What the Evidence From Sugar-Sweetened Beverages Tells Us
Vasanti S. Malik and Frank B. Hu
Key Points Regarding Fructose, HFCS, and SSBs
• Fructose is found in: sucrose, a disaccharide composed of 1 glucose molecule and 1 fructose molecule; HFCS, containing relatively equal amounts of glucose; and fruit, honey, and some vegetables as a naturally occurring monosaccharide.
• The major source of fructose in the diet comes from fructose-containing sugars (sucrose and HFCS) that are added to foods and beverages and contain relatively equal amounts of glucose.
• Thus, intakes of glucose and fructose covary, and epidemiological studies cannot completely differentiate between their effects.
• HFCS is produced from corn starch through industrial processing. The most common forms contain 42% or 55% fructose along with glucose and water.
• Use of HFCS has progressively replaced the use of sugar in the United States due to its low cost.
• HFCS is the primary sweetener used in SSBs in the United States and in many processed foods.
• SSBs include soft drinks, fruit drinks, and energy drinks that are sweetened by HFCS or sucrose, which are added to the beverages by manufacturers, establishments, or individuals.
• SSBs are the greatest source of fructose-containing sugars in the diet and thus account for the majority of total fructose intake.
• Relations between SSB and cardiometabolic diseases reflect the potential effects of fructose and glucose or unique metabolic effects of fructose alone in epidemiological studies.
HFCS = high fructose corn syrup; SSB = sugar-sweetened beverage.