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Fructose And The Low FODMAP Diet

Last updated on Feb 4th, 2019 Authored by Chloe Hall (RD)     Reviewed by Alana Scott
Cherries, Fructose and the low FODMAP diet

If you are on the low FODMAP diet then you know that excess fructose can send some people rushing to the loo! Fructose is the ‘M’ in the FODMAP acronym and is a monosaccharide. It’s a single sugar unit found in foods like fruit, and fruit products such as juice and blueberry jam, as well sweeteners like honey and agave nectar. Keep on reading to find out more about fructose and the low FODMAP diet.

What is Fructose Malabsorption?

In some people the fructose they eat isn’t completely absorbed by the small intestine, and the excess fructose then passes to the large intestine and feeds the bacteria that lives there. The bacteria ferment the fructose which can result in unpleasant symptoms such as bloating, flatulence, stomach pain, diarrhoea and/or constipation. The amount of fructose each person can tolerate at one time can vary, so it’s important that you test your tolerance levels in the re-challenge phase.

It’s good to note that not all fructose is an issue. Fruit and fructose containing foods like tomatoes and table sugar that contain equal glucose to fructose ratios are generally well tolerated in small serves. This is because the glucose molecules act as ‘porters’ that co-transport the fructose across the internal cells and into your body. When there is more fructose than glucose your body malabsorbs the fructose and it becomes food for your gut bacteria and can trigger symptoms.

Who needs to restrict fructose?

Only some people with IBS have fructose malabsorption and your Doctor or Dietitian should be able to give you guidance on whether you need to restrict fructose. In the past hydrogen breath tests have been a popular test for identifying fructose malabsorption, however recent research has found that these tests are often not accurate or reproducible (1, 2).

If you have had one of these tests or are unsure if excess fructose is affecting your symptoms, then restrict fructose during the initial phase of the low FODMAP diet. Once your symptoms are manageable, complete a fructose challenge to help you identify if excess fructose is contributing to your symptoms.

Foods High In Excess Fructose

During the initial phase of the low FODMAP diet you will need to avoid foods high in excess fructose. Some of these foods include:

  • Fruit such as apples, cherries, boysenberries, figs, pears and mangoes
  • Asparagus and sugar snap peas
  • Honey
  • Agave Nectar
  • Tropical juices
  • Fructose, fructose syrup
  • Glucose-fructose syrup (only in Canada)*
  • Fructose- glucose syrup
  • High fructose corn syrup or high fructose corn syrup solids

Also look out for these ingredients in products such as yoghurts, breakfast cereals, jams and marmalades, cereal or snack bars and savoury sauces. In addition, avoid large serves of fructose at one time by limiting your intake of low FODMAP fruit (dried, fresh or juice) to one portion per meal or snack.

If you are feeling a bit confused about fruit, then we’re not surprised.  Fruits are healthy foods that contain lots of vitamins and minerals and can help to prevent disease, however for some people with IBS the excess fructose found in large serves of fruit as well as certain types of fruit like apples, pears and boysenberries can exacerbate symptoms.

Are you ready to take control of your gut symptoms?

YES I WANT TOO!

No thanks, my gut is perfect.

*Glucose-fructose syrup is a term used to describe different types of corn syrup depending on the country. In the UK and Europe, glucose-fructose syrup is used to describe corn syrups that contain between 5% and 50% fructose (5 6). If the glucose consists of 50% or more of the syrup content, then it would be low FODMAP. However, in Canada HFCS is called glucose-fructose or glucose-fructose syrup and must be avoided (9 10).

Is there any evidence that adding glucose to fructose can help absorption?

Some earlier research suggested that adding glucose to fructose containing foods could help with absorption, however recent research has shown that adding glucose to high fructose foods often doesn’t help reduce symptoms and adds a lot of extra sugar to our diets, which can have negative health consequences such as weight gain (3, 4). This means your best option during phase one of the low FODMAP diet is to focus on eating low FODMAP foods.

What can I use as a sweetener instead of honey?

If you are used to cooking and baking with honey then you will need to use a low FODMAP swap. Both maple syrup or granulated sugar are good low FODMAP options, however if you are looking for a healthier option then a no calorie sweetener like Stevia is worth exploring.

Final Thoughts

You don’t need to avoid all foods containing fructose while on the low FODMAP diet, just focus on avoiding high FODMAP foods containing excess fructose. Next you can test your tolerance levels to excess fructose in the re-challenge phase and regain your food freedom.

Author: Chloe Hall (RD)

Chloe is a UK Dietitian with a passion for helping people with gut issues. She has a special interest in Irritable Bowel Syndrome having had symptoms herself for many years. When Chloe first started her IBS journey, coeliac disease was not initially ruled... Read More

Professional Reviewer: Alana Scott

In 2013, Alana was diagnosed with Irritable Bowel Syndrome. She also suffers from coeliac disease, is allergic to nuts and is intolerant to dairy products. This means she understands how difficult it can be to cook with multiple food intolerances. Her exp... Read More

SHOW REFERENCES
  1. Barret, J. & McNamara L. Research update: How important is diagnosis of fructose malabsorption in the FODMAP approach? Monash FODMAP Blog. 2017 November 09. Retrieved from: https://www.monashfodmap.com/blog/research-update-how-important-diagnosis-fructose-malabsorption-fodmap-approach/
  2. Yao CK, Tuck C, Barrett J, Canale K, Philpott H, Gibson P. Poor reproducibility of breath hydrogen testing: Implications for its application in functional bowel disorders. United European Gastroenterol J. 2017: 5(2) 284-292. DOI: 10.1177/2050640616657978
  3. Tuck C. Adding glucose to high FODMAP foods – does it really help? Monash FODMAP Blog. 2016 November 21. Retrieved from https://www.monashfodmap.com/blog/adding-glucose-to-high-fodmap-foods/
  4. Tuck CJ, Ross LA, Gibson PR, Barrett JS, Muir JG. Adding glucose to food and solutions to enhance fructose absorption is not effective in preventing fructose-induced functional gastrointestinal symptoms: Randomised controlled trials in patients with fructose malabsorption. J Hum Nutr Diet. 2016.
  5. Starch Europe. Factsheet on Glucose Fructose Syrup and Isoglucose. Starch Europe. 2013-06-10. Retrieved from:http://www.starch.eu/factsheet-on-glucose-fructose-syrups-and-isoglucose/?redirect=true. Retrieved on: 2015-08-03. (Archived by WebCite® at http://www.webcitation.org/6aUyOYve9)
  6. EUFIC. Frequently Asked Questions: What is Glucose Fructose Syrup. European Food Information Council. 2015. Retrieved from:http://www.eufic.org/page/en/page/FAQ/faqid/glucose-fructose-syrup/. Retrieved on: 2015-08-03. (Archived by WebCite® at http://www.webcitation.org/6aUyez54v)
  7. Smyser, J. Why Is High Fructose Corn Syrup Banned in Europe?. Livestrong. 2015-05-07. Retrieved on:http://www.livestrong.com/article/464851-why-is-high-fructose-corn-syrup-banned-in-europe/. Retrieved from: 2015-08-03. (Archived by WebCite® at http://www.webcitation.org/6aUx0wUx9)
  8. Roberts, G & Mclean, N. The deadly legacy of America’s fields of gold. The Independent. 2012-06-10. Retrieved from:http://www.independent.co.uk/life-style/health-and-families/health-news/the-deadly-legacy-of-americas-fields-of-gold-7834226.html. Retrieved on: 2015-08-03. (Archived by WebCite® at http://www.webcitation.org/6aUy4jAuX)
  9. Parker, K., Salas, M. & Nwosu, V. High fructose corn syrup: Production, uses and health concerns. Biotechnology and Molecular Biology Review. 2010: Volume 5: Issue 5. 71-78. Retrieved from:http://www.academicjournals.org/article/article1380113250_Parker%20et%20al.pdf. Retrieved on: 2015-08-03. (Archived by WebCite® at http://www.webcitation.org/6aUxpHaM6)
  10. Canadian Sugar Institute. Nutrition & Labelling Claims. Canadian Sugar Institute. 2015. Retrieved from:http://www.sugar.ca/Nutrition-Information-Service/Health-professionals/Nutrition-Labelling-and-Claims-on-Food-Products.aspx. Retrieved on: 2015-08-03. (Archived by WebCite® at http://www.webcitation.org/6aUyGc4DZ)

Feature Photo Credit: Photo by Brooke Lark on Unsplash

Asparagus Photo Credit: Photo by Christine Siracusa on Unsplash

 

 

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Feb 26

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End of summer veggies are the best and these roasted eggplants are call my name right now.

These are super simple too - roast the eggplant in oil, salt and pepper until golden and tender. Smother in golden sunshine tahini sauce and sprinkle with toasted seeds.

If you are low FODMAP the 1 small-medium eggplant = 4 servings.

Sunshine tahini dressing:
1 tsp garlic infused oil
1.5 tsp gluten free soy sauce
1 tbsp olive oil
1 tbsp lemon juice
2 tbsp water
3 tbsp tahini
1/2 tbsp pure maple syrup

Place in a jar and shake until well combined.

This recipe is part of our premium FODMAP recipe club (along with 700+ other low FODMAP recipes).

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Feb 22

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I'm stuck at the office and I'm staving! Definitely didn't pack enough snacks today... if I could I'd be drinking this right now.

Give me a ❤️ if you want to be drinking this too. Say hello to my low FODMAP strawberry and rhubarb smoothie.

Strawberries and rhubarb make the best smoothie buddies. It might sound like an odd combo but the tanginess of the rhubarb pairs super well with the sweetness from the strawberries to create a refreshing and vibrant drink.

1 serve 👇

🍓140 g (1 cup)fresh or frozen strawberries
🍓60 g (1/4 cup)stewed rhubarb
🍓250 ml (1 cup) low FODMAP milk 
🍓2 tsp pure maple syrup (add to taste) 
🍓1/2 tsp vanilla essence
🍓6 ice cubes (use if you are using fresh strawberries)

METHOD
Slice the strawberries in half, be super careful doing this if they are frozen. Place all the ingredients in the blender. Add the ice cubes if your strawberries aren’t frozen.

Blend until smooth. Taste and add a little bit more sweetener if it’s too tangy. The tanginess will depend on your stewed rhubarb (ours wasn’t sweetened).

Pour into your favourite glass and enjoy! 

FYI this recipe is also in our premium recipe club.

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Feb 13

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It’s brunch time! It’s also Valentine’s Day so I thought I’d treat my man to a cooked breakfast. Say hello to my Greek scrambled eggs.
 
Serves 2:

1 medium-sized ripe tomato (diced or grated)
1 tbsp fresh chives (finely chopped)
1 tbsp fresh parsley (finely chopped)
2 tsp garlic infused oil
2 tsp olive oil 
3 eggs (beaten)
Salt and pepper

Fry the diced tomato in the garlic infused oil for 2 to 3 minutes until the liquid reduces. Then add the olive oil, chives and parsley to the pan along with the beaten eggs. Season with salt and pepper. Move the egg mixture gently around the pan for 1 to 2 minutes until the eggs are cooked to your liking.

Serve on toast of your choice (we used gluten free bread). Enjoy!

Do you have a favourite brunch meal? Tell me below 👇

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Jan 29

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Who loves eating the rainbow for dinner? 🙌 I do! 

It's hot here at the moment which means rice paper rolls make a refreshing low FODMAP dinner option.

I love that you can prep all of the ingredients in advance so you don't have to slave over a hot stove in the evenings.

What's your go-to summer meal?

P.S. You can get the recipe on alittlebityummy.com or follow my profile link.
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Jan 28

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I have exciting news! I’m incredibly honoured to announce that I’ve been nominated as a semi-finalist for the 2021 Young New Zealander Of The Year award.

It’s a privilege supporting people with Irritable Bowel Syndrome and other gut issues and I can’t wait to see what 2021 brings.

I also want to say thanks to the team behind the New Zealander of the Year Awards for making these awards possible.

@nzeroftheyear @kiwibanknz 
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Jan 18

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You know what I miss? Berry Bliss Muesli. It's crunchy and delicious with little pops of strawberry... I'm making a coeliac friendly version of this very soon.

In the meantime give me a ❤️ if you want to try this gorgeous low FODMAP version. I make this for my mum and she absolutely adores it!

Recipe on alittlebityummy.com or follow my profile link.

I'd also love to know what your favourite breakfast is so let me know in the comments 👇
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Comments

  1. Sangrita says

    June 30, 2020 at 4:07 am

    after starting the elimination phase, how many days/weeks, does it take, until the bloating/gas, or digestive discomfort improve?

    Reply
    • Alana ScottAlana Scott says

      July 1, 2020 at 7:26 pm

      Hi Sangrita,

      That is a great question. Some people will see improvement in a few days and others it might take a couple of weeks. The general rule of thumb is that if you haven’t seen improvement within 4 weeks, then it’s a good idea to troubleshoot with a FODMAP trained dietitian. You might also find this article a useful resource: https://alittlebityummy.com/7-reasons-why-the-low-fodmap-diet-might-not-be-working/

      Reply

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