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Explanation and Intro continued

Riddled

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Diagnosis

The diagnostic test, when used, is similar to that used to diagnose lactose intolerance. It is called a hydrogen breath test and is the method currently used for a clinical diagnosis. When a breath test cannot be performed, a stool test may be used.

Treatment

There is no known cure, but an appropriate diet will help.

Diet

Foods that should be avoided by people with fructose malabsorption include:

  • Foods and beverages containing greater than 0.5g fructose in excess of glucose per 100g, greater than 3g fructose in an average serving quantity regardless of glucose intake and greater than 0.2g of fructans per serving.
  • Fructose consumed in large quantities.
  • Foods with high fructose-to-glucose ratio (NB: Glucose enhances absorption of fructose, so fructose from foods with fructose-to-glucose ratio <1, like bananas, are readily absorbed, while foods with fructose-to-glucose ratio >1, like apples and pears, are often problematic regardless of total amount of fructose in the food.
  • Foods rich in fructans and other Fermentable Oligo-, Di- and Mono-saccharides and Polyols (FODMAPs)
  • Foods rich in sorbitol
  • Foods such as high fructose corn syrup (HFCS) or honey

    Foods with a high glucose content ingested with foods containing excess fructose may help sufferers absorb the excess fructose.


    Foods with high fructose content

    According to the USDA database, foods with more fructose than glucose include:

    Food Fructose (grams / 100 grams) Glucose (grams / 100 grams)

    Sucrose 50 50
    (for reference)
    Apples 5.9 2.4

    Pears 6.2 2.8

    Fruit juice
    e.g. Apples, 5 to 7 2 to 3
    Pears

    Watermelon 3.4 1.6

    Raisins 29.8 27.8

    Honey 40.9 35.7

    High fructose
    corn syrup 55 to 90 45 to 10


    The USDA food database reveals that many common fruits contain nearly equal amounts of the fructose and glucose, and they do not present problems for those individuals with fructose malabsorption. Some fruits with a greater ratio of fructose than glucose are apples, pears and watermelon, which contain more than twice as much fructose as glucose. Fructose levels in grapes varies depending on ripeness and variety, where unripe grapes contain more glucose.


    Foods with high fructan content

    Chains of fructose molecules known as fructans occur naturally in many foods. The following foods have a high fructan content:

    • Artichokes
    • Asparagus
    • Leeks
    • Onions including spring onion
    • Wheat including most beers, breads, cakes, biscuits, breakfast cereals, pies, pastas, pizzas, and some noodles


      The role that fructans play in fructose malabsorption is still under investigation. However, it is recommended that fructan intake for fructose malabsorbers should be kept to less than 0.5 grams/serving, and supplements with inulin and fructooligosaccharide (FOS), both fructans, should be avoided.



      Other problem foods
      In addition, the following foods should also be avoided:

      • Sorbitol (present in some diet drinks and foods, and occurring naturally in some stone fruits)
      • Xylitol present in some berries, and other polyols (sugar alcohols), such as erythritol, mannitol, and other ingredients that end with -tol, commonly added as artificial sweeteners in commercial foods.
      • Any processed foods or foods prepared by others containing the foods listed above

      [*]For example:

      [*]

      Sodas and other beverages containing high fructose corn syrup (HFCS)

      [*]
      Dried fruit (including "health" bars containing dried fruit)

      [*]
      Tinned fruit in "natural" juice (often, this is pear juice)

      [*]
      Sweet wines



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