Fructose Sensitivity

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Fructose is a monosaccharide, also known as fruit sugar, which is metabolized differently from other sugars; as soon as fructose enters the cells, it is quickly metabolized to fructose-1-phosphate which may partially deplete intracellular ATP and inorganic phosphate; decreased cellular ATP causes disturbances in protein, RNA and DNA synthesis, interferences with cyclic AMP formation, and reduced ammonia detoxification; unlike glucose, fructose does not require insulin to enter cells and it has only a minimal effect on the stimulation of insulin secretion; elevations of lactate, uric acid and triglycerides may result with implications for cardiovascular disease and gout.

Since fructose intolerance is a cellular event rather than a single micronutrient deficiency, symptoms may vary considerably. Clinical symptoms of fructose intolerance include behavioral changes, depressed immune function, dizziness, fatigue, headache and weakness. Certain individuals with an intolerance to fructose may also show an elevation of uric acid, hypertriglyceridemia, and interference with copper metabolism.

Dietary sources of fructose are numerous; however, an excess intake of fructose should be avoided rather than absolute removal of dietary fructose. In this manner, whole foods containing fructose (fruits and some vegetables) may be consumed since they contain other important micronutrients and enzymes that are not found in other foodstuffs. It should be emphasized that these recommendations are relevant only to individuals with an intolerance to fructose, and individuals who are unable to adequately metabolize excess amounts of fructose.

Individuals exhibiting an intolerance to fructose should avoid concentrated sources of fructose as much as possible. This includes foods sweetened with high-fructose corn syrup, fruit juice concentrate, honey and table sugar; and reducing the ingestion of sweet foods including cake, candy, cookie, fruit drink and ice cream, to name a few. Carefully read food labels for the words: corn sweetener, corn syrup, high-fructose corn syrup, sucrose, fructose, levulose, invert sugar, and sugar. Since sorbitol is converted by the cells to fructose, its ingestion should also be reduced.

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