U. S. and British researchers say the growing use of high fructose corn syrup in food supplies around the world may be responsible for a global epidemic of type 2 diabetes.

Their study, published in the journal Global Public Health, looked at food supplies in 42 countries in North America, Europe, Asia and North Africa. The analysis found a 20 percent higher prevalence of diabetes in countries that consumed high fructose corn syrup (HFCS).

“HFCS appears to pose a serious public health problem on a global scale,” said lead author Michael Goran, PhD, a professor of preventive medicine, at the Keck School of Medicine at the University of Southern California. “The study adds to a growing body of scientific literature that indicates HFCS consumption may result in negative health consequences distinct from and more deleterious than natural sugar.”

A fructose industry trade group immediately attacked the study as “flawed” and “misleading.” The Corn Refiners Association called Goran a “known detractor of HFCS” whose previous research on the subject “was deeply flawed and roundly criticized.”

Of the 42 countries analyzed in the study, the U.S. had the highest per capita consumption of HFCS at a rate of 55 pounds, or 25 kilograms, per year. The second highest was Hungary, followed by Slovakia, Canada, Bulgaria, Belgium, Argentina, Korea, Japan, Taiwan and Mexico.

Germany, Poland, Thailand, Greece, Portugal, Malaysia, Egypt and Spain are among the lowest HFCS consumers.

Countries with high use of HFCS had an average prevalence of type 2 diabetes of 8% compared to 6.7% in countries not using HFCS.

The number of people with diabetes rose from 153 million worldwide in 1980 to 347 million in 2008. The increase coincided with the growing consumption of Western style foods with high levels of refined carbohydrates and sugar.

Fructose and glucose are both found in ordinary sugar in equal amounts, but HFCS has a greater proportion of fructose. The fructose makes HFCS sweeter and gives processed foods a better appearance because they brown more consistently when baked.

“A growing body of evidence supports the hypothesis that in addition to overall sugar intake, fructose is especially detrimental to metabolic health and risk for type 2 diabetes. This is of particular concern given the global changes that are occurring in the use of high fructose corn syrup in food and beverage production,” the authors said. “Adding sugar to the diet may contribute excess calories, which can contribute to excess fat accumulation, and in turn risk for type 2 diabetes, as obesity is one of the primary risk factors for diabetes.”

“Most populations have an almost insatiable appetite for sweet foods, but regrettably our metabolism has not evolved sufficiently to be able to process the fructose from high fructose corn syrup in the quantities that some people are consuming it,” said co-author Stanley Ulijaszek, director of the Institute of Social and Cultural Anthropology at the University of Oxford.

People with type 2 diabetes have high blood glucose due to insulin resistance. Though the exact cause of type 2 diabetes is unknown, studies have attributed it to excess weight and lack of exercise.

Researchers estimate that 6.4 percent of the world population is diabetic and by 2030, the estimate will increase to 7.7 percent, with developing countries seeing the highest increases.

“If HFCS is a risk factor for diabetes—one of the world’s most serious chronic diseases—then we need to rewrite national dietary guidelines and review agriculture trade policies,” said Tim Lobstein, director of policy for the International Association for the Study of Obesity. “HFCS will join trans fats and salt as ingredients to avoid, and foods should carry warning labels.”

“Just because an ingredient is available in a nation’s diet does not mean it is uniquely the cause of a disease,” says Audrae Erickson, president of the Corn Refiners Association, which maintains there is no scientific evidence linking HFCS to diabetes.

“Even though Japan consumes more HFCS every year than Mexico, the prevalence rates of diabetes in Japan are about half of Mexico. This example alone shows that Dr. Goran’s hypothesis is totally flawed,” Erickson said.

The association says HFCS and sugar are nutritionally the same, and consumers need to watch their weight and consumption off all extra calories.

“Diabetes is a complex disease with many underlying factors.  It is highly unlikely that one component of the diet is uniquely related to diabetes. There are well-established links between obesity and diabetes. That is where we should be focusing our attention rather than vilifying one component of the diet,” said James M. Rippe, MD, a professor at the University of Central Florida and consultant to the Corn Refiners Association.