| Are you one of the three to five million Australians | | | | malabsorbers don't have to give up all fruit. "There are |
| who suffer Irritable Bowel Syndrome? | | | | still a lot of fruits that you can eat so it's choosing |
| If so, chances are you are also a sugar malabsorber. | | | | appropriate serves of fruit," McGrice explains. "For |
| Catherine Naghten finds out more. | | | | example, oranges are still going to be a good choice or |
| The best known form of sugar malabsorption is of | | | | peaches are still foing to be a good choice." In fact, |
| course, lactose intolerance, in which sufferers have | | | | most whole-fruits contain an adequate level of glucose, |
| insufficient enzyme levels to break down milk sugar. | | | | so you can still enjoy all berries, all stone fruits, citrus |
| Recently, however, researchers have begun to realize | | | | fruits, cantaloupe, grapes and even pineapples to name |
| that fructose malabsorption may be just as serious a | | | | just a few. "I encourage people to eat more natural |
| concern in the western world. | | | | foods, such as fresh fruit and vegetables rather than |
| As Accredited Practising Dietitian Melanie McGrice, | | | | foods with additives in them where possible," says |
| who specializes in the area explains: | | | | McGrice. |
| "Fructose malabsorption is a condition where the body | | | | The real problem occurs because fructose is also |
| doesn't break down fructose very well. So, the | | | | used to sweeten processed products such as soft |
| enzymes that breakdown fructose either aren't | | | | drinks, confectionary, diet products and a range of |
| present in as large a quantity as usual or they're not | | | | other foods. "These days it is a very common |
| working properly for some reason. Researchers have | | | | additive," says McGrice. When we eat these foods, |
| really just been looking into it over the last five years | | | | not only are we not getting the vitamins we'd get from |
| and now that they've found out that there is such a | | | | a piece of fruit but we're also getting a fructose |
| thing as fructose malabsorption, more and more | | | | sugar-hit that our bodies were never meant to deal |
| research is being done into it." | | | | with. While there only a few high-fructose fruits to |
| Symptoms vary between patients, however, as with | | | | reduce, people may also experience symptoms if they |
| lactose intolerance, the classic' Irritable Bowel' | | | | consume highly processed fruit, such as concentrated |
| symptoms are the most common. These include | | | | juices, rather than whole fruit. |
| bloating, stomach pain, irregular bowel motions and | | | | The last group of foods that may cause problems are |
| flatulence. "Some people actually don't have any | | | | those containing fructans, or chains of fructose. The |
| symptoms at all whereas other people will have very | | | | evidence on fructan foods, such as onions and wheat, |
| severe symptoms, and some people may only have | | | | is inconclusive at this stage, as they seem to product |
| one of the different symptoms. So they can really | | | | symptoms in some individuals but not in others. |
| range," notes McGrice. | | | | Feeling better |
| Research has recently linked the condition to | | | | Fructose malabsorption is diagnosed using a Hydrogen |
| symptoms of pre-menstrual depression and the early | | | | Breath Test at a hospital. This non-invasive procedure |
| stages of mental depression. It is thought that fructose | | | | involves drinking a glass of sweet fructose and |
| malabsorption causes lower than normal tryptophan | | | | breathing into a bag at intervals over a three-hour |
| levels, a chemical needed for sleep regulation and | | | | timeframe. In normal patients, the body digests |
| serotonin (happy hormone) production. The condition | | | | fructose efficiently, which produces no hydrogen. |
| may also play a role in low folic acid and zinc levels in | | | | When the body fails to digest the sugar, it is instead |
| older women and colic in infants who are regularly | | | | broken down by bacteria in the gut, which produce |
| given fruit juices. | | | | hydrogen as a by-product. |
| Who's at risk? | | | | There's no cure at this stage but people with fructose |
| Although it was only discovered recently, fructose | | | | malabsorption generally start feeling much better soon |
| malabsorption could be quite common, especially in | | | | after the problem is identified. "It's about treating the |
| people who eat a lot of processed foods or 'diet' | | | | symptoms and also by avoiding large amounts of |
| products, and in those who already have a dietary | | | | fructose," says McGrice. "A lot of people experience |
| problem such as celiac disease. One study, published in | | | | excellent relief purely by changing their diet." So who |
| The Israel Medical Association Journal, found that out | | | | knows, a more natural and unprocessed diet, high in |
| of 239 patients with Irritable Bowel symptoms, 44 per | | | | whole-foods, may not only be packed with vitamins, it |
| cent were in fact fructose malabsorbers. | | | | might even solve those niggling health complaints and |
| The treatment for fructose malabsorption is simple - | | | | omprove your overall feeling of wellbeing. |
| reduce the level of fructose in the diet- however mose | | | | Problem foods |
| sufferers are currently undiagnosed. "I think there's still | | | | Processed foods containing fructose: |
| a lot of doctors that haven't heard of fructose | | | | Corn syrup |
| malabsorption," says McGrice. "It's very new and | | | | High fructose corn syrup |
| doctors probably diagnose people with irritable bowel | | | | FOS Fructose-oligo saccharide |
| syndrome without knowing what's actually causing | | | | Some added sweeteners and sugars |
| those symptoms." The trouble with this, of course, is | | | | Many soft drinks and diet products (fructose |
| that these patients will continue to eat high-fructose | | | | doesn't have to be listed on labels) |
| foods and experience no improvement in their | | | | Concentrated fruit such as fruit juices, fruit straps |
| symptoms. | | | | and dried fruit |
| What foods? | | | | Natural foods with more fructose than glucose: |
| University of Sydney researchers found that even 20 | | | | Honey |
| to 50 per cent of healthy subjects have some | | | | Pears |
| intolerance to the pure fructose used as a sweetener | | | | Apples |
| in many processed foods. Interestingly, though, they | | | | Coconut milk |
| found that most people can digest fructose when it is | | | | Mangoes |
| combined with glucose, as is the case in most fruits | | | | Figs |
| and natural foods. | | | | Fructans are chains of fructose. |
| So, even though fructose is a fruit sugar, fructose | | | | |