Following a fructose-restricted diet is the only treatment for fructose malabsorption. This condition is more and more recognized as a problem in people dealing with functional gut disorders and experiencing symptoms like bloating, flatulences, diarrhea, constipation, abdominal discomfort and cramping. These gastrointestinal issues are the results of poorly absorbing short-chain fermentable carbohydrates, such as fructose. However, fructose is not the only problematic carbohydrate in fructose malabsorbers, and gastrointestinal distress can also be experienced when eating foods containing lactose, fructans, galactans or polyols. The best way to control the symptoms is to eat foods that do not contain these fermentable short-chain carbohydrates.
Sugar
Take a look at the sweeteners you use in your tea, coffee and recipes. Look at the food labels to determine what type of sweetener is used in the foods you buy, whether soft drinks, baked goods, breakfast cereals or granola bars. Avoid sweeteners that have a high fructose content, such as high-fructose corn syrup, honey and agave syrup. Instead, you can use any regular sweetener, except for sugar-alcohols like sorbitol, maltitol or xylitol. Allowed sweeteners on a fructose-restricted diet include granulated sugar, raw sugar and maple syrup. Use these low-fructose sugars to sweeten your foods and choose foods that are sweetened with these safe sweeteners to prevent unpleasant side effects.
Fruits
Fruits with a lower fructose content include blueberry, banana, grapefruit, grape, honeydew melon, kiwi, lemon, lime, orange, mandarin, passionfruit and strawberry. These fruits are usually well-tolerated in people with fructose malabsorption. However, to avoid ingesting a high fructose load, which could trigger symptoms, keep your fruit consumption low, to no more than two to three servings a day, depending on your individual tolerance. Moreover, you should avoid eating more than one serving of fruit at a time and ensure you eat a meal at the same time.
Vegetables
Vegetables do not contain significant amounts of fructose, but many vegetables are rich in fructans, which is a molecule made of a chain of fructose. Most people with fructose malabsorption following a fructose-restricted diet need to keep an eye on their fructan intake as well and should therefore avoid onions, leeks, garlic, shallots, broccoli and cabbage. Safe vegetables with a low fructan content include bok choy, carrot, celery, red bell pepper, green beans, lettuce, parsnip and Swiss chard.
Grains
Grains and grain-based foods are not a source of fructose, unless high-fructose fruits or sweeteners are added. However, many fructose malabsorbers also need to avoid fructans, a chain of fructose, which is present in wheat and rye and any foods containing these grains or made from their flours. If you need to avoid fructans on your fructose-restricted diet, you can have other grains. Your best bet is to choose gluten-free bread, gluten-free pasta and gluten-free baked goods. Always check the ingredients, though, to ensure they do not contain any ingredients that could be problematic for you.
Dairy Products
Many fructose malabsorbers also need to avoid lactose on their fructose-restricted diet. If it is your case, you can include lactose-free dairy products into your diet without any problems, unless you are hypersensitive to lactose. In which case, you should avoid all dairy products. However, most people are able to tolerate lactose-free milk, hard cheese, lactose-free yogurt and butter.
References
- "Journal of the American Dietetic Association"; Fructose Malabsorption and Symptoms of Irritable Bowel Syndrome: Guidelines for Effective Dietary Management; Susan J. Shepherd and Peter R. Gibson; 2006
- "Practical Gastroenterology"; Clinical Ramifications of Malabsorption of Fructose and Other Short-chain Carbohydrates; Jacqueline S. Barrett and Peter R. Gibson; August 2007
- Shepherd Works: Fructose Malabsorption
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