Seek expert advice
When first diagnosed, it is recommended you visit a nutritionist/dietitian who specialises in Fructose intolerance and then research, research, research! Dr Sue Shepherd, based in Melbourne, Victoria is a specialist in this area, in fact she is one of the most well known authorities world wide on the subject of Fructose Malabsorption. She has a team of experienced dietitians and runs regular group seminars on food intolerance's. www.shepherdworks.com.au
Follow a completely fructose free diet for a few weeks
Likely you will be told to avoid anything containing fructose/sugar for a period of 2-6 weeks - which means almost all processed foods, soft drinks, all fruits and almost all veges. And all alcohol (tear!) - this is not completely necessary but advised. At the very least do not drink beer or sweet alcoholic drinks, including wine. This is not a permanent diet, you will be able to re introduce many things back into your diet that have low levels of fructose eventually. It is likely after the breath test, which involves drinking a cup of pure fructose, your fructose levels are completely out of control. I recall after my test, having an orange - which had never made me feel ill before made my stomach blow up like a balloon! This is because just a small amount of fructose on top of what was already sitting in my intestines, unabsorbed, was just too much. Because our bodies are not able to readily absorb fructose, it travels through our bodies and sits in the large intestine where it 'clashes' or 'feeds on' the good bacteria there. This then ferments and causes symptoms such as gas, bloating, diarrhoea, pain, nausea or even constipation. It is therefor important to 'detox' our system of fructose in order bring our bodies back to an acceptable level where we can tolerate small amounts symptom free.
Of all the food lists I have read, the following seems to be a safe list of foods to eat during your fructose 'detox' - foods either free from fructose or with very low levels (there are not many!)
Fruit
Avoid all fruit during this period only.
Note it is not necessary to avoid fruit altogether when you have fructose malabsorption, when a fruit is balanced with fructose and glucose, moderate amounts can be absorbed without symptoms. Fructose is generally only a problem when the fruit contains more fructose than glucose (i.e mango, apple, pear, watermelon) or too much fructose is eaten at once (for example 2-3 pieces of any fruit in one sitting)
Vegetables
- Celery (Sue Shepherd does advise to have no more than 1 stalk in a sitting)
- Spinach
- Bok Choy
- Ginger
- Silver Beet
- Alfalfa Sprouts (these can be gas forming for some, so be careful)
- Bamboo Shoots
- Iceberg Lettuce
- Olives (plain, not marinated)
- Potato
- Yams
- Water Chestnut
Meat
All meats are allowed, just avoid any cured meats such as bacon (which can sometimes be cured with honey or sugar), ham etc and anything marinated is to be also avoided.
Seafood
All is ok, just steer clear of anything marinated or cooked with garlic or onion.
Grains
Avoid all wheat based foods. The following is ok:
- Rice (I have found some information saying brown rice can upset the stomach, and it does upset mine, so I stick to white rice)
- Oats
- Tapioca
- Quinoa
- Millet
- Sorghum
- Buckwheat
- Arrowroot
- Tofu
- Sago
- Gluten Free Bread (check it doesn't contain sugar)
- 100% Spelt Bread
- Rice Noodles (Vermicelli)
- Gluten Free pasta
Dairy
- Milk
- Cheese
- Eggs
- Yoghurt - unsweetened. no sugars or fruit juice sweeteners allowed.
- Cream or Sour Cream
Sweets
For some of us going without anything sweet is torture! Try having a jar of Rice Malt Syrup on hand. This glucose based honey replacement is great with plain yoghurt or over oats/porridge. It is now available in Coles supermarkets and health food stores.
Drinks
- Water
- Tea - peppermint or green tea is great
- Hot water with lemon, perfect to aid digestion
- Coffee - although it doesn't contain fructose, it is not ideal during a detox to improve digestion so should be avoided if possible.
That's it! Please ensure you discuss with your nutritionist what they think is best for you - good luck x