The fruit offer is bigger and more varied today than ever. But not everyone can enjoy fruit without restriction. Are you also one of those people who often experience rumbling in the stomach after eating fruit? Then one can fructose malabsorption or intestinal fructose intolerance are present.
Test for fructose intolerance
How many people in Germany suffer from fructose malabsorption or fructose intolerance is not known exactly. Many seem to be affected without a diagnosis being made.
This is by means of a test, the so-called "H2 breath tests" or Fructose hydrogen breath tests, quite simple: This fructose malabsorption test measures after a load of fructose via the air, whether the typical intestinal gases are formed and exhaled. If the typical symptoms appear during the test, fructose intolerance is assumed.
Fructose malabsorption: what are the causes?
In fructose malabsorption, the uptake of fructose, ie fructose, which occurs for example in fruit and honey, is disturbed in the small intestine. Normally, a transporter removes the sugar component fructose from the food into the small intestine cells and thus into the bloodstream. In fructose malabsorption, this transport system is defective or its performance is limited.
Largely undigested, the fructose therefore reaches the large intestine in large quantities. The bacteria there reduce fructose to short-chain fatty acids and gases such as hydrogen or carbon dioxide, which can trigger the symptoms.
Fructose malabsorption or intestinal fructose intolerance?
Although the two terms are often used interchangeably, there is a difference between fructose intolerance and fructose malabsorption. From a medical point of view, the following definition applies:
- The malabsorption This occurs when the fructose in the small intestine is not properly absorbed and therefore large parts of it enter the colon.
- From one intestinal fructose intolerance One speaks when the fructose is actually incompatible and the malabsorption of fructose leads to discomfort.
Delineate hereditary fructose intolerance
Not to be confused is the fructose malabsorption also with the congenital (hereditary) fructose intolerance. This is a rare disturbance of the fructose metabolism, in which the affected person lacks an enzyme that is needed for fructose degradation. It requires a strict renunciation of fructose from birth.
Symptoms of fructose intolerance
Typical signs of fructose intolerance usually include a combination of some of the following symptoms:
- Abdominal pain or cramps
- visibly inflated belly
- (foul-smelling) flatulence
- Diarrhea or constipation
- Difficulty concentrating, tiredness or headache
If the affected persons avoid fructose, the symptoms disappear completely. A complete renouncement of fructose does not have to be with fructose intolerance, because a small amount of fructose is usually tolerated.
The fructose tolerance varies from person to person and must be determined individually. In some people, the symptoms of intolerance are temporary, while in others, fructose can be a life-long problem.
Fructose intolerance - what to do?
After the diagnosis of fructose intolerance is usually first waiting period recommended, in the completely fructose is omitted.
Then, step by step, you can (and should) integrate fructose-containing foods into your diet and test your own limits. Over time, as the intestines continue to recover, these boundaries can be pushed further and further.
A doctor or nutritionist can help to create an individualized nutritional plan to avoid malnutrition. Common consequences of fructose intolerance are one Lack of zinc or folic acid, so - after consultation with the attending physician - a feed on dietary supplements may be useful.
Diet: What foods avoid?
The simple sugar fructose is a natural component of fruits and numerous vegetables. Especially fructose rich are for example:
Fructose is also found in fruit juice, fruit yoghurt, cereal bars, dried fruit, jam, confectionery, lemonade and cola. Also, foods such as bread or sausages are often added fructose. Be careful when it comes to alcohol: sweet drinks like sweet wine or liqueur in particular contain a lot of fructose.
Therefore, with fructose intolerance, it is important to read the list of ingredients carefully while shopping. Beware, however, when labeling "Fructose-free" or "without fructose" commanded: This often means only that no additional fructose was added. Nevertheless, fructose may be present in these foods.
What to eat with fructose intolerance?
A fructose intolerance means only in very few cases a complete abandonment of East and vegetables. On the contrary: a complete renunciation can lead to vitamin deficiency and is therefore not advisable. The goal should therefore not be to eat fructose-free, but low fructose.
comparatively good tolerated foods with fructose intolerance are for example:
These factors influence the tolerability
The individual tolerability of fructose may also depend on:
- the type of preparation
- the combination of different foods in a meal
- the total amount of fructose taken on that day
The time of day or the time of eating can also play a role. So fructose is directly after a main meal and in the afternoon usually better tolerated.
Special recipes and tables with information on the fructose content of food can be found on the Internet and can make it easier for those affected to enjoy low-fry cooking. It may be advisable to keep a list of which foods are usually well tolerated.
Sugar with intestinal fructose intolerance
Also the sugar substitute sorbitol should be avoided in case of fructose intolerance. Since sorbitol in the intestine uses the same means of transport, it can reduce the intake of fructose in the short term. Sorbitol is found in some fruits and is added to many products - just like fructose - as a sugar substitute.
glucose (Grape sugar, on the other hand, promotes fructose uptake, as it stimulates the activity of the transporter. For this reason, sucrose (table sugar), half of which is fructose and glucose, is better absorbed by some. It may also be helpful in fructose intolerance to add glucose occasionally when cooking fruit or vegetables to increase the digestibility of a dish.
To sweeten stevia or rice syrup are also suitable - agave syrup, honey or maple syrup are not suitable. Milk sugar (lactose) may also be an alternative in fructose intolerance, unless lactose intolerance is also involved.