Is Coke healthier when its made with cane sugar instead of high-fructose corn syrup?

Globe and Mail

6 days ago

Earlier this week, soft drink maker Coca-Cola announced in an earnings release it will be adding a new Coke to its existing lineup in the U.S. – one that's sweetened with sucrose from cane sugar.
This news came nearly a week after President Donald Trump posted on Truth Social that Coca-Cola had agreed to do so, adding it 'will be a very good move' and that 'it's just better!'
The new beverage option will offer U.S. consumers a choice in sweetening agents. Coca-Cola currently uses high-fructose corn syrup to sweeten its American offering of the signature soft drink.
Consuming high-fructose corn syrup, or HFCS, in excess has been linked to obesity, Type 2 diabetes and non-alcoholic fatty liver disease. It's also linked to metabolic syndrome, which is a cluster of risk factors that together significantly increase the risk of cardiovascular disease and diabetes.
Many people consider HFCS to be more detrimental to health than regular sugar. U.S. Health Secretary Robert F. Kennedy Jr. has also expressed concerns about the sweetener in the past.
Are soft drinks made with cane sugar, then, a healthier choice? Here's what to know.
HFCS is a liquid sweetener made by first breaking down cornstarch into corn syrup, which is nearly 100 per cent glucose, a simple sugar. An enzyme is then added to the corn syrup to convert some of its glucose into fructose, a simple sugar that occurs naturally in fruit.
The most common forms of HFCS contain either 42 or 55 per cent fructose. The rest is glucose and water.
Since the 1970s, manufacturers have used HFCS to sweeten all sorts of processed foods including beverages, baked goods, breakfast cereals, candies, flavoured yogurt and condiments such as jam, ketchup and barbecue sauce.
In Canada, HFCS appears as sugar/glucose-fructose on soft drink ingredient lists. In foods, it's listed as glucose-fructose.
Compared to sucrose, HFCS is similarly sweet, is cheaper, has a longer shelf life and is easier to mix into foods and beverages.
Sucrose, which is extracted from sugar cane or sugar beets and then refined, is chemically similar to HFCS.
It's also made up of glucose and fructose, in similar proportions to HFCS. Sucrose is 50 per cent glucose and 50 per cent fructose.
The simple sugars in sucrose and HFCS are metabolized the same way. Glucose in the bloodstream gets into cells with the help of insulin. Fructose doesn't require insulin; it's primarily metabolized in the liver.
Nutritionally speaking, there's no difference between sucrose and HFCS. Both supply four calories per gram or 16 calories per teaspoon – empty calories since both lack significant amounts of vitamins and minerals.
A 2009 U.S. study, conducted with 32 adults who were overweight or living with obesity, compared the effects of consuming a quarter of daily calories from beverages sweetened with pure fructose or beverages sweetened with pure glucose (three daily servings).
Both groups experienced similar weight gain during the 10-day study, but only those in the fructose group had significant increases in visceral fat, which wraps around abdominal organs.
Another study, published in 2015 and conducted at the University of California, Davis, examined the effect of consuming beverages with varying amounts of HFCS for two weeks.
In 85 young adults, consuming beverages containing 10 per cent, 17.5 per cent and 25 per cent HFCS led to significant increases in uric acid, LDL cholesterol and triglycerides – risk factors for cardiovascular disease. As the drinks increased in sweetness, so did the adverse consequences.
More recently, a well-controlled 2021 study from the same university compared the effects of drinking three daily servings of either sucrose- or HFCS-sweetened beverages. Among the 187 participants aged 18 to 40, both options led to significant increases in liver fat and reductions in insulin sensitivity, within 16 days.
A 2022 review of randomized controlled trials involving 797 participants concluded there was no significant difference between sucrose- and HFCS-sweetened drinks when it came to changes in body weight, waist circumference, blood cholesterol, triglycerides and blood pressure.
The researchers noted that HFCS-sweetened drinks were associated with an increased level of C-reactive protein, a marker of inflammation, when compared to beverages sweetened with sucrose.
Whether soft drinks are sweetened with cane sugar or HFCS, they are still sugary drinks that we should limit or avoid consuming.
A 2023 evidence review of 73 meta-analyses revealed that higher intakes of added sugars were linked to a significantly greater risk of 45 adverse health effects such as childhood obesity, increased body and liver fat, high blood pressure, coronary heart disease and depression.
The researchers recommended consuming no more than 25 grams of free sugars a day – that includes added sugars and those naturally present in foods such as honey, maple syrup and fruit juice.
They also advised limiting consumption of sugar-sweetened beverages – pop, iced tea, lemonade, chocolate milk, sports and energy drinks – to less than one serving per week (200 to 355 ml).
According to 2015 data from Statistics Canada, Canadians consume an average 67 grams of free sugars each day, nearly 17 teaspoons worth. Sugary drinks and desserts were the top two contributors.
One type of added sugar is not healthier than another; our intake of all kinds needs to be reduced.
Leslie Beck, a Toronto-based private practice dietitian, is director of food and nutrition at Medcan. Follow her on X @LeslieBeckRD