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The Fructose Story

Fructose has been getting quite a bad wrap of late, with many health “experts” recommending we all avoid it. I am definitely all for eliminating processed fructose forms such as fruit juice, corn syrup and high fructose corn syrup. But do you need to be limiting all fructose in your diet including fruit?

Below I shed light on fructose and whether you and your family need to be avoiding it.

Fructose is a type of sugar that is found in soda, baked good (breads, breakfast cereals and pastries), fruits, fruit juices and fruit products.

Over 30 years ago it was first proposed that increasing dietary intake of fructose could be contributing to digestive problems including bloating, distension, diarrhoea and abdominal pain. The low FODMAP (Fermentable Oligo-Di-Monosaccharides and Polyols) diet is based around reducing fructose sugars amongst other hard to digest sugars.

Why is fructose an issue?

The reason that fructose is an issue lies in the way our digestive system addresses it. After you eat fructose, there are two ways that you can absorb it: the slow way and the fast way. The fast way requires another sugar – glucose – for absorption and occurs much more efficiently. Without sufficient amounts of glucose, any free “fructose” may not be absorbed efficiently and that is where you run into problems. If there is excessive free fructose which is hanging about in your gut it can be fermented by bacteria to cause gas, distension and pain. It may also attract water into your bowel which exacerbates bloating and may cause diarrhoea, spasms and cramping.

Fructose intolerance is very common with an estimated 50% of people unable to digest 25 gras of fructose. Even people who do not have irritable bowel syndrome may experience gastrointestinal symptoms after ingesting fructose.

If you do have irritable bowel syndrome, fructose malabsorption becomes very relevant as it may cause an exacerbation of your symptoms.

What can you do about it?

If you are prone to an irritable bowel then I recommend limiting your consumption of fructose. This does not mean that you need to avoid all fruits. Below I provide a few tips on dealing with fructose malabsorption:

  • If you suspect you may be fructose intolerant, limit your consumption of fructose to 15 grams per day and monitor for flare ups. This would be the equivalent to one medium size apple or pear (see link below for fructose content of foods). If you do get bloating, cramping or IBS symptoms then see the next point on avoiding fructose.
  • If you have a very sensitive bowel and gut health issues then I recommend avoiding all high fructose foods (from the list below) for a period of time (about six weeks) and working with a gut health practitioner to improve your gut flora and heal your gut lining.
  • Enjoy low fructose fruits including bananas, kiwi fruit, citrus fruits, passionfruit, peaches and berries (do not go overboard with these).
  • Avoid foods which are rich in sorbitol if your IBS symptoms are severe. Sorbitol is found in high amounts in pears, apples, and stone fruit. Sorbitol inhibits the absorption of fructose and may add to fructose intolerance.

List of High Fructose Foods

  • Fruit and fruit juices: apple, cherries, grapes, guava, lychees, mango, melon (honeydew and watermelon), nashi pears, paw-paw, papaya, pear, persimmon, pineapple, quince. Cooked fruit generally has lower fructose content than uncooked fruit.
  • All dried fruit, including currant, dates, figs, raisins.
  • Processed fruit: barbecue / braai sauce, chutney, fruit from cans / tins (often in pear juice), plum sauce, sweet and sour sauce, tomato paste.
  • Sweets, food and drinks with very high sucrose (table sugar) content and with high fructose corn syrup.
  • Honey and agave syrup.
  • Vegetables in larger quantities as the fructan content of these veggies is high: artichoke, asparagus, beans, broccoli, cabbage, chicory, leek, onion and peanuts.
  • Sweet wines: e.g. dessert wines, muscatel, port, sherry.
  • Wheat- based products: flour, pasta, bread, whole-grain breakfast cereals.
  • Whole-meal products in large amounts.
  • Sorbitol and xylitol containing foods: diet / ‘light’ and diabetic drinks, sugar-free chewing gum and sweets / candies, stone fruit, dried fruits (e.g. apple, apricot, date, fig, nectarine, peach, plum, raisin). Beer may be a problem in large amounts.
  • Inulin, a fructan, is also a known IBS irritant. The following foods are rich in fructans and likely to cause bloating and gas: Asparagus, dandelion leaves, garlic, leeks, onion and wheat bran.

Refer to the link below for further detail of the fructose content of foods:

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