Making a statement to AA correspondent, Prof. Dr. İlhan Satman said that glucose and fructose are simple sugars found naturally in many foods, and sugar is produced in two ways: sucrose and starch-based.
Stating that sucrose, known as table sugar, consists of glucose and fructose molecules bonded to each other at a rate of 50 percent each, Satman said, "Corn is generally used as the raw material in the production of starch-based sugar and may contain glucose and fructose in different proportions. In addition to corn, wheat, potatoes, rice and cassava (cassava) can also be used as raw materials." he said.
Pointing out that when the beet sugar and starch-based sugar quotas applied in Türkiye are evaluated together, the majority of the fructose in the sugars marketed domestically originates from beet sugar, Satman said, "Then where do the health concerns about starch-based sugar come from? From a biochemistry perspective, there is no difference between the caloric values of sucrose and starch-based sugar, 1 gram of which gives 4 kilocalories when consumed. Although it is generally accepted that their sugar contents are similar, they are especially high." "Many popular beverages sweetened with fructose corn syrup are known to contain more fructose than expected." he said.
Satman stated that when table sugar is consumed, the release and absorption of glucose and fructose requires a certain process, therefore the blood sugar level does not rise rapidly. He explained that when starch-based sugar is consumed, the glucose level in the blood rises very quickly because this process is not required.
Emphasizing that high amounts of fructose consumption reduces the sensitivity of the liver to insulin, Satman pointed out that high fructose corn syrup may lead to more fructose exposure and different metabolic effects compared to sucrose.
Satman stated that excessive sugar consumption is associated with many health problems, especially depression, cardiovascular diseases, hypertension, type 2 diabetes, obesity, metabolic syndrome, fatty liver disease and dental caries, and noted that international health and food authorities recommend limiting free sugar consumption.
Stating that starch-based sugar is used in many products from beverages to confectionery and bakery products, from dairy products to packaged foods, Satman said that it is preferred in the food industry because it is more stable than sucrose, extends the shelf life and is advantageous in terms of cost.
Stating that there is no separate innocent type of starch-based sugar whose consumption is considered safe or harmless, Satman stated that although the fructose rates are different, all starch-based sugar types carry similar metabolic risks.
Satman pointed out that public health authorities recommend reducing daily added sugar intake and emphasized that it is important to reduce sugary drink consumption and increase physical activity to protect public health.
Link between excessively processed food consumption and obesity-related cancer risk
Stating that research indicates that fructose can serve as fuel in the growth of some tumors, Satman explained that it has been suggested that high amounts of fructose consumption may contribute to the development of breast cancer by causing metabolic changes, especially in breast fat tissue.
Underlining that there are studies showing a relationship between excessive fructose consumption and pancreatic cancer, Satman said, "Increasing evidence shows that there is a significant link between excessive processed food consumption and obesity-related cancer risk. Added sugars, unhealthy fats and chemical additives in processed foods consumed in excessive amounts contribute to metabolic and endocrine dysfunctions and intestinal microbiome imbalance. It is known that almost all of these problems trigger obesity and inflammation." he said.
Satman said, "Individuals of all ages and genders, especially babies under 2 years of age, children, those with metabolic diseases or those at high risk of developing these diseases, should definitely stay away from sugar, especially starch-based sugar. Consumption of high fructose corn syrup, which has high fructose content among starch-based sugar types, may increase the risk of permanent health problems in these groups. Babies should definitely not be given added sugar in the first 2 years of life." made his assessment.
Pointing out that excessive consumption of sugar and especially starch-based sugar in children and individuals with or at risk of metabolic diseases may aggravate existing health problems and make it difficult to control diseases, Satman said, "Since serious health problems such as obesity, fatty liver, insulin resistance and type 2 diabetes are quite common in the Turkish society, starch-based sugar, which is widely used in processed foods and ready-made drinks, increases the risk of chronic diseases, especially in children and young people. It makes it difficult to control the disease in individuals with type 2 diabetes." he said.
Türkiye is one of the 5 countries with the highest use of high fructose corn syrup in Europe.
Pointing out that many countries have introduced quotas on the production of these products due to the increasing use of sugar and starch-based sugar all over the world, Satman said, "Sugar and starch-based sugar production has been limited in Turkey since 2001. The starch-based sugar production quota, which was previously 10 percent, was reduced to 5 percent in 2018 and to 2.5 percent as of 2024. High fructose, a type of starch-based sugar, In a study on the global use of corn syrup, consumption of high fructose corn syrup in 43 countries was examined based on Food and Agriculture Organization (FAO) data. The 5 countries with the highest use of high fructose corn syrup in Europe are Hungary, Slovakia, Bulgaria, Belgium and Turkey. he said.
Satman expressed his opinion that raising consumers' awareness and health literacy and gaining the habit of reading and interpreting labels could limit the consumption of sugar and starch-based sugar products in Türkiye, as in the European Union (EU) countries.
Satman pointed out that according to EU legislation, it is mandatory to indicate the types of sugar used in ready-made foods and beverages on the product label, and said:
"If sugar, starch-based sugar or sweetener is added to a product, the clear names of the sugar types should be written in the 'ingredients' list on the product label, in order from highest to lowest according to their amounts. Additionally, it should be mandatory to indicate the total amount of carbohydrates contained in the product in the 'nutritional values' table. If possible, the amounts of sugar types in the product should be stated separately on the label. Especially if a certain type of sugar is highlighted in the name or emphasis of the sugary product, for example, "The percentage of the ingredient 'fructose drink', 'honey added biscuit' should be stated. Statements such as 'sugar-free' and 'contains no added sugar' in a product should be strictly controlled."
