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Guidelines for fructose intolerants

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Fructose is a carbohydrate that is present in a large number of plant foods. It is considered to be the sweetest of all existing sugars.

Under normal conditions, its consumption does not cause any type of alteration, however, in recent decades, it has been possible to verify the existence of problems of intolerance or malabsorption at the intestinal level associated with a high consumption of this sugar in the diet.

What is fructose and where is it found?

Fructose is a monosaccharide (sugar) found in vegetables such as fruits and vegetables. It is also found as part of sucrose (table sugar) which is made up of a fructose molecule and a glucose molecule (disaccharide).
Fructose has a sweetness that exceeds up to 1.7 times that of sugar.

Foods containing fructose

The real foods that contain fructose usually belong to those of vegetable origin, fruits, vegetables , and their function is to bring them sweetness. This concentration of fructose is different in each food.

But of these 3 groups of vegetables, it is the fruits that come to have the highest concentration of fructose. It is also present in honey.

Fruits containing fructose

Fructose content varies from fruit to fruit, so high fruits and low fructose fruits can be found.

Listed below are some fruits and their fructose content per 100 g:

Dates (30 g), Figs (28 g), raisins (16 g), cherimoya (8 g), apple (8 g), pear (9 g), grape (7 g) cherry (7 g), granada (6 g), kiwi (5 g), water (5 g), fresh figs (3 g), banana (4 g), mango (4 g), melon (4 g), strawberries (3 g), orange (3 g), papaya (3 g), grapefruit, blackberries, and raspberries (1 to 3 g).

What fructose is for

However, there are other types of foods that have managed to have much higher concentrations of fructose and come from the food industry, such as: corn syrup with high fructose content.

This syrup is widely used as a sweetener in the food industry, so it can be found as part of soft drinks, pastries, sweets, fruit juices.

A few years ago, due to the high sweetness of fructose, it had also been used on its own as a substitute for sucrose (table sugar), especially in products intended for diabetics.

But for some years now, the American Diabetes Association (ADA) and the European Food Safety Authority (EFSA) have warned that excessive fructose intake can cause metabolic problems such as insulin resistance, dyslipidemia and fatty liver.

How does fructose work in the body?

Fructose is absorbed in the small intestine and, unlike glucose that passes into the blood, it passes directly to the liver, where it is rapidly metabolized to glucose.

When fructose is consumed in excess the intestine is not able to process these amounts, so the surplus of fructose that is not absorbed, passes to the colon and is when annoying symptoms such as diarrhea, gas and abdominal pain occur.

Currently, problems of intolerance or malabsorption are also considered to be due to damage or alterations of the intestinal wall.

How do I know if I have fructose intolerance?

If the above symptoms occur, it is preferable to rule out the existence of any intolerance. To do this, the expired hydrogen test is performed, which consists of blowing into an instrument that measures the amount of hydrogen existing in the patient’s breath after having ingested a certain amount of fructose (50 g approx.).

If the test result is positive and fructose intolerance or malabsorption is diagnosed, dietary treatment will be started.

The treatment of this condition consists of eliminating from the diet all foods that contain fructose, both real and processed foods, especially. It is advisable not to consume more than 2 g of fructose a day. For this reason, almost all fruits can be eliminated from the diet.

Guidelines to consider for fructose intolerant

As the appearance of the annoying symptoms will not only depend on the amount of food consumed but also the concentration of fructose they have, it is convenient:

Consume fruits that have not matured excessively, because the more ripe they are, the greater concentration of fructose they will have.

Try not to consume several foods that contain fructose in the same meal.

In addition, fructose intolerance may be accompanied by intolerance to sorbitol, so foods containing it will also be eliminated from the diet and even the presence of sorbitol in medicines should be taken into account.

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