Fructose Malabsorption

Posted by CL @lelia, Dec 5, 2018

I'd like to start a discussion on fructose malabsorption, how to control it, what to eat and not eat, etc. . Is anybody interested?

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In reply to @pjss48 "Thanks" + (show)
@pjss48

Hope it helps. Drugs and supplements can also be a problem (the "inactive" ingredients).

REPLY
@lelia

VERY LOW FRUCTOSE, LOW FODMAPS, AND GLUTEN FREE RECIPES AND DIET.
The recipes are very simple and delicious without any sugars to make it easier to stick to a restricted diet. We've developed them as we went along, and I want to share them to make it easier for others. No point in having to reinvent the wheel! Often we don't add seasonings until at the table, and then they are mostly salt and/or pepper. Note that browning food adds a lot of flavor!

I have fructose malabsorption, lactose intolerance, visceral hypersensitivity and sometimes small intestinal bacterial overgrowth. I am putting the recipes in the Fructose Malabsorption discussion section because I have found them to work for that condition, and it wasn't easy. There is so much that doesn't work, and it has been quite the journey since the viral food poisoning in 2002 I have yet to find a sugar or artificial sugar I can digest. I realize everybody is different, but we have to start somewhere. I welcome any tips anybody has; am still in the trial process and sometimes just don't feel like rocking the boat. Feel free to ask me any questions as well.

PART 1. CHICKEN BROTH. Just when you feel your worst you can only have chicken broth to eat. I have to make my own because all of the packaged versions I've seen have sugar(s) in them or seasoning I can't eat. Here's the easiest way I've found. Bring chicken thighs to a boil and simmer one hour or until done. Remove thighs. Using a measuring cup, pour the broth into wide mouthed canning jars. Place jars in refrigerator and hold until fat has solidified. Take the fat off, put the lids on (plastic are the best) and freeze. Alternately, take the fat off as you use the broth over a day or two. After thighs have cooled a bit, remove meat, divide into serving size portions, and freeze. Originally I used Cambell's no sodium chicken broth (no longer made) and was always very weak. The homemade version has much more nutrition and I never feel weak until the end of the second day or so.

PART 2. POULTRY. Bake the chicken, cornish hens or turkey. Boil white basmati rice. When the meat is done, remove from pan and set aside. Pour the drippings into a clear container such as a glass measuring cup, and let the fat rise to the top. After it has, skim it off with a gravy ladle or spoon. Then pour the drippings into the rice still in the rice pan. Serve with the meat. No seasonings are necessary while cooking; still delicious without them.

We also occasionally eat bacon-wrapped turkey tenders done on the George Foreman grill. I remove the bacon on a separate plate before eating the turkey; there is still a little sugar.

We also make canned chicken hash. We get the chicken at Trader Joe's because it has no additives (Trader Joe's Chunk White Chicken in Water). Microwave potatoes, peel, chop up and add to canned chicken. Mix in sage and/or thyme and a little extra virgin olive oil. Stir well. I sometime add a little bit of stir fried mushrooms.

PART 3. FISH. Salmon. Fry the salmon until well browned. At the same time, cook white basmati rice. When the salmon is done, remove from pan and set aside. Dump the cooked rice into the salmon pan and stir well, using the spatula to get up all the brown stuff in the pan. Serve the rice with the salmon. Again, no seasonings necessary.

Cod. Put in microwave dish. Drizzle with oil and add a little water. Cover and cook on high for about 6 minutes. As microwaves vary, check your unit's manual for cooking fish.

Orange roughy, tilapia, mahi mahi. Put in microwave dish. Drizzle with oil and add a little water. Sprinkle fish with thyme. Cover and cook on high for about 6 minutes. Again, check you microwave's directions.

Scallops. Boil basmati rice until done. Fry scallops until browned. Add rice to the scallops still in the scallops pan and stir, making sure you get up all the brown stuff. Serve.

PART 4. PORK. Fry pork chops until well browned.

PART 5. BEEF. Fry or grill hamburgers and steaks.
Meat loaf. 20 ounces ground beef, 1 c. quick oats, 2 eggs, 1/2 t pepper, 1/3 t ground sage, 2 T water. Mix all ingredients except meat and oats. Combine with meat and oats and stir well. Press lightly and evenly into greased loaf pan. Bake 350 degrees about 50 minutes.

Bacon wrapped fillets. We occasionally have these; I remove the bacon on a separate plate before eating the fillet. There is some sugar left on the fillet.

Arby's classic roast beef, plain, without the bun.

PART 6. EGGS. Fry, scramble, boil. I use canola oil. I eat eggs with fried potatoes and sometimes a piece of leftover pork chop from dinner. Occasionally I make an omelet with spinach (Trader Joe's frozen chopped spinach is great) and leftover cooked meat or fish from dinner.

PART 7. VEGETABLES. Cook all vegetables.
Spinach microwaves well. We steam the broccoli, broccolini and carrots. Broccolini or "baby broccoli" is actually a cross between broccoli and kale. Kale has fructans in it, so broccolini probably has some. However, it is so delicious and if eaten in moderation is tolerable. Incidentally, broccoli has lactose in it (and so probably broccolini) so I take a couple lactase tablets when eating it. Carrots have sugar in them, so I only eat one baby carrot every other day.

Green Swiss chard, celery in small amounts, and occasional mushrooms are also ok. Just learned mushrooms have polyols in them, but my reaction isn't that strong.

Potatoes. Boil, microwave or fry. Don't eat the skins because they have fructans in them.
Baked. Bake on the bottom shelf of the oven at 375 degrees so they are browned, giving them added flavor.
Fried. Microwave potatoes until done. Peel, chop up and brown on top of the stove. These are great with eggs, and especially good under fried eggs. I make enough for several meals and freeze in individual containers.
Mashed. Boil russets. When done, peel and mash, adding a little of the potato water (and broth if you have it). Add seasonings like sage or thyme if desired.
Arby's potato cakes.
Kettle brand potato chips, unsalted or salted. No crinkle chips - all I've seen have additives including sugars regardless of brand.
Onions. Rarely eat, and then only the clear liquid that comes out while quickly sautéing them. Remove the solids after sautéing. The solids, or the juice that isn't clear, are a definite no-no.

PART 8. GRAINS.
Oatmeal. Use quick oats. For a quick breakfast, microwave in a 2 c. measuring cup. Fill half full of oats and the remainder with water. Microwave on high about 1 1/2 minutes (or what your microwave specifies). It is good with Pompeian Extra Light Olive Oil sprinkled on top along with cinnamon.

Rice. White basmati rice works well. I believe brown rice has fructans in the husks. Tried jasmine rice but it tasted rather sweet compared to the basmati.
White rice noodles. Bought some but have yet to try them. Should be ok.

PART 9. GRILLING WITH A CHARCOAL GRILL.
This is the grill we have, and the starter fluid would get on the food and bother my stomach so we had to quit. Then discovered the "charcoal grill chimney starter," which is metal tube you fill with charcoal and then light newspapers underneath to start the charcoal. Now we can eat grilled food again!

PART 10. POT PIE TOPPER.
Bake russets at 375 degrees on the bottom shelf of the oven. When done, mash, adding egg and seasonings. Mold into desired shape

PART 11. OILS.
Canola oil
Olive oil - Pompeian Extra Light Tasting and Pompeian Extra Virgin olive oils are no sugar and very good tasting. Be careful and don't use just any olive oil, since olives are a fruit and olive oil often contains olive juice.

PART 12. SPICES AND HERBS. This is a tricky area.
Cinnamon, sage, thyme, salt and pepper are fine.
Tried rosemary, oregano, and fresh cilantro and these were not ok.
Basil and bay leaf are supposed to have no sugars, but have yet to try them.
Perhaps some no- sugar spices/herbs contain fructans?

PART 13. DESSERT.
Potato chips with cinnamon on them. My only dessert for years.

Nuts with cinnamon. Fry Planters Deluxe Mixed Nuts (remove the pistachios first) in Extra Light Tasting Olive Oil until browned. Add cinnamon after removing from pan. Let cool, and then store in refrigerator or freezer about 1 week to give the nuts a chance to absorb the cinnamon flavor. Nuts have sugars in them so eat in moderation.

Shortbread cookies. 1 c. almond flour (not meal), 1/4 t. salt, 1/4 c. Pompeian Extra Light Tasting olive oil, and 1 t. Frontier Coop Organic NonGMO vanilla extract. Eat in moderation. Almonds have fructans and perhaps fructose in them; vanilla extract has sugar in it

PART 14. BEVERAGES
I am still drinking mainly distilled water, since out city puts chloramines in the water and they bother my stomach. Can get by with a glass or 2 of city water daily but that's it. Plain black and plain green tea are supposed to be sugar free but have yet to try them.

Eating out, I ask for water from the faucet, no ice or lemon, since water through the pop machine has sugar in it.

PART 15. L-ALANINE AMINO ACID. This supplement has been shown by researchers at a university in Iowa to help the intestinal wall absorb fructose. It helps a lot. I use probably 8 t. a day when I eat potato chips, baby carrots, drugs/supplements that have sugar in them (more on this topic later), etc. If you get it at BulkSupplements.com it is very affordable. I get it as a powder and mix it in water before using. Put 2 heaping T in a 2 c. glass measuring cup, add 1/4 c. water, and microwave on high for about 1 1/2 minutes. After removing it from the microwave, stir well and then add water to the top of the measuring cup to make 2 cups.

PART 16. SUGAR CONTENT IN FOODS. The U.S. Department of Agriculture has a priceless site called USDA Food Composition Database, at
ndb.nal.usda.gov. Not only does the site give sugars in foods (fructose, sucrose, lactose, etc.), it RANKS the foods by sugar content. To look up basic foods or drinks, click on Nutrient Search, select up to 3 nutrients such as total sugars, fructose, etc., and then selected to food group you want to learn about, such as spices and herbs, cereal grans and pastas, etc. There are many other nutrients besides sugars, so the database would be useful for a lot of people. This database is the perfect example of your tax dollars at work!

This entry wouldn't be complete without thanking the doctors and staff at Mayo Clinic and our local university medical center, including a medical librarian (also an MD) who did a lot of online searching for me. My husband has also been a wonderful help, offering moral support, cooking, etc. I could not have gotten to this point without them. Also, thanks to Mayo for Mayo Clinic Connect so we can have a chance to help each other. 1/2/2019

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VERY LOW FRUCTOSE, LOW FODMAPS, AND GLUTEN FREE RECIPES AND DIET - SUPPLEMENTS AND DRUGS
Since the diet is so narrow, I also take calcium carbonate powder (NOW brand) or tablet (365 brand). Note that calcium carbonate is just as absorbable as calcium citrate (which has sugars - citrus- in it) if you take it with food according to one doctor, and my labs are normal for calcium. Also take Vit D3 2200 I.U. capsule (Solar), multivitamin/mineral (365 Age 50+ Multi Iron Free), and vitamin B complex (Naturemade Super B Complex.) I realize what I take may not work for everyone since we are all different, but this gives a start. Other supplements: L-glutamine (bulksupplements.com or Nutrabio.com), lactase (Lactaid Fast Act), probiotic (Flora Advanced adults Probiotic Seven Senior Specific Strains), and Phillips Milk of Magnesia. L-glutamine is supposed to heal the intestine; I use it as a maintenance dose. The same for the probiotic. Regarding the Phillips, I have the constipation version of fm, and use 4 T every 2d or 3rd day. I believe the food poisoning left me with a sluggish digestive system because I also need the prescription drug Creon for the pancreas even though it checks out normal. Tried stopping it and there was a noticeable difference. Also take a compounded drug, ketotifen, which I also tried stopping and realized I still need. Ketotifen is supposed to quiet the mast cells in the gut and it helps. My medical librarian found this for me (among many other things). Also take sucralfate, compounded. Finally, take OTC Prilosec which I'm trying to get off of. Am down to 1/4 tablet/ day. All for now.

REPLY
@lelia

Hope it helps. Drugs and supplements can also be a problem (the "inactive" ingredients).

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@guthealth, @baponline. I just posted an addition to the Very Low Fructose, etc. recipes and diet I listed above earlier. This entry talks about the drugs and supplements I take to augment/help digest the food. fyi. Hope it helps.

REPLY
In reply to @pjss48 "Thanks" + (show)
@pjss48

I just posted an addition to the Very Low Fructose menus and diet I entered above earlier. It deals with the drugs and supplements I take to augment/ help digest the food. fyi. Hope it helps.

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Where is your pvost on diet

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Where is the information on this diet.sample.of your menues for 1day

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@lelia

@guthealth, @baponline. I just posted an addition to the Very Low Fructose, etc. recipes and diet I listed above earlier. This entry talks about the drugs and supplements I take to augment/help digest the food. fyi. Hope it helps.

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Thank you very much for taking the time to share such valuable information.

REPLY
@lelia

@guthealth, @baponline. I just posted an addition to the Very Low Fructose, etc. recipes and diet I listed above earlier. This entry talks about the drugs and supplements I take to augment/help digest the food. fyi. Hope it helps.

Jump to this post

Thank you for taking the time to write all this information. Much appreciated.

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@pjss48

Where is the information on this diet.sample.of your menues for 1day

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If you go back up this page you'll come to it - it is a very long entry (5 pages when I typed out the draft on computer!) You can't miss it. Let me know if you have any other questions. Here is a sample of what we ate today. Brunch: oatmeal, a little bit of leftover salmon and rice, a few potato chips (for energy). Snack. Potato chips. Dinner: hamburger without the bun, baked potato, broccolini, baby carrot, a few potato chips with cinnamon for dessert. I'll eat one more time a couple hours before bedtime to insulate the stomach from the bedtime meds. That is always just a bit of Trader Joe's chunk white chicken in water. Hope this helps. Not too exciting today because I've tried too many new things lately.

REPLY
@baponline

Thanks to everyone. Alot of good info.
Regarding seasonings, have you tried any of the seed spices such as coriander, mustard, cumin, caraway, dill see, sesame seed, poppy seed, etc. to see if you can tolerate those?

I was diagnosed with FM with breathing test. I would highly recommend taking hydrogren breathing tests to anyone who doesn't have a definite diagnosis yet. (FM, Lactose, SIBO).
Regarding diet, I didn't just try low FODMAP. I did NO FODMAP. Total FODMAP elimination except for lactose since I know I don't have an issue with it. All I can say is my diet is very bland (but I'm not a foodie anyway). But never felt better. Slowly adding new foods per the Mayo Clinic FODMAP Eating Plan. It is very specific in the order in which you add categories and individual foods to see if you can tolerant them. I'm doing all of this with a nutritionist at Mayo. I know this is 'no fun', but for me having minimal food options is worth it.

I've also learned to get very good at reading labels. OTC meds are especially a problem. You wouldn't think cough medicine could cause an issue but it can.
Also, GI doc took me off Prilosec and said don't go back on. My stomach felt like it was on fire for at least 2 weeks but apparently it was part of the problem. Also absolutely no ibuprofen products or aspirin for me.
Don't know if any of this helps.

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Are you doing this in person with the Mayo nutritionist or remotely? I looked online and couldn't find the Mayo Clinic FODMAP Eating Plan. How do they determine the order of food reintroduction? What if you can't tolerate a food? Is that it for that category or do you just try each food separately regardless? For example, if you can't tolerate cabbage, do they then assume you can't tolerate cruciferous vegetables so you don't try them? How long do you wait before introducing a new food? Thanks. I'd appreciate any info you could give.

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