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Fructose Intolerance

Fruit is a usually healthy choice, but for those with fructose malabsorption, the wrong kind of fruit (or too much of it) can cause painful consequences.

Despite what you may have read or heard, fructose is not harmful or toxic when consumed in moderation—especially when it comes from whole foods such as fruit.

However, there is a limit to how much fructose your body can process at one time. Could fructose be a hidden cause of your digestive distress?   Below are tips on how to recognise and deal with fructose malabsorption.

Most of us can only absorb between 25-50 grams of fructose at a sitting—a bit more or less, depending on what other sugars are present in the meal. Unless you’re being immoderate you’re unlikely to consume that much at a meal. Some people, however, have a much lower threshold. For those with fructose malabsorption, even small amounts of fructose, such as the amount in a single serving of fresh fruit, can cause problems.

Any fructose that isn’t absorbed remains in the large intestine, where the bacteria that normally reside there will start to digest it. This produces carbon dioxide gas, which can lead to bloating, belching, or flatulence. Fructose also pulls water into the intestines through the process of osmosis, which can cause cramping and diarrhea.

How to Tell if You Have Fructose Malabsorption

With any sort of food intolerance, half the battle is figuring out which food or foods trigger problems. This often takes quite a bit of detective work because we tend to eat lots of different foods at a given meal and symptoms can take anywhere from a couple of hours to a couple of days to appear. If you know you have fructose malabsorption, however, it is fairly easy to avoid the foods that will trigger problems for you. You can even still enjoy some fruit!

Fructose malabsorption can be definitively diagnosed by your doctor with a hydrogen breath test. However, you can do a simple experiment: Follow the dietary prescription recommended for people with fructose malabsorption. If you have a noticeable improvement in gas, bloating, and other symptoms, it may be that you have some degree of fructose malabsorption.

3 Tips for Dealing with Fructose Malabsorption

Tip #1: Avoid Foods with High Percentage of Fructose

As the name suggests, fruit is a major dietary source of fructose. But it’s also found in small amounts in vegetables and grains. Concentrated sweeteners, such as table sugar, honey, maple syrup, corn syrup, and agave nectar also contain varying amounts of fructose.

You’ll almost never find fructose all by itself, however. It’s almost always accompanied by or bonded to other sugars, such as glucose. This works out well because glucose enables the absorption of fructose. The first important rule for those with fructose malabsorption is to avoid foods and sweeteners that contain more fructose than they do glucose. Below, you’ll find a list of common culprits. For processed foods, you’ll need to do some label reading – which is a good idea anyway!

Sugars and Sweeteners

Agave syrup (in Tex-Mex foods, tequila, margaritas, soft drinks), caramel, Chinese rock sugar, corn syrup solids, fructose, fruit juice concentrate, golden syrup (cane syrup), High Fructose Corn Syrup (HFCS), honey, invert sugar (treacle), licorice, molasses, raw sugar (Turbinado, Demerara, jaggery, palm sugar – gur); sweets in excess (>50g), soft drinks with sucrose, (>375 mL); Sugar substitutes: hydrogenated starch hydrolysates (HSH), sorbitol, stevia, sucralose.

Fruits

Apples, cherries, dates, figs, grapes (black), guava, honeydew melon, lychee, mango, nashi fruit, papaya, pears, persimmon, plumes, prunes, raisins, star fruit, sultana, quince, watermelon. Dried fruits, fruit compotes and jams in general.

Vegetables

Artichoke, eggplant, green peppers, green cabbage, kale, leeks, lettuce (iceberg), pickles (e.g. sweet cucumbers), radishes, squash, tomatoes, turnips, watercress.

Bread and Cereals

Brown rice, sweetened breakfast cereals (or with raisins, honey).

Proteins

Meat, fish (if processed, sweetened, or commercially breaded); coconut milk/cream.

Dairy

Sweetened milk products, ice cream

Sauces

Sauces: Barbeque’s, Sweet&Sour, Hot mustard, chutney, ketchup, relish, soy sauce, vinegar (apple cider, balsamic); Spices: chervil, dill weed, ginger, hot chilli pepper, pumpkin pie

Drinks

Fruit juices (apple, apricot, mango, orange, pear, peach, prune, sweat cherry), soft drinks with sorbitol or HFCS; alcohol (except dry white wine); powdered sweetened beverages, sweetened milk/vegetable/soy drinks, coffee substitutes with chicory.

 

Tip #2: Keep total fructose intake moderate

In addition to avoiding foods that have a high percentage of fructose, you also want to limit your total fructose intake. To that end, you’d want to limit sodas, sweetened teas, coffees, and sports drinks, sweetened breakfast cereals, flavoured yogurt, candy, ice cream, and other sweet stuff.

It is also recommended to limit your fruit intake to 2-3 servings a day and not more than one serving at any one time. Be particularly careful with dried fruit: a serving is just ¼ cup or a very small handful.

Tip #3: Fructose May Not Be the Only Problem

If following these recommendations eliminates your symptoms, keep up the good work and enjoy the benefits. If you get partial but not total relief, you may have other triggers besides fructose.