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Michael Segal's avatar

Regular sugar, sucrose, is glucose linked to fructose. Cane sugar is basically sucrose plus a tiny amount of molasses. It produces a rapidly-absorbed mixture of approximately equal parts glucose and fructose.

High fructose corn syrup has a higher fraction of fructose than glucose, achieved using enzymes; it is also rapidly absorbed.

Fructose is much sweeter than glucose; sucrose is in-between. The idea behind high fructose corn syrup was to get more sweetness per calorie. The problem is that while both glucose and fructose have bad effects, fructose can be much more dangerous, producing "fatty liver" and a damaging "metabolic syndrome": https://pmc.ncbi.nlm.nih.gov/articles/PMC6770027/

Glucose can be monitored by measuring Hemoglobin A1c, which measures the degree to which hemoglobin has glucose chemically attached to it. From this one can calculate the average glucose level over the recent months that the hemoglobin has been in red blood cells.

Fructose is broken down only slowly by the liver, and the excess is converted to fat, as also occurs for ethanol. So measuring the extent of fatty liver is a decent metric for fructose levels in recent months.

Spikes of glucose or any non-trivial amount of fructose are each harmful in their own way. Getting glucose at a consistent slow level as occurs from complex carbohydrates is healthier.

Artificial sweeteners have their own problems.

The best advice is to avoid picking your poison and instead drink water.

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