Fructose is a simple sugar that is naturally found in fruits and in some vegetables. We can also get it via packaged foods and beverages with fructose-containing sugars added during its manufacturing. Most of this fructose is metabolized by the liver to convert into energy sources. However, when taken in large amounts it can pose a health risk especially when one is fructose intolerant – in which case a diet with low fructose foods is recommended.
Dietary fructose intolerance is a common clinical problem that exhibits GI symptoms such as abdominal bloating, gas, flatulence, distension, pain, nausea, and diarrhea. Diagnosing this condition is not always simple as the symptoms overlap with other conditions such as IBS or irritable bowel syndrome. One widely adopted method of identifying fructose intolerance is breath testing after ingesting fructose, it’s called Hydrogen Breath Test.
When it comes to dietary management of fructose intolerance, there are no established guidelines. Generally, a patient with fructose intolerance will undergo an elimination phase – a diet with approximately 5g of fructose per day is introduced and kept for about 2 weeks. After the patient experiences relief from intolerance symptoms, then comes the re-introduction phase – food with slightly higher fructose is added back to the diet one at a time.
The re-introduction phase aims to identify the amount of fructose the patient can tolerate so they can come up with a diet that is the least restrictive (so the patient doesn’t necessarily feel deprived of certain foods) but still keeping symptoms under control. This is of course done under a healthcare provider’s guidance.
If you are experiencing any of the symptoms mentioned above, perhaps a diet with low fructose foods can benefit you. Seek a professional’s help to guide you in starting a low fructose diet. It is, however, to your advantage if you know what are the types of low fructose foods. It will give you an idea of how more or less a low fructose diet would look like.
To get you started, here is the list of low fructose foods that you may want to include in your meal planning:
Low Fructose Foods
Arugula has a peppery and slightly spicy and bitter taste. It’s great for salads, pasta, toppings, and even smoothies. It is also sometimes referred to as salad rocket, Italian cress, or rucola.
It contains calcium, potassium, folate, and vitamins A, C, and K. Arugula may help in blood clotting, boosting bone and tooth health as well as the immune system, and supporting heart, kidney, lung, and nerve function.
Blackberries have a sweet and sour taste. And just like raspberries, they are aggregate fruits which simply means that the big piece that we see is composed of dozens of tiny fruits growing together, they’re called drupletes.
Blackberries are rich in vitamin C and fiber. They are also great sources of vitamin K and manganese. It may help in reducing cholesterol, promoting bowel movements, managing sugar levels, lowering oxidative stress, and supporting blood clotting, bone development, and the immune system.
Brown sugar has a deep and caramel-like flavor because of the added molasses. It is slightly less sweet than white sugar and has a moist and clumpy texture. Brown sugar is also much lower in calories than white sugar.
Brown sugar contains iron, potassium, zinc, calcium, copper, phosphorus, and vitamin B6. It also has anti-inflammatory, anti-allergic, and anti-bacterial properties. It may aid in boosting digestion, curbing menstrual cramps, and supporting healthy skin.
Cantaloupe has a distinctive sweet flavor with a juicy and tender texture. It is actually the most popular type of melon in the United States. It’s a great snack idea and is also often used in fruit salads, smoothies, sorbets, and ice cream.
It’s rich in beta carotene, in fact, a study shows that it contains the same amount of beta-carotene as carrots. Cantaloupes also contain vitamin C, folate, potassium, and fiber. It may help in reducing the length of common colds in adults, preventing birth defects, reducing the risk of heart disease and diabetes, and helping lose weight.
Cucumber has a mild and slightly sweet flavor with a cool and crisp texture. When eaten with the skin on, there is a noticeable earthier taste. It’s great for salads, smoothies, coleslaw, snacks, or smoothies.
Cucumbers are actually rich in phytonutrients and vitamin K. It is also a good source of pantothenic acid and molybdenum. Cucumbers also contain copper, manganese vitamin C, potassium, phosphorus, magnesium, and vitamin B. It’s good for hydration and detoxification. It may also help with regulating blood pressure, boosting digestion, reducing blood sugar, soothing eyes, and supporting skin, hair, and nail health.
Eggplant has a mild, sweet, and slightly vegetal bitterness taste. It has a firm and spongy texture when raw and meltingly tender when cooked.
Eggplant provides a good amount of fiber. It also has manganese, folate, potassium, vitamin K, and vitamin C. It also has small amounts of niacin, magnesium, and copper. Eggplants are particularly high in antioxidants, like anthocyanins, that protect against cellular damage.
Kiwi tastes like a combination of banana, strawberry, and pineapple with a tartness similar to citrus. When it’s ripe, it leans more to tasting sweet than acidic. It can be enjoyed peeled and sliced or with skin on, simply cut in wedges and bite through the flesh.
Kiwi is particularly high in vitamin C. It’s also rich in dietary fiber. Kiwi also contains iron, carotenoids, and antioxidants. It may help in supporting heart and digestive health, boosting immunity, treating asthma, and promoting overall eye health.
Oatmeal on its own is rather bland with a slight hint of earthy notes to it. When cooked, it smells somewhat nutty and toasty. Oats are actually one of the earliest cereals cultivated by man and can be traced in human diets as early as 7,000 BC.
Oatmeal is a good source of soluble fiber called beta-glucan which aids in promoting regularity, preventing constipation, supporting healthy gut bacteria, reducing symptoms of IBS and other intestinal problems, and lowering cholesterol and blood sugar levels. It also contains antioxidants called avenanthramides that help in reducing inflammation and relaxing arteries.
Orange has a sweet-tart taste. It’s commonly peeled and eaten fresh or squeezed to make orange juice. Its rind is usually discarded but can also be used in cooking, especially the outermost layer which can be scraped off (orange zest).
Orange is known for its vitamin C content which has antioxidant properties that help protect cells from damage. It also contains phytochemicals with anti-inflammatory, antiviral, and antimicrobial properties. Orange is also a good source of citrates which helps prevent kidney formation and flavonoids which help in preventing neurodegenerative conditions.
Papaya has a mild to fairly sweet taste with a creamy and butter-like texture. Other people liken its taste to cantaloupe or tropical mango. Unripe papaya, the green ones, can be used to make salad or soups. The ripe ones, you can simply scoop out the meat or slice in wedges and simply enjoy!
Papaya contains high levels of fiber and vitamins A, C, and E. These antioxidants help in reducing the risk of heart diseases, preventing oxidation of cholesterol, and boosting immunity. Its fiber content helps in lowering cholesterol levels. It also contains folic acid which is essential for converting amino acid homocysteine (primarily found in meat products) into less harmful amino acids.
Potatoes have a mild and slightly sweet taste with a medium starch, somewhat creamy, and quite dense texture. Fun fact, did you know that potatoes are 80% water?
Potatoes are rich in vitamin C and are a moderate source of iron. It’s also a good source of fiber, vitamins B1, B3, and B6, potassium, phosphorus, and magnesium. Potatoes also contain folate, pantothenic acid, riboflavin, and antioxidants. It can help in losing weight, keeping cholesterol and blood sugar levels in check, preventing diseases by fighting free radicals, and boosting digestive health.
Pure maple syrup
Pure maple syrup is very sweet with brown sugar and heavy molasses flavor – sometimes described as very caramelly. The flavor varies depending on the grade of the syrup, grade A or B. The dark amber-colored ones are made from sap extracted later in the harvest season and tend to have a stronger maple flavor.
Pure maple syrup contains manganese, zinc, calcium, zinc, iron, and potassium. It also has antioxidants, especially dark-colored ones. Keep in mind though, that it’s still high in sucrose. It’s just a better alternative to refined sugar but you’ll still have to watch out for your maple syrup intake.
Sourdough bread tastes quite similar to yeasted bread. But with the addition of a tangy note to it which basically comes from the natural acids in the sourdough starter. It’s often easier to digest compared to other bread that has been fermented with brewer’s yeast. This is because it contains lower amounts of gluten and antinutrients and more prebiotics.
Sourdough bread compared to other bread contain higher levels of vitamins, minerals, and antioxidants. Its nutrition profile is of course influenced by the type of flour used in making it – whole or refined grains. But generally, one made from white flour contains selenium, folate, thiamine, riboflavin, manganese, iron, and copper.
Tofu, uncooked, can taste very mild with a hint of sourness to it. However, they’re a great absorber of flavors. So, you can really get creative in flavoring them because they take flavor so well. You can stir fry or pan fry firm tofu because it holds together pretty well. Simmering or braising are also great ideas.
Tofu is particularly high in protein and contains all the essential amino acids. It also has manganese, calcium, selenium, phosphorus, copper, magnesium, iron, and zinc. It may help in reducing the risk of heart disease, certain types of cancer, and diabetes. Its isoflavone content may help in boosting bone health, brain function, skin elasticity, weight loss, and reducing menopause symptoms.
Key Notes for the Fructose Intolerant
You should watch out for products that contain fructose, HCFS, crystalline fructose, honey, agave, and fruit juice concentrates. These are usually found in sugary drinks, barbeque sauces, salad dressings, ketchup, sweets, and processed fruits.
We can’t stress enough the importance of reading food labels. Make it a habit – especially so when you have food sensitivities. You can’t simply take food products at face value, don’t get carried away with their marketing stunt. Oftentimes, the more they try hard to sell how healthy their products are, the more you should pay attention to their food labels.
Check medications and vitamins
Seek your pharmacist’s assistance (or even the manufacturer's) to check whether your medications or vitamins contain fructose and or sorbitol because this information is not always found on the label.
Perhaps seeking assistance to confirm the content (or lack of) fructose and sorbitol is the best route to take especially when one is not too well-versed with technical or scientific terms. Packaged leaflets are not exactly worded in layman terms, so when in doubt, simply ask for assistance.
Watch out for FODMAPs
FODMAP or Fermentable Oligosaccharides, Disaccharides, Mono-saccharides, And Polyols – is a group of carbohydrates that may also contribute to gas, bloating, constipation or diarrhea, and bloating. Fructose is included in this group, so if after following a low fructose diet, the symptoms still persist then consult with your healthcare provider for other possible problematic food in your diet.
People experiencing gastrointestinal symptoms after eating FODMAP foods are likely those with inflammatory bowel disease (IBS) and celiac disease. And if you are already sensitive to fructose, it’s also possible that you’re also sensitive to other hard-to-absorb sugars and may need to include foods low FODMAP in your diet as well. As always, seek first your healthcare provider’s recommendation.
Keep a food journal
You’ll find that keeping a journal of the food you eat and taking notes of the symptoms observed will help you greatly in managing your condition. It may not seem like a lot of help, but it’s actually the contrary. Simply taking notes of what you had for the day, what or what didn’t you observe after eating a particular food (and then repeated for a period of time), will give you a clearer view of your eating pattern.
With the help of a food journal, one will be able to create a more conducive diet – one that is gentle to your condition and at the same time is still well-balanced to meet your nutritional needs.