Is Fructose Intolerance Causing Your Child’s Digestive Symptoms?

We all want our kids to be healthy and happy. So when your little one is experiencing tummy troubles, it can be a serious concern for you as a parent. One factor that can play a role in digestive symptoms is fructose intolerance.
Watch the video or continue reading below to find out more about whether fructose intolerance is playing a role in your child’s digestive symptoms.
What is fructose?
You might recognise the name as a sugar that is found in fruit. Put simply, fructose is a natural sugar that is found in many plant foods. Most of the foods high in fructose are fruits, but you also find it added to many processed foods.
Fructose is also found in another type of sugar called sucrose. Sucrose is a blend of fructose and glucose. So if fructose is a potential issue, we need to keep an eye out for sucrose on labels as well.
What is fructose intolerance?
Also known as fructose malabsorption, this is a digestive disorder that affects how the body absorbs fructose. The body does not produce not enough enzymes to absorb a normal amount.
A normal healthy body can absorb around 25-50g of fructose per sitting. So even the average person can’t consume unlimited fructose without experiencing some symptoms. Intolerance is diagnosed when someone can digest less than 25g per sitting.
The symptoms of fructose intolerance are caused by the fructose that remains in the digestive tract. It is fermented by bacteria in the gut, causing symptoms.
When you have fructose intolerance, it’s important to remember that it doesn’t mean no fructose can be consumed. You can still consume small amounts of fructose in the daily diet. Management involves reducing high-fructose foods to relieve symptoms.
Symptoms of fructose intolerance
The symptoms experienced with fructose intolerance are often hard to distinguish, as they can be similar to other conditions.
Common symptoms include:
- Abdominal pain
- Bloating
- Wind
- Diarrhoea and loose bowels
- Fatigue
- Brain fog
How is fructose intolerance diagnosed?
There is a test known as the hydrogen breath test. As it is a breath test, it’s easy to have tested with kids – no blood, needles or other scary things involved! You can ask your GP about having a hydrogen breath test if you suspect fructose intolerance.
Fructose intolerance and other conditions
There are strong links to other digestive conditions, and in many cases, they can overlap.
People who have been diagnosed with Coeliac disease will often have issues with fructose. They will stop consuming gluten, but still experience digestive symptoms. In this case, fructose consumption needs to be considered.
There is also a strong tie with SIBO, or small intestinal bacterial overgrowth. SIBO occurs when there is an abnormal amount of bacteria in the small intestine. Most bacteria in the gut is in the large intestine, but in SIBO, it sneaks into the small intestine and causes issues.
SIBO has many of the same symptoms as fructose intolerance. However, SIBO will often cause other symptoms such as nausea, vomiting and weight loss.
Foods to avoid with fructose intolerance
A big part of managing fructose intolerance is reducing the intake of high-fructose foods. Fruits are the most common sources of fructose in the diet for kids. The highest fructose fruits include:
- Apples
- Pears
- Watermelon
- Grapes
- Honeydew melon
- Mango
- Dried fruit
- Fruit juice
Fructose can also be found in other food sources such as:
- Honey – try substituting with rice malt syrup
- Fruit juice concentrate – commonly used as a natural sweetener in packaged foods for kids and babies
- Tomato paste – fresh tomatoes are fine, but tomato paste is a more concentrated form of fructose
- Any processed foods that contain fructose or sucrose as an ingredient
Low fructose fruits
If fructose is an issue, you can still feed your little one fresh fruit! Here are the best choices for a low fructose diet:
- Stone fruits such as nectarines and peaches
- Berries such as blueberries and strawberries
- Citrus fruits such as oranges and lemons
- Kiwifruit
- Passionfruit
- Banana
- Pineapple
Fructose intolerance and FODMAPs
The low FODMAP diet is a popular diet that is used for managing IBS symptoms. It cuts out different sugars that can cause digestive distress, including:
- Fructose
- Fructans
- Galacto-oligosaccharides (GOS)
- Lactose
- Polyols such as sorbitol and mannitol
Many of the foods that contain these sugars are what we would consider healthy wholefoods. But if fructose intolerance is an issue, there is a chance that one or more of these could also be problematic.
However, a low FODMAP diet is very restrictive, and not meant to be used long-term. On the diet, it is followed until symptoms are under control, and then each type of sugar is reintroduced one at a time. In most cases, at least one or two groups can be reintegrated into the diet.
Long-term use of a low FODMAP diet can have a negative impact on gut health, as high FODMAP foods also contain prebiotics that feed healthy gut bacteria.
Think that fructose intolerance is causing issues?
If you think fructose is causing issues, there are a few things to consider. You can start by reducing high fructose foods and consuming low fructose fruits. You can also ask your GP for hydrogen breath testing.
But removing fructose is only one piece of the puzzle. It is just as important to repair the gut and support optimal function. There are two main considerations with repairing the gut:
- Balancing the microbiome by increasing good bacteria. This supports enzyme production and builds up the tolerance to different foods. I recommend a combination of probiotic supplement use and probiotic foods for someone experiencing digestive symptoms.
- Nutrition and herbs to enhance gut function. Using therapeutic compounds such as zinc, slippery elm and glutamine can help to soothe the digestive tract and repair any damage.
Fructose intolerance is not necessarily a lifelong condition. With some gut care and a reduction in fructose consumption, the issue may resolve. Your child may be able to tolerate normal levels of fructose in time.
But as we have seen, fructose is a murky topic. Malabsorption can often come hand in hand with other health issues. It can be hard to determine what the core issue is. That is why I always recommend seeking help from a qualified practitioner.
If you’re not sure where to start with your child’s symptoms, make sure you check out the Kids Health Quiz.
This multiple-choice quiz only takes a few minutes, and it helps you to pinpoint the area of your child’s health to focus on. You’ll also be directed to the resources that will best support you based on your result. To get started, click here.