How is fructose intolerance diagnosed?

Integrative medicine expert Aviva Romm, MD, discusses which main culprits to eliminate, and the fructose-heavy foods to be most aware of.

Transcript

00:00

While there is a test you can get from your doctor for fructose intolerance, it's a bit expensive, and it's not that reliable. [MUSIC PLAYING]

00:13

So what in medicine we call the gold standard, which is the best and most reliable test, is actually just to take fructose out of your diet.

00:20

And if symptoms go away, voila, you have your answer. You probably have fructose intolerance. So an elimination diet is really easy to do,

00:28

and you do it for about 21 days. 21 days is a great amount of time to give your gut a rest and let it start to repair itself.

00:35

And it's actually pretty easy. Pretty much anybody can do anything for 21 days. It's not that long. So what you want to do is take out

00:42

anything that could be contributing to your symptoms. So with fructose intolerance, that includes anything with high-fructose corn syrup.

00:49

So you want to start to read the labels. But a lot of condiments, things like salad dressing, snack bars, are often high in high-fructose corn syrup.

00:59

You also want to take out all your fruit actually for 21 days. And you'll be fine because you can get the nutrients you

01:05

need from most vegetables. And eventually, you'll be able to add enough fruits back in and keep your nutrition optimal.

01:11

And you want to take out something that's a little bit surprising to a lot of people called sorbitol. Sorbitol is not fructose.

01:18

It's a different-- it's a sugar substitute. And so it's in a lot of low-fat and low-sugar foods, but it's also in chewing gum.

01:25

So people can be really surprised when they stop chewing gum and their gas and bloating goes away. Also, wheat is really high in fructans,

01:35

which are a complex molecule that's a lot like fructose. So it's not gluten intolerance, but it's an intolerance to the fructans that are in wheat.

01:43

So you want to take wheat out and use gluten-free alternatives. And finally, and probably most surprisingly, are actually

01:50

there's a group of vegetables that are high in something called fructans, similar to the wheat, that can also contribute

01:57

to fructose intolerance. So the big offenders are usually something that might not surprise you that much-- cabbage, onions,

02:04

and garlic, but also artichokes, asparagus, and a few other vegetables. So the safe category of vegetables that you can eat

02:12

may be easier to focus on. And that's all your leafy greens. You can eat as many leafy greens as you want. Mushrooms, yams, and sweet potatoes,

02:20

and all white potatoes are fair game. And again, it's just for 21 days. After the 21 days, when you've done the elimination,

02:27

then you want to slowly start to add things back in. So I'd start with the lower fructose fruits like berries,

02:34

bananas, and leave the highest fructose fruits like apples and pears out of the picture for now. And then every day, add in one to two servings,

02:43

usually with a meal, because that can make fructose easier to digest, of something-- one piece of fruit or one vegetable

02:49

that you'd taken out. Even consider keeping a food journal where you actually write down how you're feeling and any symptoms that come up

02:56

for the first few weeks while you're doing the reintroduction of the foods. This can tell you if certain things are causing you to have gas and bloating or other symptoms

03:05

again. If they are, just leave those out for a few months longer and focus on the ones that you can tolerate. [AUDIO LOGO]