We all want to live healthy lives and we all like healthy fruit. But after eating, more and more people have the feeling: “It tears me apart”. Especially in the evening fruit is a welcome change for many people. In the morning, however, we wake up completely whacked. There are also diffuse digestive problems. We are often irritable and tired, have difficulty concentrating, and suffer from dizziness, shortness of breath, headaches and sleep disorders. A gurgle in the stomach often announces severe diarrhoea.
Another symptom is perhaps even more stressful: depressive moods. Those who feel tired, beaten off, listless and depressed may already have suspected that they are suffering from a depressive mood or even depression.
The cause of this blue mood can be a fructose intolerance. Hereditary fructose intolerance as a genetic disease must be distinguished from intestinal fructose malabsorption. Hereditary fructose intolerance is a disorder of fructose metabolism. Affected persons are born with an enzyme defect and therefore mainly babies or children are affected. In 2 out of 3 children, however, fructose malabsorption occurs in our latitudes.
Too much fructose irritates the intestines…and affects the brain.
It is assumed that 20 – 40 percent of adults suffer from fructose malabsorption. They must avoid all foods that contain fructose or sweeteners. This not only includes many fruits, but also a number of foods that at first glance do not appear to contain fructose.
- Fruits: pineapple, apple, pear, pomegranate, cherry, kiwi, mango, plum, fruit tea and dried fruit.
But also:
- honey, ketchup, flavoured mineral water, must, soft drinks, alcoholic beverages: champagne, schnapps, wine, mustard, sweets
Fructose is added to many foods, including baked goods (croissants, etc.). Therefore, pay close attention to the list of ingredients, often fructose is hidden behind the following terms:
- fructose, fructose syrup, fructose-glucose syrup, invert sugar, corn syrup, high-fructose corn syrup (HFCS), cane sugar, juice concentrate, sorbitol
Anyone who regularly notices digestive problems such as abdominal pain, nausea or diarrhoea after these foods should think of fructose malabsorption. But what is this?
Fructose-Why is our intestine on strike?
Intestinal fructose malabsorption is the most common type of fructose intolerance, i.e. the intolerance of fructose. If a larger proportion of consumed fructose reaches the large intestine due to incomplete absorption in the small intestine, this is referred to as fructose malabsorption.
This occurs when the malabsorbed fructose also leads to symptoms such as diarrhoea, flatulence and pain. The importance of intestinal fructose malabsorption has increased in the past as the amount of fructose in food has increased significantly in recent years due to industrially available sweeteners. In contrast to allergy, intolerance means that a small amount of fructose is tolerated by the body. In a healthy person this is about 50 grams a day.
Fructose binds in the large intestine to tryptophane, a precursor that is then missing in the production of the happiness hormone serotonin.
The absorption of fructose in the small intestine takes place via certain transporters. If too few so-called GLUT5 transporters are present, the fructose continues into the large intestine. If there are particularly many fructose molecules there, complex formation occurs. Tryptophan in particular binds to fructose and cannot then be absorbed by the blood. This results in a deficiency of the essential amino acid tryptophan. Since this is a precursor for the happiness hormone serotonin, our serotonin level can be affected, which can affect our mood. A direct connection between our mood, depressive moods and our “gut feeling”.
Part of the fructose reaches the large intestine, where it is broken down by bacteria. This produces large amounts of hydrogen, carbon dioxide and short-chain fatty acids. Carbon dioxide is the “engine” for the strong flatulence. These can be very painful in the entire lower abdomen. Sometimes these terrible cramps in the lower abdomen are also the cause of many an “acute abdomen” in the emergency room. A massively bloated intestine can press on the gallbladder and the heart, making the problem much more than a local one. Another gas that is produced is methane gas, which affects our brain. Carbon dioxide and methane gas therefore hurt us.
In a third of the population over 60 years of age, we increasingly find symptoms of fructose malabsorption. The cell division rate in the intestine decreases with increasing age. The cells of the intestinal mucosa (enterocytes) decrease and there are fewer GLUT5 transporters available for the absorption of fructose. Age, depression, and sleep disturbances are the result. Zinc deficiency and folic acid deficiency can also result. Many have already heard of the “senile bed exodus”!
Fructose malabsoption and copper deficiency
There is also an important connection between a fructose intolerance and a copper deficiency. This connection has already been investigated in numerous scientific studies. With the result that the researchers found out that so-called copper transporters – proteins with a similar function as the GLUT5 transporters for fructose – are inhibited by fructose, which inhibits the absorption of copper in our body. This is then missing in our iron metabolism or in the breakdown of harmful free oxygen radicals.
In addition, more copper is needed in the intestines to keep the intestinal bacteria, which are caused by excess fructose, in check. If the copper is no longer sufficient, the symptoms of fructose malabsorption become more and more serious. In this case it is important to keep an eye on the copper status.
Life is delicious! Fructose light
But what does that mean for our nutrition? Coffee is not a problem. Lemonades as well as soft drinks such as cola drinks should not be drunk because of their high fruit sugar content, as they are usually poorly tolerated.
This applies in particular to fruit and vegetable juices, which – and this is easy to deduce – also contain a lot of fructose and should therefore be removed from the diet. Those who like to drink juices can try out whether they can dilute the juice with water (best tolerated without carbonic acid) and mix it with some dextrose. Of course, water does not contain fructose unless it is “modern” water with a fruity note. If it is pure mineral water, you can drink as much as you like. However, mineral water with little or no carbon dioxide is better tolerated by the intestines.
What about other drinks? Enjoy a glass of beer or wine in a convivial group, or a cocktail with friends… Unfortunately, it is not that simple, because beer contains sorbitol, which is not tolerated by most people with fructose malabsorption.
With wine, it depends on how much fruit and sweetness it contains. It is best to try it out and ask the wine trade for a dry wine with little fructose. It is quite possible that this is better tolerated. As far as cocktails are concerned, you should avoid those with juices and liqueurs. If you don’t want to do without cocktails at all, it is best to ask the bartender for a cocktail that is dry or bitter and therefore gets by with little sweetener from juices or sugar syrup. Other combinations with energy drinks etc. are better avoided completely, as they contain fructose due to the soft drinks or juices added to the alcoholic beverages.
We are better off with the findings of Paracelsus (1493-1541):
“All things are poison, and nothing is without poison; only the dose makes a thing no poison.”
Diagnosing fructose malabsorption
What tests are available?
- Nutrition diary
- Self-tests and provocation tests
- H2 breath test (can be carried out by general practitioners, specialists and in allergy centres, measures the hydrogen content in the breathing air)
Fructose Malabsorption Therapy
- 1 – 6 weeks waiting period (avoid fructose), then include small quantities in the menu
keep a diet and symptom diary in order to determine the individual fructose threshold - Substitution of a special enzyme: xylose isomerase, which converts fructose into easily digestible glucose (effect within 2-4 hours).
- Compensation of micronutrient deficiencies
- intestinal rehabilitation
- Use of dietary foods (here in the background the dietary foods produced by fructose-painting)
Already the ancient physician Hippocrates (460-370 B.C.) had recognized :
“The gut is the father of all tribulation.” And he said: “Everything excessive violates nature”.
