Fructose intolerance food list (with downloadable PDF) - THE IBS DIETITIAN

Dietitian-approved fructose intolerance food list

  • Dietary Advice (non Low FODMAP)

By Kirsten Jackson

Are you looking for a fructose intolerance food list? You’ve come to the right place if you have fructose intolerance.

Starting on a low fructose diet when you have fructose intolerance can be challenging, as fructose is found in many foods.

In this article, we will cover the types of fructose intolerance and their symptoms and treatment. You can download our fructose intolerance food list for easy meal planning and shopping.

What is fructose?

Fructose is a monosaccharide, represented by the ‘M’ in FODMAP. It is a single sugar molecule that forms the basis of many carbohydrates that we eat.

It is naturally found in many fruits and vegetables, as well as sweeteners, sugar and honey. It is a common ingredient in many foods and drinks.

While most people absorb fructose well, people with IBS or fructose intolerance may find it to be a trigger for their symptoms.

What is fructose intolerance?

There are two different types of fructose intolerance, including (1):

  • Fructose Malabsorption (also known as Dietary fructose intolerance)
  • Hereditary fructose intolerance

What is fructose malabsorption?

In the Western hemisphere, around 40% of people are affected by fructose malabsorption (2). A study suggests that it affects approximately 22% of people with IBS (3).

People with this condition struggle to absorb or digest fructose properly. 

As the undigested fructose travels to the colon, it can draw water into the bowel leading to increased water content, which can result in more frequent bowel movements (4).

Fructose can also become a food source for the gut bacteria residing in the colon. The gut bacteria ferment fructose to produce short-chain fatty acids and gasses (5).

The combination of excessive water and gasses can cause symptoms, including (6): 

  • Abdominal pain
  • Bloating
  • Constipation
  • Diarrhea
  • Gas

Since everyone’s tolerance level for fructose can vary, it is essential to assess your tolerance levels.

If you think you have fructose malabsorption, it is essential to speak to your doctor. It can be diagnosed by a fructose hydrogen breath test or a fructose elimination diet with a dietitian (7).

Is fructose intolerance hereditary?

Yes, this is called hereditary fructose intolerance. It is a genetic condition and a more severe form of fructose intolerance that develops in infants from birth (8). 

Symptoms usually develop soon after babies have formula containing fructose or begin eating solid foods. These symptoms can include (9): 

  • Failure to thrive
  • Hypoglycaemia (low sugar levels)
  • Jaundice (yellow skin or eyes)
  • Nausea
  • Vomiting

Unlike fructose malabsorption, hereditary fructose intolerance can even lead to life-threatening complications such as liver or kidney failure (10). 

Genetic testing can confirm a diagnosis of hereditary fructose intolerance. It is important for people with this condition to work with a dietitian to avoid fructose in their diet altogether.

What to do if you have fructose intolerance?

Treating fructose malabsorption involves adopting a low fructose diet. Reducing fructose intake often provides symptom relief without entirely eliminating it from the diet.

Symptoms typically improve within about 2 to 4 weeks of reducing fructose intake (11). You can then gradually reintroduce foods to determine how much fructose you can tolerate.

However, people with hereditary fructose intolerance must completely remove fructose from their diet. 

When restricting food sources in your diet, it is essential to seek guidance from a dietitian to ensure you are meeting all your nutritional requirements.

Does a low FODMAP diet help fructose intolerance?

Yes, it will. The low FODMAP diet does limit fructose, but it also restricts many other fermentable carbohydrates.

People with fructose intolerance will only need to reduce fructose in their diet so the low FODMAP diet will be much more restrictive than the fructose intolerance diet.

The FODMAP diet is typically recommended as a short-term intervention to identify and manage trigger foods for IBS.

What foods can you eat if you are fructose intolerant?

We created a printable fructose intolerance food list organized into categories so you will know which foods to enjoy and which to limit.

You’ll be pleased to know that many protein food sources are naturally fructose-free. Here’s a list of foods you can enjoy without worrying about fructose (12):

*Always check the ingredients list if marinated, seasoned, or breaded, as it may contain fructose. 

Fresh meat, fish and seafood are fructose free in their natural forms. However, you should avoid breaded, battered, and marinated types of meat and fish.

Low fructose fruits

Since all fruits contain some fructose, low fructose fruits should still be limited to 1 to 2 servings per day (a serving size is 1 small piece or ½ cups) (13).

Luckily, certain fruits and vegetables have lower fructose content, making them suitable choices for those with fructose malabsorption, such as:

You can also find a detailed guide about low FODMAP fruits here: ‘Low FODMAP fruit guide (includes safe list and 10 recipes)’.

Low fructose vegetables 

You can also find a full list of low FODMAP vegetables here.

Low fructose grains and starches

Low fructose dairy products

Be mindful that milk alternatives may contain fructose, like high fructose corn syrup or honey. 

You should always check the ingredients list of food products to ensure they are made with low fructose ingredients and sweeteners.

Low fructose sweeteners

You can also find a detailed guide about low FODMAP sweeteners here: ‘Which sweeteners are low FODMAP? Dietitian advice for IBS

Plenty of alcoholic and soft drinks are low fructose, so you don’t have to miss out on your favorites. Some of our favorite options are:

  • Water, carbonated water
  • Soda and other sweetened beverages made with cane sugar
  • Sports drinks made with glucose
  • Coffee and tea
  • Spirits, e.g., gin, vodka, whiskey, tequila (up to 1 ounce) (You can read more about: ‘Can you drink alcohol on the low FODMAP diet?’)
  • White or red wine (up to 4-6 ounces)
  • Beer (up to 12 ounces)

What foods are high in fructose?

When following a fructose intolerance diet, you will need to limit foods high in fructose. Some of these foods include:

High fructose fruits (14)

High fructose vegetables

High fructose grains and starches

  • Bread and baked goods, cereals, and crackers made with white, wheat, and rye
  • Flours, e.g., all-purpose, graham, rye, semolina, white, wheat (You can read more about: ‘Low FODMAP flour + High FODMAP flour list’)

High fructose dairy

High fructose sweeteners

Remember to watch out for these high fructose ingredients commonly added to products, such as:

So, when following a fructose intolerance diet, it is crucial to read ingredient labels carefully to avoid hidden high-fructose ingredients in foods, beverages, and supplements.

Remember to download our comprehensive fructose intolerance food list to take with you on your next shopping trip. 

This handy guide will help you quickly identify safe foods and avoid high-fructose items, making meal planning and grocery shopping a breeze.

Summary

You can download our fructose intolerance food list to help manage your fructose intolerance. Fructose malabsorption is a common condition treated with diet changes.

Fructose intolerance occurs when the body cannot properly digest fructose. It includes fructose malabsorption, which is common in people with IBS, and hereditary fructose intolerance.

The good news is that you can significantly reduce your fructose intolerance symptoms by lowering your fructose intake. 

By working with a dietitian, you can figure out how much fructose you can tolerate while ensuring a well-balanced diet that meets your nutritional needs.

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