title: High fructose corn syrup and diabetes prevalence: a global perspective.
abstract: The overall aim of this study was to evaluate, from a global and ecological perspective, the relationships between availability of high fructose corn syrup (HFCS) and prevalence of type 2 diabetes. Using published resources, country-level estimates (n =43 countries) were obtained for: total sugar, HFCS and total calorie availability, obesity, two separate prevalence estimates for diabetes, prevalence estimate for impaired glucose tolerance and fasting plasma glucose. Pearson's correlations and partial correlations were conducted in order to explore associations between dietary availability and obesity and diabetes prevalence. Diabetes prevalence was 20% higher in countries with higher availability of HFCS compared to countries with low availability, and these differences were retained or strengthened after adjusting for country-level estimates of body mass index (BMI), population and gross domestic product (adjusted diabetes prevalence=8.0 vs. 6.7%, p=0.03; fasting plasma glucose=5.34 vs. 5.22 mmol/L, p=0.03) despite similarities in obesity and total sugar and calorie availability. These results suggest that countries with higher availability of HFCS have a higher prevalence of type 2 diabetes independent of obesity.
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA. goran@usc.edu
authors.forename: Michael I
authors.initials: MI
authors.lastname: Goran
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Ulijaszek
authors.forename: Emily E
authors.initials: EE
authors.lastname: Ventura
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003431:Cross-Cultural Comparison; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology; D019422:Dietary Sucrose / Q000009:adverse effects* / Q000600:supply & distribution; D005632:Fructose / Q000009:adverse effects* / Q000600:supply & distribution; D014943:Global Health / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D055815:Young Adult
chemical_list: D019422:Dietary Sucrose; D005632:Fructose