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The storm clouds have been brewing over fructose for some time now, and the days when “fructose” sounded better and more natural on a label than “glucose” or simply “sugar” are fast coming to an end. Research, which implicates fructose in the development of chronic conditions, like cardiovascular disease, diabetes and obesity, is gradually mounting. We ask the question which many industry watchers must be pondering right now, namely whether fructose is destined to share the fate of trans fatty acids (TFAs), whose near-elimination from the human food supply is a very much a work in progress.
There are very few compelling parallels between fructose and trans fats. First of all, both occur naturally in our food supply. Fructose is a natural sugar found in fruit and vegetables, while trans fats feature in meat and dairy foods in small quantities owing to ruminants’ metabolic processes.
As such, neither fructose nor trans fatty acids can be wholly eliminated from the human food supply, and nor do they give cause for health concerns as long as they are consumed as part of the foods in which they are inherent, and provided that these are not eaten in excess.
The process of hydrogenation, which turns liquid vegetable oils into solid or semi-solid fats, was once believed to be a boon to public health, because it allowed consumers to replace artery-clogging saturated animal fats, such as butter and lard, with “healthy” vegetable oils and fats. Only decades later was it discovered that (partial) hydrogenation produced copious quantities of trans fats, which were even more injurious to health than saturated fats.
Fructose is still widely believed to be an innocuous carbohydrate. In fact, the European Food Safety Authority (EFSA) came to the conclusion in 2013 that fructose was more favourable for blood sugar control than other sugars, and in 2014, the EU authorised the following health claim: “Consumption of foods containing fructose leads to a lower blood glucose rise compared to foods containing sucrose or glucose”. Any food or beverage product, in which a minimum of 30% of its sucrose and/or glucose content had been replaced with fructose, was subsequently eligible to employ this claim.
The EU was widely criticised by public health campaigners for authorising such a claim, mainly from the view point that the consumption of added sugar should not be officially endorsed or encouraged in any case, but also in light of growing evidence suggesting a more direct link between fructose and chronic disease.
While there is no longer any doubt regarding TFAs’ harmful effects on cardiovascular health, the scientific evidence that could bring down fructose is only just starting to gather force.
Last year, a study published in Current Opinion in Lipidology found that, while fructose did not affect insulin production negatively, it did appear to increase cholesterol and triglycerides after eating. In January 2015, the Mayo Clinic Proceedings reported that added sugars, and particularly fructose, were fuelling the obesity epidemic and the rise of type 2 diabetes. June 2015 saw the publication of a small study in PLOS ONE, which had compared brain responses to both glucose and fructose consumption, with researchers coming to the conclusion that fructose encouraged overeating because it was markedly less effective at creating a satiety response than glucose.
To date, the evidence linking fructose to chronic disease development is not sufficient for any firm conclusions to be drawn, but it may not be wise for the industry to ignore the steady trickle of papers pointing towards a possible connection.
It is worth mentioning, though, that there is widespread consensus in one aspect, namely that the consumption of fructose in the form of whole fruits and vegetables does not have any negative consequences for health, because the metabolic impact of this natural fruit sugar is effectively “buffered” by a matrix of fibre, antioxidants and other nutrients.
There are indications that, as packaged food and beverage constituents, both fructose and trans fatty acids are on the decline in highly developed markets. Our ingredients data, which are based on recipe analysis, show that the use of hydrogenated vegetable fat (97% of which is used in food, the rest in beauty and personal care products) declined by 84% globally between 2009 and 2014, and that this was a strong trend across all regions, while hydrogenated vegetable oil contracted by 21% in the US and by 7% in Western Europe. (Note: fully hydrogenated vegetable fats/oils do not contain trans-fatty acids, but partially hydrogenated types constitute a major source).
As for fructose, 70% of which is used in beverages and the rest in packaged foods, volume dropped by 8% in North America, 9% in Australasia and 19% in Western Europe. Only Asia Pacific, Latin America and Middle East and Africa, registered positive growth, because they are home to a large number of emerging markets.
Incidentally, North American volumes of high fructose corn syrup (HFCS), which has had so much bad press over the years, shrank by 17% over the review period. This is a prime example of the impact of the clean label trend, which has also contributed significantly to the demise of TFAs.
HFCS, which consists of around 50% fructose, no longer has any place on a clean label, and, with fructose slowly but steadily veering into disrepute on the chronic disease front, it might soon go the same way.
For reasons already explained, a blanket ban on trans fatty acids and fructose in the food supply is unworkable, but many regulators around the world have nevertheless taken measures to reduce the prevalence of the former in the human food supply. Denmark and Switzerland, for example, have gone as far as banning the use of partially hydrogenated oils as food ingredients. Some countries, like Iceland and Austria, have imposed TFA limits in foods ranging from 2-4%, and in a growing number of markets, mandatory labelling applies. The US, for instance, started to introduce TFA labelling regulations in 2003, which have been tightening ever since. In June 2015, the FDA officially declared TFAs as “not generally recognised as safe”, giving manufacturers three years to remove partially hydrogenated oils from their products.
In short, TFAs are definitely on their way out. Could fructose soon be going the same way? Well, considering that the scientific evidence base in favour of fructose removal on public health grounds is less than solid at this point in time, regulatory commotion in this direction is nowhere near imminent.
However, governments are worried about chronic disease and soaring health care costs, and investigations into the matter are only going to gather pace. Should a feasible link emerge in the next three to five years, legal requirements aimed at reducing fructose in the food supply are probably at least a decade off, but the day when fructose will have to disappear from “clean labels” is coming into view already. Manufacturers of health and wellness products, in particular, need to take this into consideration where their new product development is concerned, and think about reformulation of their existing product portfolios as soon as possible.