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Information on Fructose Malabsorption

•Fructose is a type of sugar found in almost all fruits, honey, and in many vegetables.

•Some people face a problem called Fructose Malabsorption. It occurs if they aren’t able to absorb fructose in their small intestine properly.

•Some of the common symptoms include bloating, pain, nausea and diarrhea or watery stools.

•It can occur in healthy infants, children and adults, as well as those with functional bowel disease such as Irritable Bowel syndrome.

•Fructose tolerance depends on dose, small quantities may not cause symptoms.

•After an initial low fructose diet for 4-6 weeks, high fructose foods may be slowly re-introduced to find tolerance level.

•Fructose can take up to 3 days to pass through the digestive tract, start by trying a small amount every four days. If this is OK, try having it more frequently, build up the quantity. Cut back again if symptoms start to recur.

 

Hereditary Fructose Intolerance (HFI) is a rare genetic condition which causes severe toxic symptoms. It requires strict avoidance of fructose, and ongoing medical treatment. The advice in this pamphlet is not suitable for this condition.

Fructose is found in most fruits, honey and some vegetables, but not all foods that contain fructose need to be avoided. How well fructose is absorbed depends on the concentration of other kinds of sugars in the food, such as glucose, sucrose and sorbitol.

*Glucose and Dextrose can improve absorption, especially if there is more glucose than fructose (a high glucose to fructose ratio)

*Sucrose (cane sugar) is broken down during digestion into equal amounts of glucose and fructose, and may be tolerated in small amounts. However, large amounts of sucrose will release too high a total load of fructose.

*Sorbitol is a sugar alcohol found in some fruits, and is often used as a sweetener. Sorbitol will usually decrease fructose absorption, and worsen symptoms.

*Some people will also have a problem with fructans, which are fructose units linked in long chains. Wheat, in particular, has significant levels of fructans.

 

Dietary Treatment

•In some cases, simply cutting out fruit juice may be enough to alleviate symptoms. For infants, whole or mashed/pureed fruit is recommended instead of juice, Fruit juice intake should be no more than about half a cup per day.

•Some people will need to limit or avoid common problem foods to control symptoms

•Very sensitive people may require even greater restriction of fruit and vegetables, if symptoms persist.

 

Common Problem Foods

The following foods are either high in total fructose content, contain a higher ratio of fructose compared to glucose, or contain significant amounts of sorbitol or fructans.

 

Fruits

 

 

 

*Apple

*Cherry

*Grape

*Guava

*Honeydew

*Lychee

*Mango

*Paw Paw

*Persimmon

*Pear

*Quince*

*Watermelon

 

 

 

*Large amounts of dried fruit or fruit juice

*Foods containing apple or pear concentrate

*Large amounts of stone fruit (sorbitol)

*Plum sauce, sweet and sour sauce

 

Vegetables     (fructans)

 

 

 

*Artichoke

*Asparagus

*Chickory

*Leek

*Onion

*Radicchi

*Spring onion

 

 

 

 

 

*Tomato paste, chutney, barbeque sauce

 

 

*Coconut milk and cream

 

 

*Honey

 

 

 

*Foods with a lot of High Fructose Corn Syrup, or corn syrup solids

*Large amounts of high sugar foods, such as soft drinks, cordials and confectionary

*Large amounts of wheat (fructans)

 

Reference: “Irresistibles for the Irritable”, Sue Shepherd, Dept. of Food and Nutrition Services, University of Iowa Allergy Advisor Digest

 

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