Fructose Malabsorption

[Tbone107]

I really think white sugar is best because it is so pure so you are not going to compound your issues in case you have allergies. Is there a reason you don't want to use just plain sugar? Is it because palm or coconut seems healthier? They are all tropical sugars. I don't think there is any advantage to them if you were to match them up with raw cane sugar. They are just less refined than white sugar but in your case that might not be good because it makes them less digestible. There are more nutrients in palm, coconut and raw cane sugar but if you are eating other nutrient rich foods you don't need what the raw sugars will provide. And we are talking about such a small amount. Sugar cane is a grass so just think of it as eating your greens:)

Also, slow and steady wins the race. I feel people on this site get so ahead of themselves. People will start drinking 5 cups of coffee a day and feel terrible and then they say they can't tolerate coffee! But if that same person started with 1/4 cup and slowly increased it over a year they might be fine. It took me 1-2 years before I could tolerate a full cup of coffee.

Thanks ptp, the reason I am preferring coconut sugar is That everywhere I read it seems to have a lower amount of fructose than any other sugar. Is this incorrect or not something to worry about?

I do believe I started too fast. I am going to back down some with more manageable sources and hopefully I can build up a little higher.

Under the descrption for coconut sugar it says “made from fresh flower blossom our coconut nectar has 80 percent less fructose than agave” which I would think then is still in turn lower than sucrose. Let me know if you see it differently

 

[Rafael Lao Wai]

So you would suggest just adding a galactose powder to my milk for a sweetener?

What level of fructose would you start at and what increments would you suggest titrating upwards?

If I handle the coconut sugar ok in regards to other allergens would the fructose ratio technically be slightly lower than pure sucrose?

Galactose poder is very expensive.
https://www.energybalance.com/chen/galactose-ultrapure-powder-500g.html

Lactose powder is much cheaper and it should work well for liver glycogen. It won't be very sweet, since what makes sucrose very sweet is the fructose. Glucose and galactose are about at the same level of sweetness( glucose is actually a little sweeter). Lactose isn't really very sweet.
http://owlsoft.com/pdf_docs/WhitePaper/Rel_Sweet.pdf

Maybe using some stevia could work. I heard using sweetners in place of carbs is a bad idea, since it tricks the body into thinking you actually ingested something with carbs, but using a lot of carbs and some stevia should be safe, at least in this regard.

You said some oranges and berries are ok. Two oranges contain about 18 grams of sugar. Two ounces of blueberries have about 6 grams of sugar. In total, that's about 24 grams of sugar, half of which is fructose, so 12 grams of fructose. If you don't have problems with this amount, then keep eating at least this quantity per day. Maybe adding a teaspoon of either white sugar or coconut sugar per week or every other week, and keep increasing like that. If you notice discomfort from increasing your fructose comsumption, go a little slower or reduce a littl bit the dosage and when you feel comfortable, increase it again.

According to wikipedia: "The major component of coconut sugar is sucrose (70–79%), glucose, and fructose (3–9% each).[3]

Coconut sugar - Wikipedia

I don't know if there are any permutations where there is more free fructose than glucose, but if you don't notice anything bad after eating, then it should be fine.

 

[PowertothePeatple]

Thanks ptp, the reason I am preferring coconut sugar is That everywhere I read it seems to have a lower amount of fructose than any other sugar. Is this incorrect or not something to worry about?

I do believe I started too fast. I am going to back down some with more manageable sources and hopefully I can build up a little higher.

Under the descrption for coconut sugar it says “made from fresh flower blossom our coconut nectar has 80 percent less fructose than agave” which I would think then is still in turn lower than sucrose. Let me know if you see it differently

I don't really know much about coconut sugar but I just googled it and it seems like it has a pretty similar fructose to glucose ratio as sugar but was lower on the glycemic index because it contains inulin but for me inulin really triggers Fructose Malabsorption. I found fructose fibers like inulin the most problematic for me. I still have a bit a trouble with fiber. I think comparing it to agave is giving you a false sense of its low fructose content. Agave is a high fructose sugar so in comparison even cane sugar would be lower in fructose.
"An interesting fact about coconut sugar is that it contains naturally occurring inulin (5). Inulin is a prebiotic, which feeds the bacteria in our guts. When the bacteria ferment the inulin they create gas, which can cause Irritable Bowel Syndrome symptoms. Inulin is classed as a fructan and considered high FODMAP (2)."

 

[Tbone107]

I don't really know much about coconut sugar but I just googled it and it seems like it has a pretty similar fructose to glucose ratio as sugar but was lower on the glycemic index because it contains inulin but for me inulin really triggers Fructose Malabsorption. I found fructose fibers like inulin the most problematic for me. I still have a bit a trouble with fiber. I think comparing it to agave is giving you a false sense of its low fructose content. Agave is a high fructose sugar so in comparison even cane sugar would be lower in fructose.
"An interesting fact about coconut sugar is that it contains naturally occurring inulin (5). Inulin is a prebiotic, which feeds the bacteria in our guts. When the bacteria ferment the inulin they create gas, which can cause Irritable Bowel Syndrome symptoms. Inulin is classed as a fructan and considered high FODMAP (2)."

Gotcha thanks, since maple syrup is basically sucrose with the vitamins and minerals would that be preferred over the sucrose? If I get an organic with as little processing as possible?

Or if you still reccomend white sugar, what nutrients would I be missing out on that would need to be added?

 

[Tbone107]

Galactose poder is very expensive.
https://www.energybalance.com/chen/galactose-ultrapure-powder-500g.html

Lactose powder is much cheaper and it should work well for liver glycogen. It won't be very sweet, since what makes sucrose very sweet is the fructose. Glucose and galactose are about at the same level of sweetness( glucose is actually a little sweeter). Lactose isn't really very sweet.
http://owlsoft.com/pdf_docs/WhitePaper/Rel_Sweet.pdf

Maybe using some stevia could work. I heard using sweetners in place of carbs is a bad idea, since it tricks the body into thinking you actually ingested something with carbs, but using a lot of carbs and some stevia should be safe, at least in this regard.

You said some oranges and berries are ok. Two oranges contain about 18 grams of sugar. Two ounces of blueberries have about 6 grams of sugar. In total, that's about 24 grams of sugar, half of which is fructose, so 12 grams of fructose. If you don't have problems with this amount, then keep eating at least this quantity per day. Maybe adding a teaspoon of either white sugar or coconut sugar per week or every other week, and keep increasing like that. If you notice discomfort from increasing your fructose comsumption, go a little slower or reduce a littl bit the dosage and when you feel comfortable, increase it again.

According to wikipedia: "The major component of coconut sugar is sucrose (70–79%), glucose, and fructose (3–9% each).[3]

Coconut sugar - Wikipedia

I don't know if there are any permutations where there is more free fructose than glucose, but if you don't notice anything bad after eating, then it should be fine.

Good insight appreciate the help. I’ll try ramping up like that. I have been eating a fair amount of honey and maple syrup along with those everyday. I’ll slow down a lot on each.

 

[Rafael Lao Wai]

Good insight appreciate the help. I’ll try ramping up like that. I have been eating a fair amount of honey and maple syrup along with those everyday. I’ll slow down a lot on each.

You're welcome :).

 

[Tbone107]

You're welcome :).

Actually last question, sorry haha. If I am drinking 7-8 cups of milk a day do you think that would be enough lactose to cover my liver glycogen? I workout pretty regularly and don’t know how big of a difference that would make.

 

[Rafael Lao Wai]

Lol, no problem. Eight cups of milk have about 100 grams of lactose. Half that is galactose, so 50 grams. The liver has capacity for storing about 100 grams of carbs, judging by the studies I read. So maybe adding around 100 grams of lactose could work, although your current lactose intake is good. I think that muscle glycogen is more easily restored with starch or glucose, although keeping liver glycogen replenished is good to keep the stress low during exercise, so keeping your glucose intake high will make sure your msucles have energy for good workouts.

 

[Hans]

Any carb will do really to replenish liver glycogen, with fructose being the best. Plus sucrose and glucose is almost equally effective at restoring muscle glycogen.
Some people have problems storing glycogen even if they eat enough carbs. This can be caused by a slow thyroid and also by an accumulation of intracellular fats.
Glycogen stores can be replenished within 24 hours after a glycogen depletion protocol. So it would be totally ok to lift frequently, because a short weight training sessions does not completely deplete glycogen stores in the first place. And then eating lots of carbs, ~300-400g daily, should be enough to replenish spent glycogen stores.
So to solve chronic low glycogen stores is to improve liver and thyroid function and to consume small amounts of sugar/some carb source, frequently, such as every 30min, depending on the severity of the condition.

 

[tca300]

My issue is different from yours as I have an aldolase b deficiency, but I have found milk that hasn't been ultra pasteurized digests really well and doesn't result in the symptoms I get from fructose ( I think high heat can turn lactose into a fructose like substance ).

I dont eat any plants at all actually and get all my carbohydrates from milk. With the absorption issue you will want to watch out for fructan like substances as well, wheat is an example of a food that might be low in fructose, but has fructans that might cause symptoms.

I dont really have any advice other than eliminating foods that cause issues, and then avoiding them, which is rather straight forward and obvious. Wish I could offer a solution, sorry.

Best of luck!

 

[Tbone107]

I don't really know much about coconut sugar but I just googled it and it seems like it has a pretty similar fructose to glucose ratio as sugar but was lower on the glycemic index because it contains inulin but for me inulin really triggers Fructose Malabsorption. I found fructose fibers like inulin the most problematic for me. I still have a bit a trouble with fiber. I think comparing it to agave is giving you a false sense of its low fructose content. Agave is a high fructose sugar so in comparison even cane sugar would be lower in fructose.
"An interesting fact about coconut sugar is that it contains naturally occurring inulin (5). Inulin is a prebiotic, which feeds the bacteria in our guts. When the bacteria ferment the inulin they create gas, which can cause Irritable Bowel Syndrome symptoms. Inulin is classed as a fructan and considered high FODMAP (2)."

Would organic raw cane sugar be a worse choice than pure white sugar?

 

[PowertothePeatple]

Would organic raw cane sugar be a worse choice than pure white sugar?

Maybe I misunderstood your original question. All of my comments were about increasing your ability to digest fructose so you don't have issues. I was not commenting on a long term diet necessarily. So if your main goal is to increase absorption without stomach irritation I think pure white sugar is the least irritating. But as you progress I would think fruit and honey and maple syrup and raw sugars would be fine. In fact, molasses is quite nutritious and is made of sugar cane juice. I think you have to decide what your primary goal is for now. And like people always say on this site "The only source of knowledge is experience." So experiment and see what works for you. I just wanted to encourage you that I think you can improve fructose malabsorption.

 

[Rafael Lao Wai]

Any carb will do really to replenish liver glycogen, with fructose being the best. Plus sucrose and glucose is almost equally effective at restoring muscle glycogen.
Some people have problems storing glycogen even if they eat enough carbs. This can be caused by a slow thyroid and also by an accumulation of intracellular fats.
Glycogen stores can be replenished within 24 hours after a glycogen depletion protocol. So it would be totally ok to lift frequently, because a short weight training sessions does not completely deplete glycogen stores in the first place. And then eating lots of carbs, ~300-400g daily, should be enough to replenish spent glycogen stores.
So to solve chronic low glycogen stores is to improve liver and thyroid function and to consume small amounts of sugar/some carb source, frequently, such as every 30min, depending on the severity of the condition.

Isn't galactose the best carb for liver glycogen? I saw this graph that indicates that, athough the difference isn't that huge: https://cds.ismrm.org/protected/09MProceedings/files/00468.pdf

Regarding the muscle glycogen replenishment, I saw contradicting evidence. One study showed that a big load of glucose or fructose( I think it was a huge amount all at once, like 300 grams) will replenish muscle glycogen just fine( but I think they said that the glucose group had better performance after the replesnishment), while another study showed that fructose doesn't recover muscle glycogen very much at all. Regarding glucose and sucrose, I read a study which concluded that they replenish muscle glycogen the same, but sucrose was better, since it also increase whole body comsumption of oxygen. Maybe that's the one you read too.

Maybe potassium can help build stronger glycogen stores, as well as correcting hypothiroidism. @haidut posted some studies about taurine, which can increase glycogen in the liver.

Do you think any fat accumulation inside the cell is bad( even if it is saturated fat?)?

I wish they made a study to see how much a difference there is between starch and glucose when it comes to muscle glycogen replenishment.

Yeah , small frequente feedings of carbohydrate are definitely useful. I find that I naturally drink some coke or some juice about every hour or so between meals( I can go longer without doing this, but it wouldn't feel optimal).

 

[Hans]

Isn't galactose the best carb for liver glycogen? I saw this graph that indicates that, athough the difference isn't that huge: https://cds.ismrm.org/protected/09MProceedings/files/00468.pdf

Regarding the muscle glycogen replenishment, I saw contradicting evidence. One study showed that a big load of glucose or fructose( I think it was a huge amount all at once, like 300 grams) will replenish muscle glycogen just fine( but I think they said that the glucose group had better performance after the replesnishment), while another study showed that fructose doesn't recover muscle glycogen very much at all. Regarding glucose and sucrose, I read a study which concluded that they replenish muscle glycogen the same, but sucrose was better, since it also increase whole body comsumption of oxygen. Maybe that's the one you read too.

Maybe potassium can help build stronger glycogen stores, as well as correcting hypothiroidism. @haidut posted some studies about taurine, which can increase glycogen in the liver.

Do you think any fat accumulation inside the cell is bad( even if it is saturated fat?)?

I wish they made a study to see how much a difference there is between starch and glucose when it comes to muscle glycogen replenishment.

Yeah , small frequente feedings of carbohydrate are definitely useful. I find that I naturally drink some coke or some juice about every hour or so between meals( I can go longer without doing this, but it wouldn't feel optimal).

Yeah I see. Galactose is slightly better than fructose. One up for milk for its ability to replenish liver and muscle glycogen the fastest.
Fructose isn't very good at replenishing muscle glycogen, but it is able to do so very slowly.
The athletes that did better performance with the glucose probably did better due to the insulin. Even tasting something sweet increases insulin which increases exercise performance.
Ingesting a fructose and glucose combination do speed up carbohydrate oxidation more than either one alone.

An accumulation of intracellular fat is seen in fatty liver, diabetes, obesity, etc. However, they do term it the "athlete paradox" that despite the fact of having lots of intracellular fat, they are still insulin sensitive.
However, that is mainly seen in endurance athletes that burn a lot of fat during exercise. I think people that do strength training so not have nearly as much intracellular fat.
But I'd say that having intracellular fat isn't as bad as burning an excess of fat. Drugs that inhibit carnitine synthesis promote insulin sensitivity and glucose oxidation.

 

[managing]

Well, glucose requires insulin to be metabolized, and if you ingest a lot of fat in conjunction with a lot of glucose, the free fatty acids will activate the Randle Cycle and, either you will burn the glucose and store the fat or you will burn the fat and the glucose will remain in the blood( causing hyperglycemia for a while). Fructose is metabolized through a diferente pathway which fatty acids can't inhibit. It also doesn't stimulate insulin, so the amount of fat in the blood will be higher in a high fructose diet( insulin keeps the fat in the fat stores). I would keep fat very low or, at least, eat glucose and fat in diferente meals away from each other. I agree with Cirion that eggs can be problematic, since 4 eggs is about 2,4 grams of PUFA, atop of any other PUFA you'll ingest in a day.

But this is only true of PUFA and not SFA, am I correct?

 

[managing]

Here are some somewhat random connections.

If I have some stearic acid (fully saturated) with every meal, I handle all sugars better.

Fructose is mainly metabolized by the liver.

Stearic acid significantly reduces fattiness of liver and improves its function.

Ergo, might liver dysfunction be a primary factor in fructose maladsorption and, therefore, might stearic acid improve it?

 

[Rafael Lao Wai]

Yeah I see. Galactose is slightly better than fructose. One up for milk for its ability to replenish liver and muscle glycogen the fastest.
Fructose isn't very good at replenishing muscle glycogen, but it is able to do so very slowly.
The athletes that did better performance with the glucose probably did better due to the insulin. Even tasting something sweet increases insulin which increases exercise performance.
Ingesting a fructose and glucose combination do speed up carbohydrate oxidation more than either one alone.

An accumulation of intracellular fat is seen in fatty liver, diabetes, obesity, etc. However, they do term it the "athlete paradox" that despite the fact of having lots of intracellular fat, they are still insulin sensitive.
However, that is mainly seen in endurance athletes that burn a lot of fat during exercise. I think people that do strength training so not have nearly as much intracellular fat.
But I'd say that having intracellular fat isn't as bad as burning an excess of fat. Drugs that inhibit carnitine synthesis promote insulin sensitivity and glucose oxidation.

Thanks for the reply!

 

[Rafael Lao Wai]

But this is only true of PUFA and not SFA, am I correct?

I remember reading here that long chain fatty acids, including stearic acid, will compete with glucose through the Randle Cycle, although palmitic acid doesn't do this( it actually stimulates the oxidation of carbs, which is interesting, since even when you overeat carbs, the fat you make from them will actually make you burn even more carbs, as long as the Krebs Cycle and the Electron Transport Chain are good to go in order to deal with all the Actetyl Coenzyme A that wll be produced). Although stearic acid will activate the Randle Cycle, I think that the fact that stearic acid competes with arachidonic acid will make it so its net effect is still positive. I don't know stearic acid's effect on pyruvate dehydrogenase. Ray has said saturated fats activate this enzyme, but maybe he was talking about palmitic acid, which has been shown to increase this enzyme's activity. Or maybe it's that simply by replacing PUFA in the cells, you get more pyruvate dehydrogenase, which means more carbs are burned.

Here are some somewhat random connections.

If I have some stearic acid (fully saturated) with every meal, I handle all sugars better.

Fructose is mainly metabolized by the liver.

Stearic acid significantly reduces fattiness of liver and improves its function.

Ergo, might liver dysfunction be a primary factor in fructose maladsorption and, therefore, might stearic acid improve it?

Yes, stearic acid is good for the liver, which should make handling fructose easier. I never read any study that said that( the liver being overloaded with fat and so it makes the intestine absorb less of it through its GLUT-5 receptors), but stearic acid is a safe substance, so trying it is worth it, even if it ends up not helping the fructose absroption.​

 

[Cirion]

So what to do when your dietary fat appetite is massive like myself yet really need to drop body weight? Every time I attempt to drop dietary fat and replace it with protein and carbs I get insane stress responses and my pulse and temps drop like a rock. My body hates low fat diets.

I really hate this randle cycle...

And because my fat intake is so high even actively avoiding PUFA filled foods (nuts, eggs, etc) I still usually get 6-8g of PUFA. Seems impossible to eat higher fat and be under 4g a day of PUFA unless all you eat is hydrogenated coconut oil.

 

[Rafael Lao Wai]

So what to do when your dietary fat appetite is massive like myself yet really need to drop body weight? Every time I attempt to drop dietary fat and replace it with protein and carbs I get insane stress responses and my pulse and temps drop like a rock. My body hates low fat diets.

I really hate this randle cycle...

And because my fat intake is so high even actively avoiding PUFA filled foods (nuts, eggs, etc) I still usually get 6-8g of PUFA. Seems impossible to eat higher fat and be under 4g a day of PUFA unless all you eat is hydrogenated coconut oil.

Yeah, Peat mentioned this. If you eat a lot of fat, even safe fats such as tallow and butter, the PUFA starts to add up, since they still contain small amounts of it.

So you're eating about 150-200 grams of fat per day? You could try replacing most of that fat for hydrogenated coconut oil and MCT oil, both of which are completely saturated. Both of these fats are good for weight loss( I remember Peat saying that just by adding coconut oil to his diet he lost some weight without lowering calories). Since these fats are PUFA free, that leaves room for good amounts of milk, lean meats, juices etc. The only thing that concerns me is that MCT oil can cause allergies. It was posted here in the forum( I think it was @Hans) that it shouldn't be a problem as long as you are ingesting a good amount of long chain fats( stearic acic, palmitic acid, myristic acid etc.). Also @schultz posted an excerpt of a study which read:
"Interesting observations were recently described by Li et al. [56], who carried out a study on mice and showed that dietary MCT can promote allergy to food allergens simultaneously eaten with it, by hindering absorption of the allergen into blood and increasing its absorption in Peyer’s patches, where stimulation of Th2 response takes place. Medium-chain triglycerides can also cause an increase in allergic response after an oral attempt at food provocation. The study was not conducted on a human population; however, it clearly indicates that MCT should be used sensibly."

This was the study:Medium chain triglycerides (MCT) formulas in paediatric and allergological practice