Re: fructose malabsorption
Hey GrammaSunshine! What a good Grandmother you are for looking on CureZone for solutions to your Granddaughter's issue. My mother has Fructose Malabsorbtion. She has found this book very helpful: "IBS--Free at Last!" available at Amazon here: http://amzn.com/0982063504 . An interesting thing many sufferers of "FructMal" have found is that pure glucose (like in a glucose tablet) can help avoid symptoms of accidental fructose consumption. One would take the glucose at the same time as the fructose to improve the absorption of the fructose.
This child needs to heal her gut by:
Avoiding Gluten (and possibly all grains)
Avoiding all allergic foods (you'll need to discover these)
Eating some protein with every meal
Correcting low stomach acid if she has that
Supplementing enzymes if she needs those
Consuming "Bone Broth" and/or gelatin
Supplementing with l-Glutamine
Taking high quality probiotics such as Therelac (not Threelac)
Using coconut oil
Eliminating parasites if she has them
The "GI Effects" Stool Analysis from Metametrix can be very helpful in determining which of the above steps are the most important, but a negative result means nothing. FructMal is a defect that can be corrected with proper nutrition, healing foods and removing gastrointestinal stressors. The key here is to focus on restoring integrity to her GI tract.
Here's an informative article on FructMal by Dr. Jon Dunn, Licensed Naturopathic Doctor:
(http://www.drjondunnnewsletters.com/Newsletters/2009-03Fructose.html)
Fructose Blues
Gastrointestinal aliments from lactose intolerance and gluten sensitivity are well known and generally are the most common causes for bowel problems, but few are aware of the havoc wrecked by fructose malabsorption. When avoidance of all milk and wheat products fails to resolve a gastrointestinal problem, the next step to consider is a fructose elimination trial. One out of three people have problems with fructose, acute symptoms include: gas, bloating, abdominal pain, cramping, nausea, diarrhea, constipation. Chronic fructose ailments may show with: esophageal reflux/GERD, depression, anger, insomnia, anxiety, irritability, attention disorders, headache, addictive behavior and fatigue.
Fructose is a simple sugar found in many foods, especially fruits, and in many packaged beverages and processed foods. Dietary intake of concentrated fructose has increased substantially over the last few decades overtaxing our ability to absorb it. Fructans are chains of fructose molecules found in fruits and some vegetables and grains, such as wheat and onions (see list below). Both fructose and fructans can cause problems.
Fructose Malabsorption Disorder (FM or FructMal) is the inability to absorb fructose and fructans. Two other less accurate names are: Fructose Intolerance and Dietary Fructose Intolerance. This condition is not to be confused with the rare disorder of hereditary fructose intolerance which can actually lead to death if not identified in early childhood.
FM is due to a deficiency of a protein in the small intestine. The function this protein is to grab a hold of fructose when it passes by, then pull the fructose into the intestinal lining for absorption. Lacking this protein, unabsorbed fructose continues on down into the large intestine where it feeds bacteria that create and release sizable amounts of hydrogen and methane. Initial negative gastrointestinal symptoms of FM generally show within a few hours of ingestion and take up to 3 days to resolve.
Unaddressed FM can lead to decreased nutrient absorption and deficiencies of: folic acid, tryptophan, glutathione (the most important amino acid for full body detoxification including heavy metals) and vitamins C and E causing a host of ailments both physical and mental.
What to do
You will need to avoid all fructose and fructans (see list below) for ten to fourteen days, however good results may show even within a few days. Occasionally the elimination needs to be longer, up to six weeks in rare cases to see results if your condition is really chronic. If a food or beverage tastes sweet and you are not sure, avoid it for the time being (carrot juice, rice milk, etc.). Once symptoms quiet down, you can begin slowly reintroducing eliminated foods, one to three a day, every day or two, using the lists below as a guide to find your level of tolerance. If you have a reaction, back away from the last foods introduced until symptoms quiet, then continue, minus the suspect offender(s). It is good to have a general understanding of the different types of sugars.
Sugar Review
Disaccharide (two sugar combination)
Sucrose: (common names: table sugar, cane sugar, saccharose) composed of glucose and fructose. Generally well tolerated with FM
Lactose: milk sugar made from galactose and glucose. Often not well tolerated with FM, however fermented dairy products which lack lactose are likely well tolerated: aged cheese for example. You will want to avoid all milk products during the initial elimination trial in case lactose intolerance is part of your problem.
Monosaccharides (single sugar molecule)
Fructose: a simple sugar found in many foods which gets metabolized in the liver.
Glucose (also called dextrose or corn sugar) is made within the body for energy and stored as fat. Commercial glucose comes from corn starch and other plants. Glucose alone is readily absorbed, and sucrose, made of fructose and glucose, is generally well absorbed because of the glucose component. This means that fruits with higher glucose content will be more tolerable. Some people will take a glucose tablet after ingesting fructose and likely get by if it is just a little fruit, but this will not work if you have a whole piece of apple pie. While glucose will bind with fructose to aide absorption, it will not help with the absorption of fructans.
Other sweeteners:
Sorbitol, Mannitol, Xylitol and the other ‘-ols’ inhibit fructose absorption and some of them contain fructose for a double whammy. So, if you have fructose with any of these ‘-ols’, symptoms will be worse.
After the Elimination
Initial reintroduction:
Once symptoms have quieted down, first try small servings of the less problematic foods due to a higher glucose to fructose ratio:
Fructose
avocado, grapefruit, green beans, lemon, lime, raspberry, rhubarb, orange, pineapple, potato (peeling may help), strawberry, tomato paste, zucchini
Fructans
artichoke, asparagus, beets, brown and wild rice, chicory, chocolate, garlic, granola, inulin, kamut, leek, legumes/beans, onion, parsnip, many protein bar products, soy products, spelt, sweet potato, wheat (sourdough bread is generally well tolerated because the fermentation process destroys the fructans)
Later Introduction:
If you tolerate the less problematic foods, go ahead and try some of the more problematic foods with high fructose to glucose ratio:
Agave, *apples, cherries, coconut milk, dried fruit, figs, grapes, guavas, honey, lychees, melons, mangos, maple syrup, molasses, paw-paws, *pears, peaches, persimmons, plums, prunes, raisins
* Worst offenders because they have both a high content of fructose, plus the fructose absorption inhibitor sorbitol.
Miscellaneous Fructose Tips
For many with FM, the concern is a cumulative one, with small occasional servings possibly being well tolerated especially when stress levels are low making for more effective digestion and absorption.
FM people often don’t tolerate probiotics such as acidophilus and bifidus and are particularly sensitive to prebiotics (nutrients which feed bacteria) such as fructo-oligosaccharides (FOS). If you are sensitive to probiotics then very likely you have FM.
Rye, oats, buckwheat, teff, millet, amaranth, tapioca flour, potato flour, corn flour and white rice seem to be fairly well tolerated with FM.
High fructose corn syrup (HFCS) is a ubiquitous additive in the food industry. Aside from being problematic with FM, it contains high levels of mercury. Young Americans consume about 70 grams a day of HFCS containing about 40mcg of mercury which is 10 times the reference range considered safe. It is also a common cause of non-alcoholic fatty liver. HFCS should be taken off the market.
Aside from FM, most Americans consume concentrated fructose at levels far beyond what the body can handle contributing to obesity, heart disease and diabetes.
Cooking and freezing may alter fructose content, increasing or decreasing the impact.
