Fructose Malabsorption and Sugars

I would personally like to tell everybody to just eat everything in moderation and enjoy food as part of enjoying life. Unfortunately it is not that simple.
In the last hundred years the huge increase in complex sugars, chemical additives and the introduction and permutation of Genetically Modified Foods (GMOs) in our diet has led to an equally huge increase in health problems ranging from severe bowel disorders to obesity, diabetes and brain function disorders.

Our body has not adapted to these changes in our diet. Only recently scientists are beginning to understand the role of (intestinal) microbes in our body and their importance for our overall health.  The studies of food intolerances and food malabsorption (when food cannot be digested well) are finally gaining significance in the medical community. It turns out that these negative reactions to food are very often the basic cause of many illnesses and health problems (i.g. IBS, Diverticulitis, Crohn’s Disease, Asthma, Autism etc).

Food intolerances are causing an overgrowth of unhealthy bacteria in the gut (dysbiosis) and inflammation of the intestinal mucosa.

In addition to lactose and gluten intolerance (see my article from last month), a high percentage of people cannot digest fructose, a condition called fructose malabsorption.

Fructose malabsorption is a digestive disorder in which the absorption of fructose into the blood stream is impaired by a deficiency of a certain carrier substance (GLUT 2 and 5) that escorts the fructose across the intestinal wall into the bloodstream. Fructose that has not been adequately absorbed is metabolized by bacteria into fatty acids, producing the byproduct gases hydrogen, carbon dioxide and methane. These gases go via bloodstream into the lungs and are then expelled through the breath.  The hydrogen breath test is the clinical test for fructose malabsorption and lactose intolerance.

People with fructose malabsorption may notice that they react badly to fruits (which should normally be a very healthy food), sweets and starches (very often what seems to be gluten intolerance is actually a fructose or lactose problem). People cannot always identify their negative reactions to certain foods because they feel chronically not well due to gastrointestinal problems.

The list of problems ranges from bloating, flatulence, diarrhea, constipation, stomach pain, nausea, repetitive parasitic/amebic infections to even depression. The link to depression is the impaired production of serotonin (the wellbeing hormone) through dysbiosis and the inflamed intestinal mucosa (Triptophan-Serotonin metabolism). Lack of serotonin can also be the cause of chronic constipation.

Fructose is a simple monosaccharide found in many fruits and vegetables, along with glucose and lactose that are absorbed directly into the bloodstream during digestion. Interesting is that glucose, which is also found in fruits, works as a carrier of fructose into the bloodstream. This means that fruits balanced with almost equal amount of glucose and fructose are easier to tolerate than others with a higher ratio of fructose.

The only “treatment” of this condition is a strict fructose free diet for 2 – 4 weeks so that the inflamed digestive system can recover and heal.   After this time the body can usually tolerate about 30 g/per day of fructose.  Probiotics should be taken during this time or even longer, depend on the general condition.

Foods that should be avoided include:
Fruits, honey, agave nectar, corn syrup, table sugar (sucrose), fruit juices (they are extremely high in fructose), regular sodas, sport drinks, sweetened milk beverages, sweet yoghurt, ice cream and all sweets.
Dried fruit – apples, dates, figs, raisins, cranberries etc.
Foods containing sorbitol and xylitol (commonly added as artificial sweeteners in commercial foods).

In cases of fructose malabsorption it is also recommended to reduce the consumption of wheat products, cakes, cereals, pies, pastas and noodles.
For further information or detailed list of food please search internet or contact  Barbara Rotthaler, German certified Health Practitioner and Naturopath, Tel. (376) 1080 444, Sta.Isabela 240, Riberas de Pilar, email:,

One thought on “Fructose Malabsorption and Sugars

  1. I suffer from a sorbitol and fructose malabsorption and Im assuming because of the starch I struggle a lot with potatoes and rice as well. What would there be left to eat in those 2-4 weeks apart from meat and cheese if wheat products and pasta shouldn’t be consumed as well?

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