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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@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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Another recipe, for breaded baked chicken. I used Trader Joe's frozen chicken pieces, thawed, because there are no bones, and Cream of Rice (raw) for the breading. Mix the cream of rice with a little salt and pepper and whatever herb you want. I used sage and thyme. Did the chicken pieces in a beaten egg and then in the breading mixture. Place on a greased baking dish and bake at 350 degrees for 30-40 minutes until chicken is done. This comes out with a bit of a crunch and is quite tasty.

REPLY
@lelia

The symptoms you can get from fructose malabsorption can be really horrible. I developed it after a case of viral food poisoning as severe as that caused by e coli, and it was almost fatal. You can't digest the fructose because the lining of the intestine is damaged. I had incredible gas and belching, bloating, and asthma from the gas, and didn't care whether I lived or died. What's to live for if you can't eat, breathe or sleep? I also got esophageal dysmotility and food caught in the esophagus (even scrambled eggs) and had GERD from it, and small intestinal bacterial overgrowth from it. One time had to blend all my food for weeks. Also have visceral hypersensitivity. Anyway, it took about 10 years to get it diagnosed; be sure to go to a reputable gastroenterologist, at a university medical center if possible. Mayo diagnosed mine. I have a friend who has it and she can eat a lot more sugar than I can. She figures if I can eat it so can she. I've found I can hardly eat any, including artificial sugars. I want to share what I've learned. By the way, I've been to 4 dietitians and none of their recommendations worked for me because my system is so intolerant of sugar. This is a minimalist diet but it's a good start if you're still struggling to discovered what you can eat. Here's what I eat: Protein: eggs, meat, fish (all unprocessed- no ham, sausages, etc). Carbs: potatoes without the skin, white Basmati rice, Kettle Brand Kettle Chips (for energy). Vegetables: cooked spinach, cooked broccoli (in moderation), broccolini (in moderation), one baby carrot every other day (has sugar in it). Since I also have lactose intolerance and broccoli and broccolini (?) have a bit of lactose in them, I take 2 lactase pills with those. Occasionally have mushrooms, a bit of celery, green Swiss chard. Whatever you do, don't ever eat garlic, and if you try onion, only eat a little of the clear juice, not the solids. Fruit: none. Drinks: distilled water. Spices and herbs: cinnamon, thyme, sage, salt, black pepper. Nuts: occasional small amounts of Planters Deluxe mixed nuts (remove the pistachios). Oils: canola oil, extra virgin olive oil, extra light olive oil. Be careful with olive oil - olives are a fruit, and other olive oils have olive fruit juice in them. Regarding no potato skins or brown rice, I believe they contain fructans, chains of fructose, also indigestible if you have fructose malabsorption. Anyway, if anyone knows of any spices/herbs that are ok, I'd appreciate knowing. I've tried oregano and rosemary and they didn't agree. Another thing I use is L-Alanine powder, an amino acid, which was found by a researcher at the U. of Iowa or Iowa State to help the intestine absorb fructose. I take probably 6 tsp. of this a day with the potato chips, etc. All for now. There is a web site that gives all the names for sugars, to help you identify them, and another that gives the sugar content of fruits, vegetables, etc. Next time. I'm not going to talk about FODMAPS etc. but just give practical advice that has worked for me.

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Does L-Alanine powder help you? where can you get it from ? I am suffering from Fructose inolerance and would like to try anything which helps.

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@suesood

Does L-Alanine powder help you? where can you get it from ? I am suffering from Fructose inolerance and would like to try anything which helps.

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It helps with small amounts of sugar, like in potato chips, nuts, and drugs/supplements with problem "inactive" ingredients. I get it from bulk supplements.com. I don't eat many nuts because but occasionally a few are ok. Good luck. Maybe the disolute mentioned three posts up would help. I haven't tried it yet.

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I also have fructose malabsorption also cannot have any sugars or fruits but didn't realize that cucumbers, peppers, tomatoes, and anything with seeds are also fruit. Cheated over the hoildays and paid the price for several months!

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@saucy

I also have fructose malabsorption also cannot have any sugars or fruits but didn't realize that cucumbers, peppers, tomatoes, and anything with seeds are also fruit. Cheated over the hoildays and paid the price for several months!

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Sorry to hear about your having to pay the price for several months! Most vegetables have sugar in them in some amount; the trick is to eat the lowest sugar ones possible. Tomatoes are technically a fruit, as are olives (never would have guessed that one!). Corn is a high sugar vegetable; the source of corn syrup, right?

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@lelia

The symptoms you can get from fructose malabsorption can be really horrible. I developed it after a case of viral food poisoning as severe as that caused by e coli, and it was almost fatal. You can't digest the fructose because the lining of the intestine is damaged. I had incredible gas and belching, bloating, and asthma from the gas, and didn't care whether I lived or died. What's to live for if you can't eat, breathe or sleep? I also got esophageal dysmotility and food caught in the esophagus (even scrambled eggs) and had GERD from it, and small intestinal bacterial overgrowth from it. One time had to blend all my food for weeks. Also have visceral hypersensitivity. Anyway, it took about 10 years to get it diagnosed; be sure to go to a reputable gastroenterologist, at a university medical center if possible. Mayo diagnosed mine. I have a friend who has it and she can eat a lot more sugar than I can. She figures if I can eat it so can she. I've found I can hardly eat any, including artificial sugars. I want to share what I've learned. By the way, I've been to 4 dietitians and none of their recommendations worked for me because my system is so intolerant of sugar. This is a minimalist diet but it's a good start if you're still struggling to discovered what you can eat. Here's what I eat: Protein: eggs, meat, fish (all unprocessed- no ham, sausages, etc). Carbs: potatoes without the skin, white Basmati rice, Kettle Brand Kettle Chips (for energy). Vegetables: cooked spinach, cooked broccoli (in moderation), broccolini (in moderation), one baby carrot every other day (has sugar in it). Since I also have lactose intolerance and broccoli and broccolini (?) have a bit of lactose in them, I take 2 lactase pills with those. Occasionally have mushrooms, a bit of celery, green Swiss chard. Whatever you do, don't ever eat garlic, and if you try onion, only eat a little of the clear juice, not the solids. Fruit: none. Drinks: distilled water. Spices and herbs: cinnamon, thyme, sage, salt, black pepper. Nuts: occasional small amounts of Planters Deluxe mixed nuts (remove the pistachios). Oils: canola oil, extra virgin olive oil, extra light olive oil. Be careful with olive oil - olives are a fruit, and other olive oils have olive fruit juice in them. Regarding no potato skins or brown rice, I believe they contain fructans, chains of fructose, also indigestible if you have fructose malabsorption. Anyway, if anyone knows of any spices/herbs that are ok, I'd appreciate knowing. I've tried oregano and rosemary and they didn't agree. Another thing I use is L-Alanine powder, an amino acid, which was found by a researcher at the U. of Iowa or Iowa State to help the intestine absorb fructose. I take probably 6 tsp. of this a day with the potato chips, etc. All for now. There is a web site that gives all the names for sugars, to help you identify them, and another that gives the sugar content of fruits, vegetables, etc. Next time. I'm not going to talk about FODMAPS etc. but just give practical advice that has worked for me.

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Thank you for sharing!

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@0712

Thank you for sharing!

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You're welcome! I couldn't see not doing what I could to help other people through this maze. Hope you feel better soon! Lelia

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@lelia

Thanks for asking. I haven't tried it yet because I am getting digestive issues from a Reclast infusion for osteoporosis. Am not trying anything new right now. I'll keep you posted, and thanks so much for the information and your helpfulness. Lelia

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RECLAST ALERT! More info on the Reclast infusion I had. If you have g.i. issues, DON'T get it! I finally had everything mostly under control after 17 years, and was actually sleeping lying down flat in the bed, etc. Now all food bothers my stomach, even that which used to be ok. I'm back on Prilosec and taking the maximum ashthma meds. I know it's the Reclast and not something else because I only change one variable at a time and getting the Reclast infusion was what I changed. I've also gotten a boatload of other quality of life threatening symptoms which I've never had before including labored breathing with exercise. Some non g.i. issues I already had were made worse by the Reclast. My primary doctor says to never get the infusion again, and even to not use any form of bisphosphonates of any kind such as pills. To see the list of about 118 possible side effects of ReclastI, go to the Mayo Clinic web site, select Patient Care..., then Drugs and Supplement A-Z, and then Zoledronic Acid (intravenous route). There are about 5 pages, the first being Descriptions, then Before Using (scroll down to Other Medical Problems and you will find stomach absorption problems), with the last screen being Side Effects. I only got 1/2 dose; wonder what hell I'd be going through it I'd gotten the full dose. The 1/2 dose should last 6 months; I'm 3 months into it and finally starting to feel little bit better the last day or so. I think it is because I've upped the amount of water I am drinking, to 11-12 8 oz glasses/day. Mayo says to drink 11 1/2 cups per day. I don't think this would include beverages with caffeine. That's it for now.

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I have been an IBS sufferer for many years and over the last 3 to 4 years had become worse. That's when I found out about LOW FODMAP diet. Having adopted it, am much much better over the last 2 years. Fructose intolerance could be associated with other intolerances like Lactose and Sorbitol. Hope you got these tested and eliminated. Fructose is found in many fruits -- Mangoes are the worst; jack fruit, very ripe bananas are others. I use an ANDROID app called "FODMAP" from Monash Univ, Australia -- who pioneered this diet. They have tested a large number of food sources and provide details of lactose, fructose, sorbitol content in different food items. You might find this useful to find the low FRUCTOSE foods.

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Sounds great if you can eat some fructose! Unfortunately the low FODMAP diet has too much for me. Thanks for sharing.

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