Fructose Intolerance: Symptoms, Causes & What to Eat Instead

Understanding Fructose Intolerance

What Is Fructose Intolerance?

People with fructose intolerance cannot properly absorb fructose, which can cause uncomfortable side effects or symptoms, including digestive issues. 

The body typically processes fructose in the liver, where it contributes to glucose, fatty acids, or lactose. If your body cannot properly digest fructose, you may experience a range of health issues, including gastrointestinal issues and liver or kidney damage.

LifeSpring Home Nutrition offers a range of meals that support a low-fructose diet.

Types of Fructose Intolerance

What Is Hereditary Fructose Intolerance (HFI)?

Hereditary fructose intolerance (HFI) causes infants to experience uncomfortable symptoms if they ingest foods or drinks with fructose, including bloating, vomiting, low blood sugar, abdominal pain, and diarrhea or constipation. 

HFI is an autosomal recessive disorder characterized by defective aldolase B and metabolic assimilation of dietary sugars.

According to MedlinePlus, “Affected individuals develop signs and symptoms of the disorder in infancy when fruits, juices, or other foods containing fructose are introduced into the diet.” In addition, “Affected infants may fail to grow and gain weight at the expected rate (failure to thrive).”

Continuing to ingest fructose can lead to damaged kidneys and other health issues unless the infant receives treatment for their condition.

Both adults and children can develop fructose intolerance. However, it generally manifests differently across age groups and may have unique underlying causes. For example, hereditary fructose intolerance becomes noticeable in infancy, and dietary fructose intolerance usually develops in adulthood.

How Is Dietary Fructose Intolerance Different?

Dietary fructose intolerance, also known as fructose malabsorption, is a condition that typically develops in adulthood, in which the body has difficulty breaking down digested fructose, which can lead to fermentation and uncomfortable or painful side effects. 

People with a diagnosis of fructose malabsorption often adopt a low-fructose diet to put less strain on their digestive system. However, you may need enzymes or supplements to ensure you receive the recommended daily amount of nutrients.

LifeSpring Home Nutrition makes it easy to adopt a low-fructose diet, allowing you to avoid foods with sorbitol, sucrose, and other sugars that may trigger symptoms.

Causes and Risk Factors of Fructose Intolerance

What Causes the Body to Struggle With Fructose Absorption?

Physical damage, protein deficiencies, or genetic mutations impact how much fructose gets absorbed. 

Each type of fructose intolerance has unique causes and treatment options.

Multiple factors can impact your body’s ability to absorb fructose, including: 

• Damage to the intestines caused by irritable bowel syndrome (IBS), celiac disease, and other conditions
• Mutations of specific genes that may cause an enzyme deficiency, reducing fructose absorption
• Deficiencies in transport proteins that move fructose through the intestinal wall

The root cause of your fructose intolerance will determine what treatments you may benefit from and how best to approach dietary changes. A dietitian, gastroenterology expert, or another healthcare provider can assist you in creating a tailored meal plan to help you avoid symptoms and improve your quality of life.

Common Symptoms of Fructose Intolerance

What Are the Most Common Digestive Symptoms?

Some of the most common digestive symptoms of fructose intolerance include: 

• Excessive gas
• Abdominal swelling and discomfort 
• Nausea or vomiting 
• Diarrhea 
• Painful cramps

You should also look out for non-digestive symptoms, including unusual fatigue, mood swings, skin problems, and migraines. Fructose intolerance manifests differently in each person, and you may not experience any non-digestive symptoms.

Every person responds to food intolerances differently depending on their current mental or physical health, ability to cope with symptoms, and access to medical support. Symptoms vary in intensity, and certain foods or drinks may exacerbate or intensify more persistent or severe issues. For example, a sugar-free diet may be necessary for people with HFI.

Treatment for dietary fructose intolerance typically involves identifying which foods you can tolerate and which ones you cannot. You may experience only a few symptoms or all of them, depending on the severity of your condition.

Diagnosing Fructose Intolerance

What Is a Hydrogen Breath Test and How Does It Work?

A hydrogen breath test checks for extra hydrogen in the breath, which generally indicates bacterial overgrowth and digestive issues, such as difficulty absorbing carbohydrates. 

A breath test may confirm blood test results to ensure you receive an accurate diagnosis.

According to the Indian Journal of Clinical Biochemistry, “Hydrogen breath tests are widely used to explore pathophysiology of functional gastrointestinal (GI) disorders.” The test involves ingesting a specific amount of glucose and then collecting hydrogen breath levels. “Modern methods involve interval sampling of H2 breath samples after carbohydrate load.”

Once a breath test confirms whether you have an intolerance, your doctor can help you create a tailored meal plan to manage your condition.

What Role Do Blood Tests or Genetic Tests Play?

Doctors use blood tests or genetic tests to check for hereditary fructose intolerance. 

Genetic testing checks for mutations in the ALDOB gene, which provides the instructions for the aldolase B enzyme, responsible for breaking down dietary sugars. Blood tests check for abnormal liver or kidney function, blood glucose levels, and high uric acid.

Foods High in Fructose to Limit or Avoid

What Are the Main Fructose-Containing Foods?

Many foods people eat every day contain fructose, including processed foods with added sugars. 

Processed meats, savory dishes, and other foods you may not think could contain fructose often have added sugars. Always check labels to ensure you do not accidentally consume sugars that may cause discomfort or pain.

Some of the primary sweeteners and high fructose foods include: 

• Watermelon 
• Dried fruit 
• Ice cream
• Table sugar
• Prunes 

Be mindful of processed foods and hidden sources of fructose, including packaged snacks like granola bars, common condiments, sodas, other soft drinks, and fruit juices. Anything containing honey, agave syrup, maple syrup, high fructose corn syrup (HFCS), or other added sugars often has high levels of hidden fructose.

Low-Fructose Foods and Smart Substitutes

What Are the Best Low-Fructose Fruits and Vegetables?

Leafy vegetables and many fruits offer quick and easy low-fructose meal options. 

A few of the best low-fructose fruits and vegetables include: 

• Rhubarb 
• Blueberries, blackberries, strawberries
• Citrus fruits in moderation
• Honeydew and other melons
• Cucumbers
• Green beans
• Spinach
• Kale
• Lettuce

You can use these foods to make delicious meals, snacks, and desserts. Lettuce wraps, fruit salads, and sautéed vegetables are a few of the delicious meals you can make with low-fructose foods.

What Sweeteners Can You Use Instead of High-Fructose Corn Syrup?

People with dietary fructose intolerance can build up a sugar-free or low-fructose diet by using these artificial sweetener replacements: 

• Stevia
• Erythritol 
• Xylitol

Everyone has different dietary needs and intolerance triggers. Always consult with a medical professional before adding a new sweetener to your foods or drinks. Some people may also experience allergic reactions to artificial sweeteners, making it essential to monitor your reactions closely.

How Can a Dietitian Help You Build a Balanced Low-Fructose Diet?

A dietitian takes into consideration any current medical conditions or dietary requirements you may have and helps you develop a healthy, balanced, and fructose-free or low-fructose meal plan. 

A dietitian offers insights into various health topics related to your overall wellness. Cases involving pediatrics and hereditary fructose intolerance especially benefit from the expertise of a dietitian. A dietitian will ensure you or a loved one understands the amount of fructose you need or if you should avoid fructose entirely.

Creating a low-fructose diet with the support of a dietitian allows you to make educated decisions about your diet. Dietitians provide guidance and information on how to incorporate essential nutrients into your weekly meals.

LifeSpring Home Nutrition offers consultations with a dietitian for clients who have special dietary requirements.

Managing Fructose Intolerance Through Nutrition

How Can You Reduce Fructose Without Sacrificing Nutrition?

Some easy, low-fructose meal and snack ideas include fresh fruit or vegetables.

Fruits and veggies, like radish, carrot, cantaloupe, or seed snacks, make an excellent source of nutrients with little or no fructose. LifeSpring Home Nutrition helps support a low-fructose diet by offering a range of tailored meals.

The Connection Between Fructose Intolerance and Gut Health

How Does Fructose Malabsorption Affect Gut Bacteria?

Hereditary or dietary fructose intolerance disrupts the gut microbiome by causing bacteria to ferment undigested fructose, leading to a disturbance in the balance of gut bacteria.

Your gut microbiome impacts your physical and psychological health. Maintaining healthy gut bacteria reduces your risk of preventable diseases and other health conditions.

According to Heliyon, “Dietary high-fructose can increase intestinal permeability and circulatory endotoxin by changing the gut barrier function and microbial composition.” In addition, “Excess fructose transports to the liver and then triggers inflammation as well as de novo lipogenesis leading to hepatic steatosis.”

Fermentation of undigested fructose can cause bloating and discomfort in individuals with fructose intolerance. Probiotics and enzymes support better digestion by helping your body absorb more fructose, reducing the side effects of the fermentation process.

Living Well With Fructose Intolerance

How Can You Eat Out or Travel With a Low-Fructose Diet?

Planning your trip carefully and knowing where and what you plan to eat ahead of time will eliminate a lot of stress and make the journey easier.

Avoid eating street food unless you can confirm that it will meet your dietary needs. Always be cautious when eating at new or unfamiliar places to prevent cross-contamination or other potential issues.

Be careful when travelling to make plans to accommodate your low-fructose diet, including: 

• Checking online menus 
• Packing your own snacks before you leave 
• Communicating your dietary needs to restaurant staff 

Always exercise caution when eating in a new area or trying unfamiliar foods. Some people may not be aware of what a low-fructose or zero-sugar diet means and may unintentionally give incorrect information about menu items. Always be clear and transparent about your needs to reduce the risk of accidental exposure.

What Role Do Hydration and Fiber Play in Digestive Health?

Hydration plays a crucial role in breaking down food and facilitating its passage through the digestive tract. Fiber prevents constipation and contributes to a healthy gut microbiome. 

Adults should drink a minimum of two liters of water a day to remain properly hydrated. Some medications or medical conditions may require you to drink more to stay hydrated. In addition to breaking down food, hydration also improves nutrient absorption.

Fiber, combined with water, softens stool and facilitates its passage through the large intestine. Some forms of fiber, known as prebiotics, improve the health of beneficial gut bacteria. Fiber also reduces your risk of specific medical issues, including hemorrhoids or diverticulitis.

How Can Frozen Meals Offer Flexibility and Freedom for Those Managing Food Intolerances?

Frozen foods retain their nutrients and have a much longer shelf life compared to fresh foods. 

Flash-frozen meals offer pre-portioned, convenient, and easily identifiable options that provide greater freedom in your diet. LifeSpring Home Nutrition utilizes a flash-freezing process to prepare food for delivery, ensuring clients receive the highest quality food.

In addition, the source of some food intolerances may increase as food ages. Freezing food prevents it from gaining extra sugars through natural processes before you eat it.

Frequently Asked Questions About Fructose Intolerance

Can you outgrow fructose intolerance?

The type of fructose intolerance you have will determine whether it can be managed with a dietary approach. 

Hereditary fructose intolerance is a lifelong condition. However, dietary fructose intolerance may improve over time with careful nutritional adjustments. You can work with a dietitian or your doctor to remove foods with fructose from your diet and then slowly reintroduce them to identify your specific triggers.

Is fructose intolerance the same as a sugar allergy?

No. A sugar allergy involves the immune system, while fructose intolerance involves the digestive system. 

Both conditions cause people to experience uncomfortable and painful side effects. However, they have very different causes and treatments. People with a sugar allergy generally cannot ingest any sugar without experiencing symptoms, while those with dietary fructose intolerance may eat some sugars without experiencing symptoms.

You should consult with a medical professional if you believe you may have a sugar allergy or intolerance.

LifeSpring Home Nutrition offers medically tailored meals (MTMs) to help you adhere to the strict dietary guidelines provided by your care team. You can enjoy delicious, home-delivered meals without worrying about potential exposure to dietary sugars.

How much fructose is safe to eat per day?

Most people with dietary fructose intolerance can safely eat up to 10-15 grams of fructose a day.

A complete lack of dietary fructose may lead to deficiencies and other issues for individuals with a dietary intolerance. However, people with hereditary fructose intolerance usually follow a strict fructose-free diet.

Under the supervision of a dietitian or other medical professional, a fructose-free diet is safe for long-term use when necessary to ensure your health and safety.

Can fructose intolerance be confused with lactose intolerance?

Yes! Many symptoms overlap between lactose intolerance and fructose intolerance, as both conditions result in gut fermentation. 

Some people may find it challenging to distinguish between fructose intolerance and other food sensitivities or allergies. For example, lactose intolerance often causes bloating, excessive gas, abdominal discomfort, nausea, and vomiting. Fructose intolerance has the same symptoms. Although both conditions have different root causes, they look similar.

When should you talk to a gastroenterologist or healthcare provider about digestive symptoms?

The digestive system has a direct impact on many body systems, and any issues should be taken seriously to minimize your risk of malnutrition or nutrient deficiencies. 

If you begin to notice digestive or gastrointestinal issues, monitor your symptoms and potential triggers. A doctor can use that information during their assessment to make an accurate diagnosis.

If you notice the following issues, seek help from your doctor or another medical expert: 

• Blood in stool
• Persistent and severe abdominal pain
• Unintended and unexplained weight loss
• Chronic diarrhea or constipation 

Many people hesitate to get help when they have significant or life-threatening health issues because the symptoms do not feel dangerous. If mild symptoms last longer than two weeks, seek medical advice.

However, if you see blood in your stool or experience severe pain that does not subside, consult a doctor promptly, and they will refer you to a gastroenterologist or other specialist if necessary.

Fructose intolerance can significantly impact your quality of life and general health. LifeSpring Home Nutrition provides low-fructose meals to ensure you have a balanced diet that allows you to avoid high levels of fructose. To learn more about our services and to receive weekly meal deliveries, call us today at (800) 798-5767.