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Diet and Nutrition 2023

Intolerância à fructose: what é, main symptoms and what to eat

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Intolerância à fructose: what é, main symptoms and what to eat
Intolerância à fructose: what é, main symptoms and what to eat

Fructose intolerance corresponds to the difficulty in absorbing foods rich in this type of sugar, which can lead to the appearance of some symptoms, such as nausea, vomiting, excessive sweating, diarrhea and abdominal distension after consumption of foods rich in fructose.

Fructose is a type of sugar mainly found in fruits, however vegetables, cereals and some industrialized products also have this sugar in their composition. Thus, it is important to identify foods rich in this sugar that cause symptoms and avoid them.

Main symptoms

Fructose malabsorption can be hereditary and, therefore, symptoms often appear in the first 6 months of life, however, intolerance can be acquired throughout life due to intestinal changes that can cause difficulty in the digestion of this compound, as in the case of irritable bowel syndrome.The main symptoms indicative of fructose intolerance are:

  • Nausea and vomiting;
  • Cold sweat;
  • Abdominal pain;
  • Lack of appetite;
  • Diarrhea or constipation;
  • Excessive gas;
  • Swollen belly;
  • Irritability;
  • Dizziness.

As breast milk does not contain fructose, the baby only starts to have symptoms when he starts to ingest artificial milk, milk formulas, or with the introduction of foods, such as baby food, juices or fruits.

If the amount of sugar consumed by the child with intolerance is very large, there may be more serious symptoms such as apathy, convulsions and even coma. However, it is important to remember that the presence of gas, diarrhea and a swollen belly can also be symptoms of lactose intolerance, and it is important that the child is evaluated by the doctor.

How to confirm the diagnosis

The diagnosis of fructose intolerance is made by the gastroenterologist, endocrinologist or nutrologist, who evaluate the person's clinical history, and a test is performed with the withdrawal of fructose from the diet and observation of the improvement of symptoms.

If in doubt, urine and blood tests can also be performed to assess the effects of fructose on the body, in addition to the expired hydrogen test, which is an exam that measures, through breathing, the of fructose absorption by the body.

Allowed foods

As fructose intolerance varies from person to person and has different degrees, ranging from mild, moderate to severe, consumption restriction must be adjusted according to each case. Therefore, it is important to seek guidance from a nutritionist so that a nutritional plan suitable for the person's needs is indicated, as well as follow-up and educate the person on the subject.

In addition, it is also important that the person keeps a food diary, in which the foods consumed and the reactions observed in the body must be recorded. See how to make a food diary.

It is important to give preference to foods prepared at home, in addition to checking the label of the products before consuming them, so that foods must not contain high fructose corn syrup, fructose, sucrose, sugar, sorbitol and molasses. Some of the foods that do not have fructose and can be consumed are:

  • Dairy products such as milk, butter, cheese and plain yogurt;
  • Sweeteners, such as stevia;
  • Dried fruits and seeds, such as walnuts, peanuts, chestnuts, hazelnuts, chia, sesame, flaxseeds and sesame;
  • Spices such as s alt, vinegar, herbs and spices;
  • Cereais, such as oats, barley, rye, rice, brown rice and products prepared from them, such as bread, crackers and cereals, provided they do not contain fructose, sucrose, sorbitol, honey, molasses or corn syrup;
  • Animal proteins, such as white and red meat, fish and eggs;
  • Drinks, such as water, tea, coffee and cocoa.

A FODMAP diet could be of great help in solving the problem of fructose malabsorption. This diet has the principle of removing from the diet foods that are poorly absorbed in the small intestine and that are fermented by bacteria belonging to the intestinal microbiota, such as fructose, lactose, galacto-oligosaccharides and sugar alcohols.

This diet should be carried out for a period of 6 to 8 weeks, and the person should be aware of any improvement in gastrointestinal symptoms. If symptoms improve after 8 weeks, foods should be progressively reintroduced, starting with one food group at a time, so that it is possible to identify what causes abdominal discomfort, and consumption should be avoided or consumed in small amounts.Learn more about the FODMAP diet.

Foods to avoid

There are foods that contain high amounts of fructose and other low amounts, which should be excluded from everyday life or consumed according to the person's tolerance level, as follows:

Category Low Fructose High fructose content
Fruits Avocado, lemon, pineapple, strawberry, tangerine, orange, banana, blackberry and melon All fruits not mentioned above. Special attention should be paid to juices, dried fruits such as plums, raisins or dates and canned fruits, syrups and jams
Vegetables Carrots, celery, spinach, rhubarb, beets, potatoes, turnip greens, squash, brussels sprouts, cauliflower, lettuce, cabbage, tomatoes, radishes, chives, green peppers, white carrots Artichokes, asparagus, broccoli, peppers, mushrooms, leeks, okra, onions, peas, red peppers, tomato sauce and products containing tomatoes
Cereals Buckwheat flour, nachos, corn tortillas, gluten free bread, crackers, popcorn and quinoa Foods with wheat as the main ingredient (wheat bread, pasta, and couscous), cereals with dried fruit, and cereals containing high-fructose corn syrup

Products such as fruit yogurts, ice cream, soft drinks, box juices, cereal bars, ketchup, mayonnaise, industrialized sauces, artificial honey, diet and light products, chocolates, cakes, puddings, fast foods should also be avoided, caramel, white sugar, honey, molasses, corn syrup, fructose, sucrose and sorbitol, in addition to processed meats and sausages, such as sausage and ham, for example.

Some foods such as peas, lentils, beans, chickpeas, white beans, corn and soy can cause gas and, therefore, their consumption depends on the person's tolerance. Although it can be a difficult task, people with this type of intolerance should avoid consuming fructose, as if consumption is not controlled, serious complications such as kidney or liver failure can arise.

Fructose intolerance menu

An example of a he althy menu for people with fructose intolerance might be:

Meal Day 1 Day 2 Day 3
Breakfast 200 ml of milk + 2 scrambled eggs with cheese + 1 slice of bread 1 plain yogurt + 2 teaspoons chia seeds + 6 walnuts 200 ml of cocoa milk + 2 slices of wholegrain bread with white cheese
Morning Snack 10 cashew nuts 4 wholemeal toast with cottage cheese 1 homemade oatmeal muffin sweetened with stevia
Lunch 90 grams grilled chicken breast + 1 cup brown rice + lettuce salad with grated carrots + 1 teaspoon olive oil 90 grams of fish fillet + 1 cup of mashed potatoes + spinach with olive oil 90 grams of turkey breast + 2 boiled potatoes + Swiss chard with olive oil and 5 walnuts
Afternoon Snack 1 plain yogurt Herbal tea + 1 slice of rye bread with ricotta cheese 200 ml cocoa milk + mix of nuts, walnuts and almonds

It is important to remember that you should always check the label of processed foods to make sure they do not contain ingredients prohibited in fructose intolerance, such as honey, molasses, corn syrup and the sweeteners saccharin and sorbitol. In general, diet and light products, cookies, ready-to-eat drinks and bakery products usually contain these ingredients.

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