Mayo Clinic Connect
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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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.
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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Thank you for providing these recipes. However, I would caution anyone with IBS to consult a list of high Fodmap Foods before preparing them. There are some foods that may be OK for the writer but may cause problems for others—e.g. mushrooms and broccoli.
The diet and recipes are low FODMAP, not no FODMAP. Perhaps we need to look at the big picture. I deliberately eat broccoli because broccoli and spinach are two of the most nutritious vegetables. I doubt if Sue Shepherd said to eat no FODMAPS. I can't eat brussel sprouts or cauliflower or kale, also of the same family. Anyway, since the rest of the food on the diet is very low or no FODMAPS, it may allow a person to eat a little FODMAPS like healthy broccoli. We alternate spinach and broccoli at dinner, one one day and the other the next, and don't eat huge portions of broccoli. Mushrooms we eat maybe once a month, a very small serving. We alternate oatmeal and eggs for breakfast, since the oatmeal is good for keeping LDL cholesterol down.
I developed this diet over the years after a bout of severe viral food poisoning that trashed my g.i. tract. I was hospitalized at the Mayo Clinic, and the nurse told my cousin they didn't know if they could save me. Of course they didn't tell me that, only that I had a massive infection. My cousin told me later; I wondered why my cousins quit visiting me in the hospital. They were afraid they'd get it. Anyway, if nothing else, this diet and recipes may give others hope that some day they'll get out of the pit they are in and regain a fair degree of normalcy.
Thank you for posting the recipes, taking so much time to explain how to prepare these foods and how you went about developing a diet that works for you.
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.
Thanks for the info! I haven't tried seeds because of visceral hypersensitivity. The L-Alanine powder I get is not so much a powder as granulated, and it bothers my stomach as is without dissolving it in water. I didn't know Mayo has a FODMAP eating plan – will have to take a look at it. Regarding meds, they can be a huge problem and my next step iis to talk about them. The so-called inactive ingredients often are active for people with fm.
High fructose, refined sugars, complex carbs all are hard for an inflamed intestine to digest and absorb and provide fuel for bad bacteria to feed on.
Sugarless gum too? Can you give specific foods?
Have you heard of and/or tried low FODMAP? I was diagnosed with GERD 20+ years ago but recently they found I am fructose intolerant. They put me on the FODMAP elimination diet/eating plan. Haven't felt better in years. Still in the food reintroduction phase. Lots of good information out there. Starting to think I never really had GERD.
What's left to eat?
I am also on the Low FODMAP diet. I was relapsing until I started working with a nutritionist about two months ago. Before then, I had suffered from chronic, nonstop diarrhea for three months and lost 20 pounds. I am now on my 21 day without diarrhea. I am in the early stages of recovery and slowly trying and introducing new foods. I am cautiously optimistic, and truly believe the diet is what has kept me from relapsing this time. I started the diet on my own and made many mistakes until I met with the nutritionist. My troubles started after taking Clindymycin. It was first thought I had CDiff but the GI doctor eventually diagnosed me with SIBO. Never thought an antibiotic could totally unbalance someone’s gut to this extent. I do believe diet is key to recovery in these cases and I am glad to read someone else is benefitting from it. Gives us all hope.
What do you eat ?
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.
Hope it helps. Drugs and supplements can also be a problem (the "inactive" ingredients).
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.
@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.
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.
Where is your pvost on diet
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