What can I eat if I have fructose malabsorption?
Please be aware that this list is not exhaustive and that food products are subject to naturally variable amounts of substances. Apart from that, every person is different, which means that you need to find out for yourself what foods you can tolerate more and which foods you can tolerate less!
Well tolerable are:
- Grains and products made from grains: Bread, pasta, gnocchi,... (if no sugar, syrup, etc. is added!)
- Milk products without added fruits, syrups, or sugar alcohols
- Mushrooms: (Be careful with mushrooms and test them individually)
- Salads: lambs lettuce, endive salad, cucumber, chinese cabbage, zucchini (courgettes), chicory, dandelion leaves (cause flatulence due to their inulin content), lettuce, ruccola, radishes, beetroot
- Well-tolerated vegetables: spinach, avocado, bamboo shoots, celeriac, chickpeas, peas, chard, sweet-corn, rhubarb, plantain, horseradish, broccoli
- Vegetables tolerated moderately well: cauliflower, kohlrabi and asparagus (in moderation, bloats!), white cabbage, bell peppers (not chillis!), fennel, cucumber, pumpkin, zucchini (courgettes), carrots
- Fruits: Bananas, prickly pears (Indian fig), tangerines, lemons, limes, coconut
- Nuts (not peanuts!) in small quantities
- Fish and shellfish
- Vinegar (most of all aromatic vinegar; pay extra attention to the list of ingredients when buying vinegar!)
A general rule for fruits and vegetables: Don't overdo it!
Vitamins and mineral nutrients
Those who have fructose malabsorption should not be worried about being unable to get enough supplies of vitamins or minerals. All you have to do is to be more selective in your choice of foods and observe certain rules, and you will be able to eat a healthy diet even with fructose malabsorption!
As has been described in "Diagnosis: Fructose malabsorption" it will be possible to start to normalise the food intake again after the first 2 weeks (It is extremely important to do the fructose-restricted diet in the first 2 weeks!). This means that small amounts of fructose can be eaten and the amounts can ans MUST slowly be increased. From then on it will be possible to re-introduce certain types of fruit again and thus supply the body with some vitamins and fibres. The goal ist to be able to eat kind of normal amounts of fructose again.
The supply of Vitamin A, Vitamin C, folic acid, potassium, magnesium and zinc is compromised in patients affected by fructose malabsorption. Fruits that are well tolerated should thus be eaten frequently.
You will find several tables with tolerable types fruits and vegetable in the download centre.
Nor does it hurt to take some vitamin and mineral supplements. It is very important here that you read the list of ingredients (watch out for sorbitol, mannitol, etc...) and consult a medical professional, a pharmacist or a registered dietician for advice. You should avoid alcoholic drinks, i.e. beer and wine, as much as possible. This also helps to take the pressure off the liver (see "Fatty liver and fructose malabsorption").
How can I sweeten recipes when I have fructose malabsorption?
Instead of honey or sugar you can use rice syrup, Stevia or Glucose (Dextrose). You should not use any other syrup products! Household sugar can be tolerated in small amounts in most cases, because it is made up of the same amount of fructose and glucose (but this depends on the individual)! Those who do not have additional lactose intolerance can sweeten their foods with lactose, but this can cause a laxative effect!
Some more tips regarding fructose malabsorption:
- Drink lots of water with a high mineral content (alkaline is best) and tap water (in those places where it is safe to drink).
- Diet Sodas are normally tolerated well, but you shouldn't drink too much of it; Test it yourself!
- Dietary fibre: If you can tolerate these it is best to choose whole grain flour and whole grain rice (Please try them out first! Whole grain flour often has higher fructose content than white flour)
- Intestinal regeneration programmes with probiotic yoghurts are good for the gut flora, but don't do these treatments for too long or too often. Careful: No fruit yoghurts, added syrups, ...
- Eat fruits like tangerines, bananas or prickly pears (Indian figs) on a daily basis - but listen to your body! - fruit and fructose table
- Fruits are tolerated best after your meal and in the afternoon
- Try not to use glucose too often! It is better to do without a meal that is high in fructose content. Adding glucose is a less-than-ideal solution!
- Thoroughly rinsing, cooking and rinsing vegetables again can minimally dissolve the fructose in the vegetables, thus making them easier to tolerate. But be careful! This will also wash away vitamins and important plant minerals!
- Avoid sugar alcohols!
- Avoid High Fructose Corn Syrup, Honey, dried fruits, syrups and sweet sodas
- Do NOT stop eating fructose! Fructose intake stimulates the expression of GLUT-5 transporters, so you need to eat fructose. Otherwise your malabsorpotion will get worse.
Stryer, L., Biochemie, Specktrum Akademischer Verlag, 4. Auflage
Souci-Fachmann-Kraut, Lebensmitteltabelle für die Praxis, 3. Auflage
Kamp, A; Schäfer,Ch; "Gesund essen, Fruktosearm geniessen" Gräfe und Unzer Verlag, 1. Auflage 2007