.
    Thanks for asking. No, the rains aren’t threatening our home. In fact, it’s a beautiful clear day today.
    Happy Thanksgiving.

  34. Dr. Eades,
    Sorry to be off topic, but I just wanted to say THANK YOU.
    This Thanks giving day I want to let you know how grateful I am for your blog
    and all you share.
    That’s all 😉
    Best wishes to you and your loved ones!
    Thanks for the good wishes, Marc. The same back to you and yours.
    Happy Thanksgiving.

  35. Dr. Eades,
    Sorry to be off topic, but I just wanted to say THANK YOU.
    This Thanks giving day I want to let you know how grateful I am for your blog
    and all you share.
    That’s all 😉
    Best wishes to you and your loved ones!
    Thanks for the good wishes, Marc. The same back to you and yours.
    Happy Thanksgiving.

  36. I’ve read that one of the reasons HFCS is used in soooo many products in the US is because it increases the shelf-life of foods. That means it acts as some kind of preservative. That’s kind of scary to me. Would regular sugar have done this or is it something unique to corn syrup?
    And of course, that extra sweet taste in products that would not normally be sweet has a tendency for making us want to eat more of them than we normally would.
    Add the above to being cheap to use and HFCS is definitely an all-around boon for the food industry.
    Incidentally, on the trusting in the free market comment—in order for the free market theory to function it means there is free access to knowledge for all parties. That is certainly not the case between manufacturers and consumers. It is not a level playing field. Their livelihood depends upon the ignorance of the consumer, and they take full advantage of it. Any threat to their livelihood and they haul out the marketing and lobbying machine.
    PS I tried to click on the parody video, and it said it was no longer available…are “evil” forces at work here or just technical difficulties?
    Yes, HFCS does increase the shelf life of foods. So does sugar. I don’t know if there is a difference in the two in terms of shelf life.
    I just clicked on the parody video, and it works fine. Maybe it was just down for some reason when you tried it.

  37. Alicia makes a good point about the problem of free access to knowledge. One thing to add is the collusion (deliberate or not) of the government in providing horrendous dietary advice.

  38. Dr. Eades,
    I was hoping to get your thoughts on this protein powder here;
    It’s pure whey, I’ve tried it and I prefer it over the powders that are artificially sweetened. I don’t like the taste of artificial sweeteners.
    Also, now that this powder has been brought to your attention, would you consider switching over to it? Why, why not? Is there anything particularly better about the MRM protein that you have suggested above?
    The protein product in your link is a good one. But it is also an expensive one. There are a several methods of processing whey, with the two most commonly found in protein powders being whey isolate and whey concentrate. Of the two, the whey isolate is vastly more expensive. But I don’t think necessarily worth the extra money. The whey is a good source for good quality protein, i.e., all the essential amino acids. The whey concentrate provides these amino acids at substantially less expense than the whey isolate.
    Cold processing supposedly ensures that the specific peptides in the whey aren’t denatured (altered in structure) so that the immune-enhancing effects aren’t reduced. Problem is that whey itself is a byproduct of cheese making, which is done at high temperatures, so the proteins in the whey have already gone through a denaturing process. So, from that perspective, the cold processing is sort of like closing the barn door after the horse is already out.
    The MRM protein uses no artificial sweeteners – it is sweetened with a little stevia. And it costs $23 per container. The same size protein powder in the link you provide costs $45. It is a little better product overall, but not, in my opinion, worth the almost doubling in price.

  39. Report on cauliflower stuffing:
    Make this in accordance with your own traditional:
    saute 1 lb of sausage
    add one chopped onion and equal volume of chopped celery
    I add a fairly large amount of poultry seasoning
    add one chopped head of cauliflower
    add one can of decent chicken broth
    Cook until cauliflower has lost its cabbage like taste, DO NOT overcook (this is the secret to all faux cauliflower recipes – potato salad, mashed potatoes, gratins etc. There is a magic window where it is tender and kind of tasteless (sorry, couln’t think of a better word)
    It was better the second day when I had some good turkey gravy. It does not have the great mouth feel of a good bread/cornbread stuffing, but otherwise is pretty good. I suspect that had the gravy had pieces of giblets or other turkey meat it would have been even better. It is better than OK. On Thanksgiving day itself I had just a small serving of regular stuffing, and my blood sugars were not much affected.
    Thanks for the recipe. It sounds great.

  40. “Like sugar, HFCS is fine in moderation!” Yeah, now define “moderation.” If you drank one 12 ounce soda a day and ate no other sugar at all — no ketchup, no canned baked beans — nothing — you’d be getting something like ten times the sugar our ancestors were eating a couple of hundred years ago. So what’s “moderation?” My sugar intake *is* moderate, which is to say, I don’t refuse to use stuff like Worcestershire because it has sugar in it, but that’s about the extent of my sugar consumption. It’s the American idea of “moderation” that is *wildly* immoderate.
    BTW, Dr. Mike, I smiled at this: “However, since I eat no sweeteners throughout the day, someone else has to eat double to keep the averages the same.” For years I’ve been telling people “The average American eats 152 pounds of sugar per year — and somebody’s eating more, folks, ’cause I’m eating less.”
    Yep, since I eat maybe two pounds of sugar per year (if that) somewhere, someone else is eating 300 pounds per year. Which is not a small amount.

  41. Hi Dr. Eades~
    I’m a very new reader of your blog. I’m concerned about agave as I had understood it to be a low glycemic sweetener? (I’m insulin resistant). My main use of added sweeteners is for my tea. I tend to use either agave or erythritol as I don’t care for the taste of Splenda and I gave up diet Pepsi (and thus my only source of aspartame) about a year ago.
    So, now that you are talking about fructose in the agave, I’m concerned, as it seems that you are saying either that it is not low GI afterall, or that even if it is low GI, that agave has something else about it that makes it not a good choice for those who watch their weight and are concerned about their health. Thanks in advance for any further enlightenment you can offer.
    Welcome to the blog. Glad to have you.
    Agave nectar or syrup is about 90 percent fructose. Fructose is a sugar with a low glycemic index, meaning that it doesn’t raise blood sugar much. But the reason fructose doesn’t raise blood sugar is that it basically converts to fat in the liver, which is not a good thing. If researchers want to make lab animals develop the insulin resistance and the metabolic syndrome, they feed them fructose. Fructose in large doses is the last thing you want to eat if you are insulin resistant.
    Having said that, I can also say that fructose has the sort of paradoxical effect of actually helping the body deal with glucose, but only if the fructose is consumed in very small amounts, say, a few grams. Tiny amounts of fructose seem to prime the body to better use glucose.
    For each teaspoon of agave you are putting in your tea, you are getting about 3.6 grams of fructose. If you are drinking one cup of tea per day with a teaspoon of agave, you’re probably not getting enough to matter. But if you are using a couple of teaspoons and drinking multiple cups of tea throughout the day, you are more than likely getting way too much fructose.

  42. Hello Dr. Eades: Lots of food out there in the supermarket shelves have corn-starch, and specially corn-syrup. For instance i love coffee a lot, and I’ve been drinking my coffee with coffee-creamer. But i’ve noticed that whenever i drink coffee with coffee-creamer in it, i get bloated and i feel a fattening effect of carbohydrates like if i had a potatoes or sweets. And damn, corn syrup is an evil food indeed, specially for those of us who are carbohydrate sensitive and for the majority of people who are trying to lose weight, but even though they walk and run hours a day cannot lose weight because of the *damned* carbohydrates hidden in most of our foods that keep our insulin levels real high.
    By the way, i also wanted to tell you that i ate so much in thanksgiving, i had a lot of carbohydrates and cake. However i won’t celebrate christmas day, i just won’t be part of the gluttony. I’ve noticed that engaging in binge-eating is such a short-lived pleasure. I think that the pleasure of eating low in carbs and in calories is a *long lived* pleasure, compared with the hedonic short lived pleasure of binge-eating. specially when we look ourselves in the mirror. And as the philosopher Nietzsche said: What is good? All that makes you powerful. What is bad? All that makes us weak. And beauty makes us powerful.
    Take care
    Binge eating is indeed a short-lived pleasure. Too much of it can lead to a short-lived life.

  43. I can’t believe I used to drink – on average – 2L of Pepsi a day, before I went zero carb. The horror.
    I wonder how many of the inches lost from my waistline was from my liver shrinking. 😉

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