Nutritive and Non-Nutritive Sweeteners

NNNS: High Fructose Corn Syrup (HFCS) (2010)


Theodore J. Angelopoulos, Joshua Lowndes, Linda Zukley, Kathleen J. Melanson, Von Nguyen, Anik Huffman, and James M. Rippe The Effect of High-Fructose Corn Syrup Consumption on Triglycerides and Uric Acid. J. Nutr. 2009; 139: 1242S-1245S.

Study Design:
Narrative Review
R - Click here for explanation of classification scheme.
Quality Rating:
Neutral NEUTRAL: See Quality Criteria Checklist below.
Research Purpose:

The objective of this article was to examine the responses of triglycerides and uric acid following consumption of HFCS.

Inclusion Criteria:

Not applicable, review article

Exclusion Criteria:

Not applicable, review article

Description of Study Protocol:


Not applicable


Narrative review 

Blinding used

Not applicable


Not applicable

Statistical Analysis

Not applicable


Data Collection Summary:

Timing of Measurements

Not applicable

Dependent Variables

Not applicable

Independent Variables

Not applicable

Control Variables 

Not applicable


Description of Actual Data Sample:
  • Initial N: Not applicable
  • Attrition (final N): Not applicable
  • Age: Not applicable
  • Ethnicity: Not applicable
  • Other relevant demographics: Not applicable
  • Anthropometrics: Not applicable
  • Location: Not applicable.


Summary of Results:

 Key Findings

  • Hepatic fructose metabolism can produce the required components for triglyceride synthesis thus potentially increasing triglyceride levels
  • Excess fructose consumption may increase uric acid levels
  • These factors may play an important role in the development of the metabolic syndrome
  • Most evidence comes from studies with pure fructose and less is known regarding the contribution of high-fructose corn syrup (HFCS)
  • In one reviewed study on mice, HFCS consumption contributed to elevated triglyceride levels. Mice fed HFCS also became insulin resistant as early as four weeks into the study.
  • In two reviewed human studies, no differences in triglycerides were observed between HFCS and sucrose consumption. Fasting triglycerides were elevated compared with baseline levels after all treatments, suggesting that consumption of a diet of 25% sugar may have negative short-term metabolic effects regardless of the identity of the sugar.
  • No studies were found to evaluate the effects of HFCS consumption on uric acid levels
  • Data from a human study evaluating glucose/fructose combinations suggests the fructose load in HFCS may not be sufficiently greater than that of sucrose to affect uric acid levels differently
  • A statement is made indicating that a study by the authors did not show an affect of HFCS on uric acid levels in women.
Author Conclusion:
  • This review highlights the fact that limited data are available about the metabolic effects of HFCS compared with other caloric sweeteners
  • The data suggest that HFCS yields similar metabolic responses to other caloric sweeteners such as sucrose.


Funding Source:
ILSI North America
Other non-profit:
Reviewer Comments:
  • There were a very limited number of studies reviewed by this article
  • No information was given on the search strategy to find articles
  • A couple of the studies briefly mentioned were performed by the authors of this review paper
  • More details about the reviewed studies would be beneficial for an analysis.
Quality Criteria Checklist: Review Articles
Relevance Questions
  1. Will the answer if true, have a direct bearing on the health of patients? Yes
  2. Is the outcome or topic something that patients/clients/population groups would care about? Yes
  3. Is the problem addressed in the review one that is relevant to dietetics practice? Yes
  4. Will the information, if true, require a change in practice? ???
Validity Questions
  1. Was the question for the review clearly focused and appropriate? Yes
  2. Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described? ???
  3. Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased? No
  4. Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible? No
  5. Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined? N/A
  6. Was the outcome of interest clearly indicated? Were other potential harms and benefits considered? Yes
  7. Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described? No
  8. Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included? ???
  9. Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed? Yes
  10. Was bias due to the review's funding or sponsorship unlikely? Yes