40 years of adding more fructose to high fructose corn syrup than is safe, through the lens of malabsorption and altered gut health–gateways to chronic disease

Abstract Labels do not disclose the excess-free-fructose content in foods/beverages. Objective was to estimate excess-free-fructose intake using USDA loss-adjusted-food-availability data (1970-2019) for high fructose corn syrup (HFCS) and apple juice, major sources of unpaired fructose, for comparison with malabsorption dosages (~5g-children/~10g-adults). Daily intakes were calculated for HFCS that is generally-recognized-as-safe/(55% fructose/45% glucose), and variants (65/35, 60/40) with higher fructose-to-glucose ratios (1.9:1, 1.5:1), as measured by independent laboratories. Estimations include consumer-level-loss (CLL) allowances used before (20%), and after, subjective, retroactively-applied increases (34%), as recommended by corn-refiners (~2012).ResultsExcess-free-fructose daily intake for individuals consuming HFCS with an average 1.5:1 fructose-to-glucose ratio, ranged from 0.10 g/d in 1970, to 11.3 g/d in 1999, to 6.5 g/d in 2019, and for those consuming HFCS with an average 1.9:1 ratio, intakes ranged from 0.13 g/d to 16.9 g/d (1999), to 9.7 g/d in 2019, based upon estimates with a 20% CLL allowance. Intake exceeded dosages that trigger malabsorption (~5 g) around ~1980. By the early 1980’s, the tripling of apple juice intake, had added ~0.5 grams to average-per-capita excess-free-fructose intake. Contributions were higher (3.8 g /4-oz.) for individuals consuming apple juice consistent with a healthy eating pattern (4-oz. children, 8-oz. adults). This analysis did not account for contributions from crystalline fructose or agave syrup.ConclusionThe displacement of sucrose with HFCS, its ubiquitous presence in the US food supply, and industry practice of adding more fructose to HFCS than generally-recognized-as-safe, have contributed to unprecedented excess-free-fructose daily intake levels, malabsorption, gut dysbiosis and associated chronic disease.