Talk:Fructose malabsorption

message: A note in the USDA Matthews et. al. (1987) report on the Sugar Content of Selected foods indicates that the values in the report are superceded by the USDA Nutrition Database SR16 and SR16 has now been superceded by SR20. The values in the modified table are taken from SR20 and show the values of fructose and glucose. Food items with no values were removed as they are now mentioned elsewhere (see the Dietary section)  —Preceding unsigned comment added by 69.11.51.185 (talk) 16:48, 13 October 2007 (UTC)
thread_title:  Fructose Table 

message: Sue Shepherd (scroll down) researches Fructose Malabsorbtion and informed me (in a group session for people with the disorder) that spelt has a similar fructans content to wheat and should be avoided. Is there a reference stating that spelt is ok, or is my information otherwise out of date?
Your information is out of date. The research has significantly evolved over the years. Spelt had previously not been tested. True spelt breads are low in fructans, but be careful as some contain added flours such as lentil flour which are high in galactans, another FODMAP. Dr Jaci Barrett, PhD, APD. Monash University Eastern Health Clinical School. 
Is 100% spelt flour bread low in fructans, or just the sourdough variety of 100% spelt flour bread?  Dr Barrett's comment above implies that the non-sourdough variety is acceptable, yet the most current version of the Monash University FODMAP app only lists sourdough spelt breads as being safe.  LA 19/05/2015.  — Preceding unsigned comment added by 130.102.158.12 (talk) 05:49, 19 May 2015 (UTC)
thread_title:  Spelt 

message: Coconut milk is listed as a high fructose containing food. The National Public Health Institute of Finland (http://www.fineli.fi/food.php?foodid=29014&lang=en) does not support this observation. 
Can some please provide a reference that supports the high fructose content of coconut milk?
Medical Observer in Australia lists a reference to coconut milk
http://www.medicalobserver.com.au/displayarticle/index.asp?articleID=6260&templateID=108§ionID=0§ionName=
Coconut milk/cream and desiccated coconut have only recently been tested with the latest laboratory techniques. We have not published this work, but I can tell you that 1/2-1 cup of any source of coconut is actual below the limits that indicate high fructose/FODMAP. So we now include these foods in the diet of people with fructose malabsorption. The only thing is that sometimes the fat content can cause symptoms, but this is a separate issue to fructose/FODMAP content. Dr Jaci Barrett, PhD, APD Monash University, Eastern Health Clinical School. 
Unfortunately the author of the Australia article appears to be some what misinformed. Under 'Other' wheat is listed. According to the USDA database 100 grams of whole wheat flour has about 0.4 grams of sugar AND enriched white flour has 1.12 grams of sugar of which 0.03 grams free glucose and 0.3 grams of free fructose. Wheat is definitely not a high fructose food compared to 100 grams of honey which has 82 grams of sugar of which 36 grams is free glucose and 41 grams of free fructose OR 100 grams of pears contains 9.8 grams of sugars of which 2.8 grams is free glucose and 6.2 gram is free fructose. (by free I mean glucose and fructose and bounded together in equal amounts in the form of sucrose).
The problem with wheat is not that it contains fructose - rather it is its fructan content that makes it appear on the problem food lists. There is a lot of confusion because everyone thinks its all about fructose, when in fact the other FODMAPs are often just as problematic.  Dr Jaci Barrett, PhD, APD. Monash University Eastern Health Clinical School. 
A search of the research literature using the ISI database revealed nothing that supports fructans as a problem in fructose malabsorption. Also, there is no mention of fructans in relationship to IBS in Skoog, S. M. and A. E. Bharucha, 2004: Dietary Fructose and Gastrointestinal Symptoms: A Review. American Journal of Gastroenterology, 99, 2046-2050.
http://www.bashaar.org.il/files/101022005111814.pdf
There is significant research that shows that fructans are just as much of a problem in IBS! Sue Shepherds research involved rechallenge with fructose and/or fructans in fructose malabsorbers and showed that symptoms returned with ingestion of fructose OR fructans AND both.  —Preceding unsigned comment added by 58.161.98.169 (talk) 07:52, 29 January 2011 (UTC)
thread_title:  Coconut Milk 

message: I am a fructose malabsorber. If you read the papers in which Sue Shepherd is listed as a co-author, in particular the latest one titled "Review article: fructose malabsorption and the bigger picture", you will read in the abstract "Restricting dietary intake of free fructose and/or fructans may have durable symptomatic benefits in a high proportion of patients with functional gut disorders, but high quality evidence is lacking." Not all fructose malabsorber have difficulty with fructans. Putting this in another context in the paper "Fructan and Free Fructose Content of Common Australian Vegetables and Fruit" it says "Nevertheless, we have recent evidence to suggest that doses (10-20 g/day) [fructans] may exacerbate symptoms in patients who suffer from irritable bowel syndrome (IBS)". A slice of white bread (65 grams) contains just less than 2 grams of fructans (see Shepherd 2006 dietary guidelines). If white bread was the only dietary source of fructans then the lower limit of 10 grams would not be exceed until more than 5 slices of bread had been eaten. There may be individual tolerance differences to free fructose and fructans. It is important not to isolate wheat as a culprit but to put into the perspective of moderating its consumption along with other high fructan containing foods such as onions and Jerusalem artichokes that contain 9-12 grams/100 gram serving.
As a clinically diagnosed sufferer, I have been advised by a professional dietician that Fructans ARE a problem for sufferers of Fructose Malabsorption. dacoutts —The preceding unsigned comment was added by 203.14.223.10 --Couttsie 02:57, 8 February 2007 (UTC)
thread_title:  Fructans 

message: In some of the fructose Elimination diets I have read, galactans are listed to avoid. Do people with fructose malabsorption have any recorded issues with galactose or galactans?  — Preceding unsigned comment added by Jbozz21 (talk • contribs) 20:11, 10 August 2013 (UTC)
thread_title:  galactans 

message: The lead section says that eating glucose helps, but there's no reference and no follow-up in the article itself. Is there a reference or at least more information on this point? Jonathan Tweet 14:30, 9 February 2007 (UTC)
thread_title:  glucose/dextrose 

message: A clue: looking at structural formula on the fructan page http://en.wikipedia.org/wiki/Fructan , fructans are fructose complexes.  This page also says fructans are "Chains of fructose molecules".  It sounds like fructans are fructose analogs of starches, which are complexes, or chains, of glucose molecules.  If this is true, fructans would digest, at least partially, to fructose similar to the way starches digest to glucose and fructans would therefore be contributory to fructose malabsorption issues.  Other molecules that digest to fructose, such as the sugar alcohol, sorbitol also would contribute to these issues.
This is not true. Humans do not have an enzyme to breakdown fructans, so they remain in the chain form and are fermented by bacteria producing gas and contributing to IBS symptoms. Dr Jaci Barrett Monash University Eastern Health Clinical School. 
A suggestion: Nomally, a fructose molecule "piggy backs" across the basolateral membrane of the small intestine with a glucose molecule in 1:1 ratio via GLUT-5, though this seems to be in some dispute or not generally acknowledged.  It seems to be generally thought that glucose facilitates fructose absorption. http://jn.nutrition.org/cgi/reprint/125/8/2156.pdf Though this report is on rat intestine, the experimants are definitive.  See page 2161 for a graph of glucose facilitation and page 2163 in the discussion for comments relating to human absoption. It should be made clear in the article that glucose facilitates fructose consumption and simultaneous ingestion of glucose and its precursors, such as starches, facilitate absorption.
A thought:  Fructose is a non-essential molecule.  No known requirements exist for its consumption. See the dietary reference intakes at the NAS, http://books.nap.edu/openbook.php?record_id=10490&page=265 There is, in fact, no need for any carbohydrates at all beyond infancy. In my view, fructose "malabsorption" is really a protective mechanism, since fructose is a very potent endogenous AGE-former ranging from 6 to 15 times more active than glucose, depending on the report.  http://www.ncbi.nlm.nih.gov/pubmed/7599353?dopt=Abstract http://www.ncbi.nlm.nih.gov/pubmed/3132203?dopt=Abstract  http://www.ncbi.nlm.nih.gov/pubmed/2675027?dopt=Abstract  http://www.ncbi.nlm.nih.gov/pubmed/15343583?dopt=Abstract  Fructose is strongly linked to obesity and many age-related chronic diseases. http://www.ncbi.nlm.nih.gov/pubmed/12399260?ordinalpos=9&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum  http://www.ncbi.nlm.nih.gov/pubmed/18051988?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum http://www.cmi.ustc.edu.cn/3/5/351.pdf http://glycob.oxfordjournals.org/cgi/content/abstract/15/7/16R and there are thousands more references linking fructose and human illnes/dysfunction. 
Interestingly, this article http://linkinghub.elsevier.com/retrieve/pii/S1521691803001070 suggests that "There are no known defects of fructose absorption." For the above reasons I think this wiki article's focus should be shifted from pathological, i.e. "malabsorption" to a simple informational point of view like "incomplete fructose absorption," or some such title.  It could then be a redirect from "malabsorption" for people searching for that.
Just to clarify that it is fructose as a sweetener that has been linked to obesity rather than natural fructose within foods such as fruits and vegetables. Dr Jaci Barrett Monash University Eastern Health Clinical School. 
Jwanderson (talk) 21:00, 13 April 2008 (UTC)
thread_title:  some thoughts 

message: 'Fructose malabsorption is found in approximately 30-40% of the population of Central Europe,[2]' 
This claim, and the following one within the same sentence originate from this, as referenced: http://books.google.com/books?id=hLYgFxCuQNoC&pg=PA74&lpg=PA74&dq=%22fructose+malabsorption%22+tyrosine+-forum&source=web&ots=lvwEGCUpmA&sig=dIIEfuRUc-SZOCfAVsq9vNW76tQ#v=onepage&q=%22fructose%20malabsorption%22%20tyrosine%20-forum&f=false
The book above claims that Born et al. - in the following paper (which was hard to find): https://www.thieme-connect.com/ejournals/abstract/zfg/doi/10.1055/s-2000-7512 - suggests 36% is the figure. I cannot check this, frankly given being unwilling to pay up - however, see the following.
I believe the 'approximately 30-40%' found here must originate from the fact that Born - later citing the 1994 paper himself here, but in fact regarding another point: http://74.125.155.132/scholar?q=cache:vY0gT5k9NgYJ:scholar.google.com/&hl=en&as_sdt=2000&sciodt=2000 - suggests up to 30% of the Western population likely suffer. 
I strongly believe this last paper, being published in 2007 in the WJG, ought to be the one quoted. I think I shall now go ahead and change the claim on the page, and if disagreement arises from this (despite the fact that this seems the most evidenced approach to take) then I hope this will be found in favour.  —Preceding unsigned comment added by 2.122.34.32 (talk) 22:35, 1 January 2011 (UTC)
thread_title:  Question regarding claim  

message: "This condition is common in patients ... although occurrence in these patients is not higher than occurrence in the normal population" makes no sense at all to me. Surely if it is noteworthy / relevantly "common", then it has higher incidence among these patients than normal population. If the incidence is the same, it's not (with any relevance) "common" in these patients.  —Preceding unsigned comment added by 14.200.2.233 (talk) 13:01, 31 January 2011 (UTC)
thread_title:  Third paragraph makes no sense? 

message: A couple of thoughts...
Small quibble: Why is HFCS-90 listed in the USDA table? My understanding is that it basically isn't used in food products, but rather in producing HFCS with lower fructose content (42 or 55 percent). See: http://www.newsdesk.umd.edu/sociss/release.cfm?ArticleID=1470
Larger thought: Can we merge the subsections under "Treatment" into simply "Diet" (as written) and "Dietary Guidelines"? The article seems to be repetitive in this section. IMHO, it would be helpful to read the general guidelines and then read the favorable/unfavorable foods. The USDA table seems extraneous, and the sections "food with high fructan content" and "other problem foods" could all fit under "unfavorable foods." Organo435 (talk) 21:25, 26 April 2011 (UTC)
thread_title:  Consolidating "Diet" Sections 

message: Please do not remove the See Also link to Hereditary_fructose_intolerance
The two topics should distinguish the two conditions on an agreed best science evidence basis.
G. Robert Shiplett 10:30, 3 August 2013 (UTC)
thread_title:  Hereditary fructose intolerance 

message: "Treatment
There is no known cure, but an appropriate diet and the enzyme xylose isomerase can help.
Xylose isomerase
Xylose isomerase acts to convert fructose sugars into glucose. Dietary supplements are limited in the amount of fructose they can convert, thus the amount of fructose in a meal must be estimated and an appropriate dosage taken to work.[citation needed][8]"
Except the Wikipedia page on Xylose isomerase indicates that it is an enzyme used "to produce high fructose corn syrup from glucose" - which seems like the opposite of what's stated in this article.  Which is right?  Are they both right?  — Preceding unsigned comment added by 204.11.35.221 (talk) 20:17, 27 January 2016 (UTC)
thread_title:  Contradiction in treatment? 

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