High Fructose Corn Syrup

THE VALUE OF AN EXCLUSIVE RED MEAT DIET IN CERTAIN CASES OF CHRONIC GOUT."
To the -Editors of THE LANCET.

SIRS,-Mr. William Armstrong’s paper under this heading in The Lancet of July 3rd has shown the good that can be done by sometimes using what on the face of it appears to be a theoretically wrong diet. Reasoning as the writer does on the subject of auto-intoxication the diet has much in its favour; its results are good in his practice.

Speaking of children in whom the uric acid diathesis is sometimes very marked, I will give a case in my own practice which supports the assimilation theory. A child at two days old passed a quantity of red urine which alarmed the nurse, so much so that she saved me a specimen which on being tested was found to contain pure uric acid crystals. This urine was constantly being passed by the child, who screamed a great deal, had flatulence and sickness, and seemed very miserable altogether. The mother's milk was rich in cream, but turned acid rapidly. Careful dieting of the mother had no effect on the child for good. I found eventually that no milks would agree, so I abandoned milk and put the child on mutton juice. This agreed perfectly, the crying and sickness ceased, the general aspect of the child changed for the better, and the uric acid ceased to be marked after twenty-four hours of mutton-juice feeding. I gradually brought the feeding back to a sterilised cream mixture; the child is now well and taking food without difficulty. Curiously enough the family history of this infant reads like a list of Spa patients--viz., paternal grandmother has rheumatoid arthritis; the father has passed quantities of uric acid calculi; the mother has what Sir Willoughby Wade would call gouty neuritis accompanied by acid dyspepsia.

When Dr. Eustace Smith introduced meat-juice feeding he saw the wonderful way in which the albumin was assimilated, and I am quit econvinced that it is in cases of uric acid diathesis that milk-mixed carbohydrate-diets often disagree. Beef-tea I never give to children, as I only see harm from its use. In several other cases of children unable to digest milk well I have noted uric acid, but the family history is not so marked. When one considers that sugar, which is almost harmless in itself, can (as Sir Dyce Duckwork has pointed out) by setting up fermentation produce flatulence and acidity, it is obvious that carbohydrates may retard stomach digestion by acting as diluents alone, as well as by improperly fermenting and throwing the whole digestive tract out of gear by sending into the duedenum a fermenting mass, the toxins of which are absorbed--veritable taskmasters to an overworked system. Sir William Roberts has called attention to the value of mixed diets, and they certainly are more comfortable than the single red meat and water or vegetarian; but in the special cases mentioned by Mr. Armstrong the microbes must be mastered. 

I am, Sirs, yours faithfully,

Lennox Wainwright, M.D. Brux., &c. 

Folkestone, July 19th, 1897

Such are the sugar resources of the United States that they might render the country independent of such production and exportation combinations as recently were entered into by Cuba, Czechoslovakia, German, and other sugar growing countries. This native source of supply, aside from Porto Rican and Louisiana can and Colorado beets, resides in the country's corn fields.

The production of pure crystal corn sugar on a commercial scale is an infant industry. The conversion of the grain is an intricate process. After cleaning, it is subjected to the action of warm water and sulphur dioxide to soften it and prevent fermentation. 

The solubles near the surface are thus washed off and, regained by evaporation of the steep water, are utilized as cattle feed. 

Later the grains are crushed and the germs, floating on the surface, are collected for their oil. The rest of the mixture is ground, washed and screened until the fibrous cellulose material, also used in cattle feed, has been removed. Starch and gluten remain in the water solution, from which the starch settles out on a series of shallow, slightly inclined troughs, while the gluten passes on with the overflow. 

The starch is flushed out of the troughs, pressed, and dried. When it has been highly purified, it is converted into sugar by hydrolysis, the digestive processes that take place within the human body being reproduced. The starch, suspended in the pressence of chemically pure hydrochloric acid until it has been converted into glucose, or dextrose, perhaps some maltose and dextrines. 

By means of evaporation the solid sugar is then crystallized out and cut in large slabs, which are "aged" for crude corn sugar of various grades. 

Corn sugar, being dextrose, is a different substance from what is ordinarily known as sugar, which is sucrose, whether obtained from sugar cane, sugar beets, sorghum, maple or palm. It has proved useful in medicine, especially for infant and invalid feeding. It also serves a purpose in the food industry. Last year almost 700,000,000 pounds of corn sugar were produced. 

HFCS was first produced by Richard O. Marshall and Earl R. Kooi in 1957 after they created the enzyme glucose isomerase. The enzyme rearranged the composition of glucose in corn syrup and made it into fructose.

HFCS is produced from corn that was milled into corn starch. Which is then turned into corn syrup. The glucose isomerase enzymes are then added to turn the some of the glucose in the corn syrup into fructose. Then you've got HFCS.

A technique is described for the measurement of muscle capillary basement membranes by electron microscopic examination of needle biopsies of the quadriceps muscle. With this procedure it has been possible to obtain an objective evaluation of the significance of capillary basement membrane hypertrophy in diabetic microangiopathy. The results of such studies of muscle capillary basement membrane thickness in 50 normal, 51 diabetic, and 30 prediabetic patients have demonstrated the following. First, that the average capillary basement membrane width of diabetic patients is over twice that of normal subjects; moreover, such basement membrane thickening is a very constant finding among overtly diabetic patients, in that approximately 98% of individual diabetic subjects demonstrated this lesion. The degree of basement membrane thickening in diabetic patients is, however, unrelated to age, weight, severity, or duration of diabetes. Second, capillary basement membrane hypertrophy has been found in approximately 50% of patients who are genetically prediabetic but who have not yet demonstrated evidence of the manifest carbohydrate disturbances of diabetes mellitus. Third, in contrast to the results obtained in genetically diabetic patients, subjects with severe hyperglycemia due to causes other than genetic diabetes only infrequently show basement membrane hypertrophy.

These results indicate that thickening of the muscle capillary basement membranes is a characteristic of genetic diabetes mellitus, and further, that the hyperglycemia of diabetes is probably not the factor responsible for the microangiopathy characteristic of diabetes mellitus. Finally, the discovery of thickened capillary basement membranes in prediabetic patients suggests that basement membrane hypertrophy is a relatively early lesion of the diabetic syndrome and provides further support for the conclusion that this vascular defect is independent of carbohydrate derangements of diabetes mellitus.

J Clin Invest. 1968;47(9):1973-1999. https://doi.org/10.1172/JCI105886.

HFCS was rapidly introduced to many processed foods and soft drinks in the U.S. from about 1975 to 1985. Soft drink makers such as Coca-Cola and Pepsi still use sugar in other nations but switched to HFCS in the U.S. due to higher sugar costs.

HFCS is used in almost every packaged food and soft drink American consumers see today. HFCS has replaced more expensively priced sugar in a variety of uses including; the beverage industry (41%), processed food manufacturers (22%), cereal and bakery producers (14%), multiple-use food manufacturers (12%), the dairy industry (9%), and the confectionery industry (1%).