Fructose Malabsorption (FM)
Fructose is a monosaccharide found in three main forms in the diet:
1. Free fructose
2. A constitute of sucrose
Polymer of fructose, usually in oligosaccharide form, with a terminal glucose also known as inulins, fructo-oligosaccharides (FOS) or oligofructose.
Fructose is a monosaccharide (or a simple sugar). Fructose is also known as fruit sugar. It is found in three main forms in the diet: as free fructose (present in honey and fruits); as a constituent of the disaccharide sucrose (equal glucose/ fructose ratio); or as fructans, a polymer of fructose usually in oligosaccharide form (present in wheat and some vegetables). This short chain carbohydrate is found widely in our diet as a free hexose in fruits as a disaccharide in sucrose and in a polymerized form known as fructans.
Fructose is present in many of the foods that we eat, both natural and processed including countless fruits and vegetables. Honey, pears, fruit juices, agave syrup and apples are just a few natural foods that contain significant amounts of fructose. All fruits contain some fructose, so portions are very important. Fructose is commonly added as a sweetener in the form of high fructose corn syrup in processed foods, beverages and soft drinks.
Fructans are oligosaccharides and polysaccharides of fructose units with a glucose terminal end. These chains of fructose molecules known as fructans occur naturally in many foods. Fructans alone induce abdominal symptoms because they are not hydrolysed or absorbed in the small intestine. Fructans are a big problem for fructose malabsorption sufferers. Some foods with high fructan content are wheat, artichokes, leeks, onions and inulin and fructooligosaccharide (FOS). Inulin and fructooligosaccharide (FOS) are fiber added to some foods and supplements. It is important to keep the amount of fructans in the diet limited if not avoided completely.
Glucose, known also as dextrose, is another monosaccharide or in other words a simple sugar. Glucose is one of the simplest forms of sugar that serves as a building block for most carbohydrates. Both fructose and glucose have about the same caloric value, fructose being quite a bit sweeter. Fructose absorbs easier when combined with glucose. Even with consumption of glucose there is a limit as to how much fructose the body can handle. Glucose tablets are available in most drug and grocery stores, usually in the diabetic section or at the pharmacy. Dextrose powder (or glucose powder) can be used for many recipes or to sweeten drinks. You can purchase it at beer and wine making supply shops, some vitamin and health stores and also online.
It is not as sweet as sugar or fructose but many people find it to be just sweet enough. You can always add more. Some fructmals use a one to one and half ratio to substitute glucose for sugar in recipes. Also smarties and sweet tart candies have a main ingredient of glucose. These candies can be eaten to absorb excess free fructose. However you must always check labels because they change their ingredients here and there. Some actually contain high fructose corn syrup and that is a great big no-no for fructmal sufferers. The main ingredient should read glucose or dextrose. Labels are read by the understanding that the first listed ingredient is the main ingredient and the list follows suit in this order with the last ingredient having the least amount within.
Sucrose or table sugar is made of two sugars, fructose and glucose. It is known as a double sugar made of one part fructose and one part glucose. People with fructose malabsorption can eat sucrose (limited amounts) because the glucose assists with the absorption of fructose. Large amounts of sucrose in one sitting might pose problematic, as a large load of fructose in any form will cause symptoms.
All humans have a limited amount of fructose that they can absorb. The ability of the human small intestine to absorb fructose is limited and unique to each individual. A healthy person can only absorb twenty-five to fifty grams of fructose per sitting. No one has an unlimited free-reign on consumption of fructose so everyone is fructose malabsorption to some degree. Fructmals are described as being able to absorb less that twenty-five grams per sitting. The degree of malabsorption can vary from individual to individual.
Some people are very sensitive and less fructose is likely to cause the gas and bloating that result quickly from an excess of fructose. As with lactose (a milk sugar found in milk and dairy foods), individuals have a threshold for the amount of fructose that can ingest without developing symptoms. Fructose malabsorption is actually written to be fairly common, yet is not well-known. Most people are unaware of what it is, including doctors and medical professionals.
High fructose corn syrup (HFCS) has been getting a lot of attention these days. High fructose corn syrup (HFCS) is a sweetener made from corn and can be found in numerous foods and beverages on grocery store shelves in the United States. HFCS is composed of either 42 percent or 55 percent fructose, with the remaining sugars being primarily glucose and higher sugars. There is a lot of controversy as to how safe it is for consumption. Many allege that it leads to obesity.
The Corn Refiners Association claims that HFCS is natural and similar to table sugar. Research is underway as to whether or not the claims against HFCS are true or false. Sugar in any form should being consumed in moderation for everyone is important. Elimination of HFCS is crucial for those who suffer from fructose malabsorption if there is a desire to heal and live a healthy life. Many processed food and beverages are made with high-fructose corn syrup. Currently the Corn Refiners Association is requesting that they can change the name of high fructose corn syrup to corn sugar so be aware.
To avoid symptoms, people with Fructose Malabsorption need to be aware of four main things in their diets:
1. The amount of fructose in a meal, total
2. The ratio of fructose to glucose in a meal
3. The presence of polyols (sugar alcohols, like sorbitol, xylitol, mannitol, etc.)
4. The presence of fructans (especially short-chain mono-, di-, and oligosaccharides, like Inulin, FOS, etc.)