The Fructose Malabsorption Elimination Diet
If you have been diagnosed with fructose malabsorption, chances are that you aren't feeling very well. Like most, you are probably desperate to find relief from your symptoms. It can be confusing and stressful trying to figure out what you can and can't eat, especially with lingering symptoms from foods you have already eaten. That is why it is so important to do an elimination diet before beginning to experiment with foods. First, feel better. Then start introducing foods to see if you can tolerate them. It will be easier to pinpoint trigger foods this way. So let's get started on that "feel better" part, shall we?
Low and Fructose-Free foods
I'll warn you, this list is going to be short and a bit bland. But trust me, it's worth the effort. If you know with certainty that you are not lactose intolerant (most fructose malabsorbers are), then you may eat small amounts of dairy in addition to the list below (milk, cottage cheese, hard cheeses like cheddar and parmesan, sour cream, or unflavored and unsweetened yogurt that does not contain inulin).
Season these with:
Butter (in moderation)
Meats that are not breaded or seasoned in any way (no bacon, ham, hot dogs, etc.)
Canola margarine or oil
Mayonnaise (no garlic or lemon in the ingredients)
Rice pasta (white only)
White rice (not brown)
How Long Does the Elimination Diet Last?
Follow the elimination diet for 3 to 4 weeks before reintroducing your first food. When you begin reintroducing foods, keep a journal and introduce them one item at a time. Note any symptoms that occur.
Wait three days, or until any side effects subside before introducing the next food. Since the tolerable amount of fructose varies for each individual, it would be worthwhile to test each food in varying amounts as well. Start with a small amount, and if there are no side effects, eat a larger amount later in the day and see what happens.
Symptoms to watch for
- Gas and bloating are the body's most common first reaction to fructose
- Diarrhea (this may not be instantaneous, either)
- GI pain
- Stuffy nose or other respiratory issues
- Brain fog / confusion
- Joint pain or inflammation
Reintroduce Food Groups One at a Time
People tend to have a different reaction to fructose than they do to fructans, raffinose and galactans, so work your way through one group before moving onto the next. I suggest trying each of these groups in the order they are listed:
- Fructose is in so many things, and since it isn't necessary to eliminate it completely, there are many vegetables and fruits that can be eaten in moderation. See this list of foods that are lower in fructose. It should be noted that fructose is more easily tolerated when consumed with other foods and when meals are kept small. Try spacing out smaller meals more frequently throughout the day and always eat fruit with a meal instead of on its own.
- Raffinose and galactans are found in beans, and if you find that beans are a problem, then you may also have trouble with foods like broccoli, Brussel’s sprouts, cabbage, cauliflower, kale, lentils, peas, soy products, turnip greens and whole grains.
- Fructans include agave, artichoke, asparagus, barley, chicory, dandelion greens, onions (including garlic, leeks and spring onions), radishes, rye and wheat. Save wheat until the end, as a gluten sensitivity is a condition all its own.
One thing I should mention before wrapping this up is that if you find at the end of your elimination diet, before you have reintroduced any foods, that you are still experiencing symptoms; you should consult your doctor for more testing. It would seem that fructose intolerance isn't the only thing going on in this case.
I hope these guidelines help and that you are well on your way to feeling better on a low fructose diet.
© 2013 Katie Hamre