What foods should be avoided by people with fructose malabsorption?

Foods that should be avoided by people with fructose malabsorption include:

Foods and beverages containing greater than 0.5 g fructose in excess of glucose per 100 g and greater than 0.2 g of fructans per serving should be avoided.

Foods with >3 g of fructose per serving are termed a ‘high fructose load’ and possibly present a risk of inducing symptoms. However, the concept of a ‘high fructose load’ has not been evaluated in terms of its importance in the success of the diet.

Foods with high fructose-to-glucose ratio. Glucose enhances absorption of fructose, so fructose from foods with fructose-to-glucose ratio <1, like white potatoes, are readily absorbed, whereas foods with fructose-to-glucose ratio >1, like apples and pears, are often problematic regardless of the total amount of fructose in the food.

Foods rich in fructans and other fermentable oligo-, di- and mono-saccharides and polyols (FODMAPs), including artichokes, asparagus, leeks, onions, and wheat-containing products, including breads, cakes, biscuits, breakfast cereals, pies, pastas, pizzas, and wheat noodles.

The role that fructans play in fructose malabsorption is still under investigation. However, it is recommended that fructan intake for fructose malabsorbers should be kept to less than 0.5 grams/serving, and supplements with inulin and fructooligosaccharide (FOS), both fructans, should be avoided.

Foods containing artificial sweeteners like sorbitol (present in some diet drinks and foods and occurring naturally in some stone fruits), xylitol (present in some berries) and other polyols (sugar alcohols, such as erythritol, mannitol and other ingredients that end with -tol, commonly added as in commercial foods).

Foods containing high fructose corn syrup.

Foods with a high glucose content ingested with foods containing excess fructose may help sufferers absorb the excess fructose.

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