Medically reviewed on Sept 20, 2023 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
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Fructose is a natural sugar found in most fruits and vegetables, as well as honey and agave syrup, some processed foods, and table sugar. Given its prevalence, foods high in fructose content are staples of many Western diets. However, it may cause certain health risks, particularly for people who experience fructose malabsorption. [1]
High fructose intake has also been linked to both a rise in obesity and metabolic disorders.2 Accordingly, many people opt for a low fructose diet to support their overall health. If you’re considering a low fructose diet, keep reading to discover our top tips and recommendations, as well as more information on whether a low fructose diet may be right for you.
During the 1980s, North American food processors largely replaced sucrose—table sugar—with high fructose corn syrup (HFCS), particularly in carbonated sodas. As the consumption of HFCS sodas increased, researchers observed a rise in obesity and cardiovascular disease. [2]
Research has also found that fructose may induce insulin resistance (a precursor of diabetes), as well as hypertriglyceridemia (which is characterized by a high level of fats in the blood) and hypertension (high blood pressure). [2]
In 2008—28 years following the widespread introduction of high fructose corn syrup (HFCS) —the Third National Health and Nutrition Examination Survey observed that fructose comprised 10% of the average American’s diet. [2]
That said, low levels of fructose may be beneficial to overall health. More specifically, in small amounts, fructose can [2]:
Fructose malabsorption occurs when the small intestine cannot properly absorb fructose into the bloodstream. Instead, undigested fructose remains in the gut for longer periods of time, and bacteria flock to it.
The result mimics many of the symptoms of irritable bowel syndrome (IBS), including [1]:
Unabsorbed and undigested fructose can also increase water content in the colon, thereby increasing bowel movements.
If you believe you have fructose malabsorption, visit your healthcare provider. They’ll be able to assess your condition using an elimination diet or fructose hydrogen breath test and prescribe a low fructose diet if appropriate. [1]
HFI is a genetic disorder in which people inherit the inability to digest fructose, as well as sugar, sorbitol, and brown sugar. A deficiency in the enzyme fructose-1-phosphate aldolase causes a buildup of fructose-1-phosphate in three vital organs [1]:
As a result, people with Hereditary Fructose Intolerance (HFI) can experience fructose intolerance symptoms such as abdominal pain, vomiting, and low blood sugar. If left untreated, liver and kidney damage may develop. HFI patients may also develop a distaste for sweets and fruits. [3]
Like fructose malabsorption, a low fructose diet is the primary method of treatment. [3]
Creating a low fructose diet can be a beneficial dietary approach for individuals who have fructose malabsorption, HFI, IBS flare up, or other conditions that make it challenging for the body to process fructose properly.
This type of diet involves reducing the intake of foods and sweeteners high in fructose to manage symptoms and improve overall health. To formulate your low fructose diet, follow the steps below.
A low fructose diet limits foods with excess fructose, which include [3]:
Foods high in natural fructose content include certain fruits, such as [1,4]:
Some vegetables, like artichokes, sugar snap peas, and asparagus also contain moderate to high levels of fructose. Additional vegetables to avoid include [1,4]:
Beyond produce, people on a low fructose diet should also limit [1,4]:
Opt for fruits and vegetables that have relatively low levels of fructose. Low fructose fruit alternatives include [4]:
Safe vegetable options for a low fructose diet include [4]:
ou can also incorporate plain, unprocessed meats and deli meats into your daily meals, as well as eggs, tofu, wheat-free grains and pastas, low fructose dairy products, and beverages and desserts made with glucose or cane sugar. [4]
You can include some sweeteners in your diet, too. Sweeteners that are low in fructose include [4]:
Like fructose, fermentable oligosaccharides, disaccharides, monosaccharides, and polyols carbohydrates (FODMAP) carbohydrates can be difficult to digest. In a similar fashion, the small intestine cannot properly absorb these sugars. As a result, many people with FODMAP sensitivities can experience [1,5]:
Low FODMAP and low fructose diets often overlap. Accordingly, you may benefit from limiting certain high FODMAP foods from your diet, too, like [5]:
Instead, substitute with low FODMAP foods, such as [5]:
Adopting low FODMAP practices can reduce gastrointestinal symptoms in 86% of people with IBS or similar conditions. [5]
When you're crafting a low fructose diet, it's essential to find that sweet spot where you manage your fructose intake while ensuring you're still getting all the essential nutrients your body needs to thrive.
Fortunately, you can balance your nutritional needs with your dietary needs by incorporating the following:
Don't limit yourself to a narrow range of foods. Variety is the key to getting a diverse mix of the vitamins, minerals, and nutrients that your body craves. So, while you're watching your fructose intake, make it a point to introduce a wide array of foods into your diet. [6]
Add some color to your plate by including different low-fructose fruits and vegetables. Each hue comes with its unique set of health benefits, so don’t be afraid to mix it up. This way, you'll expose your body to a broader spectrum of nutrients. [6]
Fiber is your digestive system's best friend, regardless of dietary restrictions. It helps keep things moving smoothly, prevents constipation, and nurtures a healthy gut microbiome.7 On a low fructose diet, it's vital to choose foods that are both fiber-rich and fructose-friendly. These include:
Protein is essential for repairing tissues, supporting your immune system, and maintaining muscle mass. Lucky for you, there's a range of lean protein options that won't cause fructose troubles. [8]
Don't forget about the importance of including healthy fats in your diet. These fats, like the ones found in avocados, nuts, and olive oil, play crucial roles in: [9]
Avocados, in particular, are rich in healthy monounsaturated fats and can be a tasty addition to salads, sandwiches, or creamy dips. Nuts and seeds, such as almonds, walnuts, and flaxseeds, are also top-notch sources of healthy fats. Sprinkle them on yogurt or toss them into smoothies for added flavor and nutrition.
When cooking, opt for olive oil or use it as a salad dressing to boost your meals' taste while enjoying the benefits of healthy fats.
Maintaining good hydration is vital for overall health and a happy digestive system. Adequate water intake keeps your natural bodily processes—including digestion and waste elimination—running smoothly. To that end, water should be your go-to for maintaining healthy digestion and preventing uncomfortable constipation.
Aim to sip on plenty of water throughout the day. You can also consider adding herbal teas, like peppermint or ginger, to your hydration routine. These teas are caffeine-free and can provide a soothing touch for your stomach.
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IBS Flare Up: Treatment and Prevention
High FODMAP Foods: What to Know
Common Fructose Intolerance Symptoms
References