Fructose intolerance

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jayburd
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Fructose intolerance

Post by jayburd »

Hello! I'm new to the forum as of today (07/30/06). I've been eating a high-fruit diet for some time now (3 years). I've gone through periods of purely raw fruitarian dieting and more Paleo inspired diets, to the conventional Western Diet thoughout these three years. Throughout the past couple of monthes I have only been on a Peleo/Raw regime, and have just started the fruit, oil, and raw animal products method a few days ago.

One thing has been constant for me with eating high-fruit. (When I say high-fruit, I simply mean that the majority of my food intake is fruit (when not eating raw)). This one constant thing is that I experience abdominal bloating and distension when I eat fruit, and it is pretty uncomfortable. Some fruits seem to increase the intensity more than others (such as Apples, Mango, and dried fruits), and fruits like Bananas, Muskmelon, and other fruits that have at least a 50/50 fructose/glucose ratio don't seem to give me as much of a problem.

I've recently become aware of information (via the Internet) about fructose malabsorption. Essentially I have learned that the majority of people do not FULLY absorb fructose, and that fructose by itself is almost not absorbed at all (or something to that extent). Fructose, however, in the presence of equal amounts of glucose (which is the case for some fruits) is shown to be absorbed very well, if not completely, hence the importance of a 50/50 fructose to glucose ration in fruit.

Back to my main point... I experience bloating and abdominal distension regardless of the type of fruit I eat, to differing extents. I do not get gas in the form of flatulance, but it is obvious that there seems to be some type of malabsorption going on in that the food is reaching my intestines not completely digested/absorbed and feeding intestinal bacteria, which in turn produce gases that result in my bloating and distension. Could I be eating to much fruit at one time?

I should note that this is the case even when following the Wai diet VERY strictly. I eat sweet fruits, a good variety (I limit the dried fruits), do not juice, and consume coconut oil with ripe banana (which digests very well, as I follow very strict food combining rules) or alone. I have only just started including fresh raw egg yolk in my diet, as I am still new to coming on board to that. I should also note that I "religiously" peel all of my fruit and ensure I only eat adequately ripe fruits. I also do not eat ANY vegetables, as I know from personal experience that these can cause quite a bit of digestive upset.

My ultimate question is whether anyone else seems to have this type of problem? I am about 99% certain that it is the fruit that is causing me this uncomfortable problem because when I used to eat a paleo diet, I was eating only fruit and cooked meat. When I ate the cooked meat, the abdominal bloating and distension minimized quite a bit about an hour after the meal, but once I started having fruit about 4 hours after a meat meal, the bloating and distension returned.

I'd appreciate anyone's analysis of my situation, regardless of whether you can personally relate. Could this be a fructose malabsorption problem? Does anyone think that this is something that I should be worried about?

I'd like to add that I generally have a case of dry eye, which seems to have come about at the time I started going high-fruit (about 3 years ago). I've read on a particular site on fructose malabsorption that "achy eyes" is a common symptom, as well as the more common abdominal bloating and distension. The only course of "cure" for such a condition is avoidance of fructose (i.e., fruit in my case), a prospect of which I am not very happy about. Has anyone else experienced any problems with dry/achy eyes due to high-fruit consumption, or does this just seem to be a personal problem for me? I'd like to say that I do think I'm getting enough fat everyday according to the Wai methods.

Just as a note, as a "youngin," I had a light acne problem and went on one course of Accutane (which I regret now). I've always thought this might have something to do with a shrinkage of the oil glands in/around my eyes, creating a dry condition for my eyes, but have never been sure because the problem didn't occur while I was on the drug or relatively closely after stopping it, only after going high-fruit.

What do you think? Would love to hear any suggestions on how to reduce the distension, or any other members' personal accounts.

Thanks! And I'd like to say this is a great forum, even though I do not follow the Wai methods for acne reasons, but for mental and physical health.
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Oscar
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Post by Oscar »

Hello Jayburd, welcome on the forum. :)

I can't say I'm experiencing the bloating you describe, nor the dry eyes.
You say you've been on a Paleo/Raw diet for the past months, what exactly doet that mean? If it included food which might thow off your digestive system i.e. intestines, it could be that it still needs time to recover.

Since you don't experience flatulence, the bloating doesn't seem like normal gas production, which happens in the colon, and subsequently passes through the rectum. Hence it seems more likely the problem lies in the small intestines. Bacteria might have spread from the colon, or the muscles might not work properly in moving the food through. The latter is called a functional obstruction.
A functional obstruction is not caused by an actual physical blockage, but rather by the poor functioning of the muscles of the stomach or intestines that propel the intestinal contents. When these muscles are not working normally, the intestinal contents will accumulate and distend the abdomen.
It could be an absorption problem, but I don't know enough of it to answer that... :?

Oh btw, I'm also in it for general health... ;)
jayburd
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Post by jayburd »

Thanks for your response, Oscar.

Sorry for not being clear before. What I meant by Paleo/Raw diet is that for, let's see, 22 days now I have conformed to a diet known as the Specific Carbohydrate Diet (see: http://www.breakingtheviciouscycle.info/index.htm for detailed information). I've pursued this diet because over the past few years I have been experiencing chronic difficulties with my digestion, namely IBS, all of which i have been able to manage much more successfully, with the exception of my abdominal bloating and distension. The idea is that starches, di-, and poly-saccharides all contribute to a damaged, mucus lined intestine (large & small). So, until a few days ago, my diet mostly consisted of cooked meat/eggs and mostly fresh sweet fruit. The past few days I've been only fruit and coconut oil and small amounts of raw egg yolk (Wai).

I should note that I misstated that I don't experience flatulence, but it is very little and is not of a foul odor. It seems small compared to the level of bloating and distension I experience. (In other words, I should be farting out a heck of a lot more gas that I am if it really is gas that is producing my bloating/distension).

You are lucky to not be experiencing the problems I am, as I wish to pursue a Wai-type diet, but as much as I try, it doesn't seem to agree with my system 100%.

Here are some medical study abstracts from PubMed.gov that coorelate with my symptoms:

http://en.wikipedia.org/wiki/Fructose_malabsorption

http://www.ncbi.nlm.nih.gov/entrez/...

http://www.ncbi.nlm.nih.gov/entrez/...
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Oscar
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Post by Oscar »

I will read the articles later, but it's my bedtime now... :?

IBS means the intestinal muscles don't function as they should, no? Also, your bowels might be more sensitive. Fiber irritates the intestines, so maybe you could juice a bit more, and eat smaller meals to start off with. Other than that I'd just keep with the diet and see how things develop. Some changes might take quite some time, unfortunately. :?
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Post by benzapp »

In general, its been my experience that any feelings of bloating can be eliminated by peeling fruits. Its very tempting, especially in the summer, to eat lots of fruits like peaches, plums, etc to the extreme.

The skin of these fruits doesn't digest well in my experience, so try to peel them first.
jayburd
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Post by jayburd »

I'd just like to note that in my original post, I noted that I peel ALL fruits. I am becoming more and more convinced that I have fructose malabsorption. I must refrain from eating fruit and can no longer pursue this diet completely.
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Oscar
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Post by Oscar »

The only problem with diagnosing what your problem is, is that the circumstances for your intestines so far haven't been optimal. This means that there are a number of options still available. In order to be able to make a successful diagnose, you have to eliminate possibilities, by following an elimination diet, namely the Wai diet (ie Acne Sample Diet). A few days isn't enough though, I'd say more a few weeks, to notice changes.

Did you already take a hydrogen breath test, as suggested in the Wikipedia article?
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RRM
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Re: Fructose intolerance (abdominal bloating & distensio

Post by RRM »

jayburd wrote:... fruits like Bananas, Muskmelon, and other fruits that have at least a 50/50 fructose/glucose ratio don't seem to give me as much of a problem.
...
I must refrain from eating fruit and can no longer pursue this diet completely.
You dont need to stop at all; there are plenty of fruits you can eat... (see second section)

ratio glucose / fructose

apples 2,0 / 5,7
pears 1,7 / 6,7
pineapple 2,1 / 2,4
orange 2,3 / 2,6
kiwi 4,3 / 4,6
avocado 0,1 / 0,2
guava 2,1 / 3,4
mango 0,9 / 2,6
peach 1,0 / 1,2
watermelon 2,0 / 3,9
grapes 7,2 / 7,4
raspberries 1,8 / 2,0
strawberries 2,2 / 2,3

mandarin 1,7 / 1,3
muskmelon 1,6 / 1,3
litchi (lychee) 5 / 3,2
papaya (paw paw) 1,0 / 0,3
grapefruit 2,4 / 2,1
banana 3,6 / 3,4
granadilla (passion-fruit) 3,6 / 2,8
apricot 1,7 / 0,9
sweet cherries 6,9 / 6,1
dried dates 25 / 25
dried figs 26 / 24
dried plums 16 / 9
raisin (sultana) 31 / 31
prickly pear (opuntie) 4,9 / 0,1
sapodilla 6 / 6
sapote 3,4 / 1,4
mirabelle 5,1 / 4,3

Fructose malabsorption is due to the limited capcity of our body to absorb free fructose.
Most fructose is absorbed when fructose and glucose are in balance (or when glucose dominates).
Free fructose (5 to 50 gram) may be absorbed by the GLUT5 and GLUT2 transport proteins, but that capacity is limited,
though upregulated (particularly GLUT5) when the diet normally contains much free fructose.
But in the presence of sufficient glucose, it may also go through the sucrase related transport system (embedded in the membrane of the small intestine),
and the fructose is then glucose-dependent cotransported.
This system favours sucrose though (as here fructose and glucose always come hand-in-hand),
so that additional sucrose inhibits the uptake of free fructose through the sucrase-related transport system.Fujisawa T et al Ushijima K et al Full Free Text
Marty
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colitis/IBS

Post by Marty »

Yes, I have posted also on the fruit sugars (and sugars in general) with sensitivity not to fibre but to type of sugar (fructose + glucose in equal proportion, as you say).

The combination of sugars I take seems to be very much a question of sensitivity that improves over time, once you notice this is the critical variable. For me it is perhaps because I had colitis a very long time and the intestinal wall was quite broken down; not able to digest the polysaccharides (complex linked sugars) it should; the simple sugars that are monosaccharides do not tax the large intestine for catalysis of them quite so much.

however, this gets better over time if you do not tax the system.

It is possible to take fruits almost exclusively in the form of juice.

For me, I peel large grapes and juice them; yes it is a lot of job, but white grape juice is very easy to digest (supplemented with oil). It's very easy to maintain this diet and adjust according to your individual sensitivity.

And I may say that your sensitivity is a moving target; the more I adhere to this, the more I can eat sucrose. And indeed it seems very hard to store energy; the way I eat sugars in the form of fructose + glucose very exactly mixed takes time, and I sometimes don't eat enough.... So it seems I am constantly sipping and making sure of hte next energy and monitoring all of this. I seem to have very few reserves.

But it works, and I keep eating this way, because you really do highlight both the sensitivity and the possibility of erasing or minimizing it, if only you listen to the body carefully.
djkvan
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Re: Fructose intolerance

Post by djkvan »

The easy workaround for fructose malabsorbers is to mix enough dextrose powder by weight to cover off excess free fructose. Easy to purchase in bulk sections of markets and quite easy to mix with OJ which does have quite some (1.25g) free fructose per cup.
I do so like green eggs and ham. Thank you, thank you. Sam I am.
djkvan
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Re: Fructose intolerance

Post by djkvan »

Just a correction... OJ contains only .22g fructose in excess of glucose per cup. I just consulted the USDA database and there appears to be an error in the Wai calculator as far as this value goes. Still .22g is significant if one cannot deal with free fructose at all as in my case it would yield 3.52g when drinking 4L OJ daily
I do so like green eggs and ham. Thank you, thank you. Sam I am.
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RRM
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Re: Fructose intolerance

Post by RRM »

djkvan wrote:
djkvan wrote:OJ which does have quite some (1.25g) free fructose per cup.
Just a correction... OJ contains only .22g fructose in excess of glucose per cup. I just consulted the USDA database and there appears to be an error in the Wai calculator as far as this value goes.
One cup of OJ:
in Wai calculator
5.70 g. glucose
6.94 g. fructose (free)

In source 2 (Souci et al)
5.70 g. glucose
6.94 g. fructose (free)

So, no error, other than that the source is not the USDA.
The USDA does not list fructose and glucose in raw OJ (#09206).
Which NDB number did you use as a source?
djkvan
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Re: Fructose intolerance

Post by djkvan »

Ahh... I see the errors: 1.) the database lists the NDB # for OJ from concentrate next to sugars on the raw OJ page; 2.) I did't notice this fact. LOL! Strange... why would there be such a large discrepancy between raw and concentrate levels for fructose? That can't be right... Would you be able to provide the souci value for OJ from concentrate if it exists? I know it's not Wai but I'm still trying to find a way to make this work for me and raw OJ creates additional symptoms vs. pasteurized concentrate. At least with concentrates I am able to maintain focus/mood. The information would be helpful so I can mix appropriate amounts of dextrose and not have to use too much each time. Thanks?
I do so like green eggs and ham. Thank you, thank you. Sam I am.
djkvan
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Re: Fructose intolerance

Post by djkvan »

Re: assisting fructose absorption with added glucose...

http://www.ncbi.nlm.nih.gov/pubmed/3202090
I do so like green eggs and ham. Thank you, thank you. Sam I am.
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RRM
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Re: Fructose intolerance

Post by RRM »

djkvan wrote: Would you be able to provide the souci value for OJ from concentrate if it exists?
Sorry, there is no "OJ from concentrate" in Souci, but...

In "OJ concentrate" it lists:
47.1% total available carbs
32.3% invert sugar
14.8% sucrose
no free glucose / fructose listed

In "OJ, unsweetened commercial product", it lists:
9.0% total available carbs
3.9% sucrose
2.6% fructose
2.5% glucose
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