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Is It Celiac Disease or Fructose Malabsorption? The Latest in Food Allergies and Intolerances

A lot of times, I’ll read an article in my social media newsfeed that really pisses me off. But rarely do I respond. Maybe I don’t feel like engaging in some drawn out Facebook argument, or maybe I don’t feel like getting a million notifications later from a bunch of other people who I don’t even know, but also commented on the same article. The only time things get personal is when said article mentions food, health, or a combination of food/health trends.

So when I read an article that basically says the gluten-free food trend is a total joke, naturally I took things personally. I’ve been eating gluten-free for years, how could some random site say it’s all a bunch of crap?! There was no way I was going to be labeled as a ‘whiner.’

Then I learned about another food allergy, an allergy no one is talking about. Have you heard of fructose malabsorption? No, fructose malabsorbtion is not when your body has some weird X-Men characteristic which allows you to absorb sugar through your skin. Fructose malabsoprtion is actually a really common problem with gut health—and no one is talking about it! It can explain why you have IBS, why doctors haven’t been able to figure out your food allergies, and why you might still experience Celiac Disease symptoms even after embarking on a strict gluten-free diet.

What is Fructose Malabsorption?

First, let’s establish what fructose is. Fructose is a simple sugar and form of carbohydrate naturally found in plants. Fruits, vegetables, and honey are the body’s three main ways of acquiring fructose.

There are two types of fructose malabsorption: one is a genetic inability to break down fructose because the body lacks the enzyme adolase B (this is usually diagnosed when you’re a baby) . But for some people, even when they have adequate levels of adolase B, they still have problems with fructose. In both cases, the fructose passes extremely quickly through the small intestine where it gets dumped into the large intestine. But because the food doesn’t have enough time to break down in the small intestine, it ferments. This explains why symptoms of fructose malabsorption include bloating, gas, cramps, diarrhea and other stomach problems.



Photo Courtesy: Our Body Health

There is still a ton of debate going on about why fructose malabsorption has become such a big problem for many people—not to mention the millions of people out there who have IBS but really could be experiencing signs of fructose malabsorption. Although the jury is still out, scientists are linking fructose malabsorption to excessive consumption of man made and synthetic fructose, which all points to one food: high fructose corn syrup. Check out this paper that talks about how high fructose consumption isn’t just linked to fructose malabsorption, but also other gastrointestinal disorders like IBS, Celiac Disease, and Crohn’s.

The Causes of Fructose Malabsorption and the Link With Celiac Disease

So if excessive fructose consumption, specifically HFCS, is linked to fructose malabsorption, how exactly did we get here? In other words, why is fructose all of a sudden such a problem? And what does it have to do with Celiac Disease?

My theory is that it’s not that we’re allergic to fructose by any means, but simply there is WAY too much of it in our diets. We need to remember that food products like high fructose corn syrup have been manipulated in labs with high heat to create a cheap, gooey, sweet substance that can save food companies millions of dollars in production and manufacturing costs. If you look at our fructose consumption from an evolutionary perspective, remember that fruits and honey were rare commodities found in the wild, and not available in the abundance that they are today. Essentially, like gluten, fructose is in just about everything we eat. The over-consumption of fructose has potentially contributed to why everyone is having such crazy reactions to it right now.

Image Courtesy: Cupcake Love Affair

How exactly does fructose malabsorption relate to Celiac Disease? New research indicates there could be a connection between the two, that some people who suffer from Celiac also experience issues with fructose malabsorption and adolase B levels. This could explain why if you have Celiac and follow a gluten-free diet, you could still be experiencing symptoms and gastrointestinal atrophy.

How Do I Combat Fructose Malabsorption?

If you follow a gluten-free diet, you’re incredibly lucky in that so much awareness has been generated about this protein in wheat, launching entire food campaigns with gluten-free products you can enjoy guilt-free. But where exactly is fructose? Identifying sources of fructose and reducing or eliminating them is one of the best strategies for minimizing fructose malabsorption symptoms.

Since fructose is naturally found in fruits and honey, you’ll want to reduce your consumption of certain fruits like apples that have high fructose levels. This doesn’t mean you can’t eat any fruit! Fruits like berries provide loads of health benefits and they’re pretty low in fructose.

You also need to watch out for processed food. Almost everything has some form of high fructose corn syrup in it, which is pretty much fructose on steroids. Avoiding cookies, cakes, sweetened beverages and other products that use high fructose corn syrup is a must.

If you want a little more structure for your fructose malabsorption plan, a diet you might want to try is the FODMAP diet. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. It was developed in 1999 by Dr. Sue Shephered for IBS patients. These types of carbohydrates put you at most risk for experiencing symptoms of fructose malabsorption like bloating, gas, and cramps. Avoiding them reputedly helps with IBS symptoms.

And if you simply don’t have the time (or desire) to do loads of research about the FODMAP diet, check out this handy dandy infographic!


Low fodmap diet chart Infographic

Image Courtesy: Yorktest Laboratories

Remember that like Celiac Disease, Fructose Malabsorption isn’t a death sentence! It is a completely avoidable condition that can be alleviated with some simple lifestyle modifications. Have you experienced problems with what what you now think is fructose malabsorption?

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