Nutrition Guide For Fructose Malabsorption

In the table below there are lists of foods – safe to eat, to try, and to avoid in fructose malabsorption, according to several dietitians’ and fructose malabsorbers’ recommendations. The list may serve only as an orientation, since absorption of fructose and other nutrients may vary considerably among individuals with FM, so everyone should make his/her personal lists of not/allowed foods and their tolerable amounts, according to his/her own experience. In small children fructose absorption often improves with age.

Table: Foods – safe, to try, and to avoid in fructose malabsorption

FOOD GROUP SAFE TO EAT TO TRY (IN MODERATION) TO AVOID
SUGARS AND SWEETENERS Acesulfam pottasium (Nutrinova, Sweet One, Sunnett, Ace-K, Acesulfame K), dextrin, glucose (dextrose, glucodin), glycogen, maltodextrin (modified starch), moducal, trehalose. Barley malt syrup, brown rice syrup, brown sugar, corn syrup (if no fructose is added), grape syrup, maple syrup, sorghum syrup, sucrose (table or cane sugar).
Sugar substitutes: dulcitol, erythritol, isomalt, lactalol, lacticol, litesse, lycasin, maltitol, mannitol, saccharin (Sweet ‘n Low), sucanat, trimoline, xylitol.		 Agave syrup (in Tex-Mex foods, tequila, margaritas, soft drinks), caramel, Chinese rock sugar, corn syrup solids, fructose, fruit juice concentrate, golden syrup (cane syrup), High Fructose Corn Syrup (HFCS), honey, invert sugar (treacle), licorice, molasses, raw sugar (Turbinado, Demerara, jaggery, palm sugar – gur); sweets in excess (>50g), soft drinks with sucrose (>375 mL); Sugar substitutes:hydrogenated starch hydrolysates (HSH), saccharin (Sweet ‘n Low), sorbitol, stevia, sucralose (splenda).
FRUITS Cumquat, grapefruit, lemons, limes. Avocado, bananas, blackberries, boysenberries, blueberries, cranberries, grapes (white), jack-fruit, kiwi, mandarins, oranges, passionfruit, pineapple, rhubarb, strawberries, raspberries, tamarillo, tangelo;Apricots, nectarines, peaches, (not for persons sensible to sorbitol). Apples, cherries, dates, figs, grapes (black), guava, honeydew melon, lychee, mango, nashi fruit, papaya, pears, persimmon, plumes, prunes, raisins, star fruit, sultana, quince, watermelon. Dried fruits, fruit compotes and jams in general.
VEGETABLES Bouillon, celery, escarole, hash-browns, mushrooms, mustard greens, Pea Pods (immature), potatoes (white), shallots, spinach, Swiss chard. Asparagus, beets, carrots, dandelion greens, cauliflower, endive, legumes (beans, peas and lentils), lettuce, mushrooms, onions, green onions, soy, sweet potatoes, turnip greens, zucchini. Artichoke, eggplant, green peppers, green cabbage, kale, leeks, lettuce (iceberg), pickles (e.g. sweet cucumbers), radishes, squash, tomatoes, turnips, watercress.
BREADS AND CEREALS Barley, breads and pasta without fructose or gluten-free, wheat-free rye bread, corn meal (degermed), cornflakes (non-flavoured), grits, grouts, oatmeal, porridge (cooked oatmeal), plain muffins, rice (white), rice or buckwheat noodles, rye flour, tortilla Wheat (including dinkle, kamut, sourdoughs, spelt, wholemeal and wheat products: biscuits, noodles, pasta, pastry). Brown rice, sweetened breakfast cereals (or with raisins, honey).
PROTEINS (MEAT, FISH, EGGS, NUTS) Meat (fresh, not commercially breaded), fish (fresh or tinned without sauce), other seafood, eggs, grains and seeds: amaranth, flax seed, millet, poppy, pumpkin, sesame, tahini, sunflower; nuts: pistachios. Legumes: chick peas, lentils, lima, mung, soy (including tofu);
Nuts		 Meat, fish (if processed, sweetened, or commercially breaded); coconut milk/cream.
DAIRY Plain, unsweetened milk, yogurt, cheese. Sweetened milk products, ice cream
SAUCES AND SPICES Basil, bay, cinnamon, cumin, curry, maryoram,
oregano, parsley, rosemary, thyme.		 Distilled vinegar.
Coriander, garlic, onions, parsnip, spring onions. 		Sauces: Barbeque’s, Sweet&Sour, Hot mustard, chutney, ketchup, relish, soy sauce, vinegar (apple cider, balsamic);
Spices: chervil, dill weed, ginger, hot chili pepper, pumpkin pie seasoning.
DRINKS Water: tap water, non-flavoured bottled water, mineral water, tea, coffee (not chicory based coffee substitutes). Fruit juices: blackberry, cranberry, white grapes;
Alcohol: dry white wine (1 glass/serving).		 Fruit juices(apple, apricot, mango, orange, pear, peach, prune, sweat cherry), soft drinks with sorbitol or HFCS; alcohol (except dry white wine); powdered sweetened beverages, sweetened milk/vegetable/soy drinks, coffee substitutes with chicory.
WHEAT (fructans) Persons with FM, who cannot safely eat wheat (white bread, pasta, breakfast cereals etc) may also have problems with artichokes, asparagus, chicory roots, chicory greens (whitlof, Belgium endive), chicory based coffee substitutes, dandelion greens, leeks, onions (after cooking throw onion away, enoy the taste), raddish, spring onions (7). Tinny amounts of wheat in wheat thickener, maltodextrin and dextrose are not problematic.
BEANS (raffinose (23), galactans) Persons with FM, who cannot safely eat beans may also have problems with other legumes (peas, soy, lentils), broccoli, brussel sprouts, cabbage, cauliflower, kale, turnip greens, and whole grains.
ADDITIONAL LOW FRUCTOSE DIET TIPS Cooked vegetables (e.g. carrots) may have higher fructose content then raw ones. Whole-grain bread has more fructose than refined bread. Brown rice has more fructose than white rice. New potatoes have more fructose than old ones. Medications like antibiotics, vitamins and supplements often contain fructose or sorbitol, so it is suggested to find fructose/sorbitol free alternatives.

NOTE. List of safe foodsis pretty strict. A person with a mild fructose malabsorption will be probably able to safely eat most foods from to try list and even some foods from to avoid lists.

Individuals with fructose malabsorption often have lactose, glucose or gluten intolerance, so they might need additional lactose-free, sugar-free, gluten-free or FODMAP diet.

You might want to check about mechanism, symptoms and diagnosis of fructose malabsorption, low fructose diet, and check the list of foods high in fructose/sorbitol/fructans/FODMAPs .


Further Reading :
  • Foods, High in Fructose, Sorbitol, Fructans and FODMAPs
  • Low Fructose Diet in Fructose Malabsorption
  • Small Intestinal Bacterial Overgrowth (SIBO): Symptoms, Treatment
  • Toddler’s Diarrhea, Chronic Diarrhea in Small Children
  • Bowel Movement Problems