Vegetarian needs guidance for possible fructose intolerance
To Your Good Health
BY KEITH ROACH, M.D.
DEAR DR. ROACH: What can you tell me about fructose intolerance and/or malabsorption? Is there a genetic predisposition to this? Can it develop later in life? What are the symptoms, and how is it diagnosed? What type of doctor can best make a diagnosis? I’ve read conflicting reports online regarding the breath analysis test. Can it be treated, or must one eliminate foods containing fructose completely from one’s diet?
My father was diagnosed with some sort of fructose problem years ago. I have no other information about his condition as he has since passed away. I have developed some intestinal issues over the past year and have noticed I frequently experience stomach cramps after eating grapes and green apples, specifically. I am a vegetarian, and my diet consists of lots of fruits and vegetables. I’m wondering if I may have an issue with fructose. I hope not! What are your thoughts? — D.K.
ANSWER: Fructose intolerance is common but it is seldom diagnosed. One cause, hereditary fructose intolerance, is a genetic disorder that can cause serious symptoms in infants and children, but it is usually mild in adults. The symptoms of fructose intolerance are very similar to another sugar intolerance — lactose, the sugar in milk. Many people cannot tolerate lactose and if they eat too much of it will have cramping and diarrhea. Unlike lactose intolerance, which has a simple diagnostic breath test, there is no commonly available test for fructose intolerance.
Fructose is a simple sugar, called a monosaccharide, and is found in many fruits, especially apples, pears, cherries and dates. Fructose is also found in honey and is part of the disaccharide sucrose (table sugar), where it is combined with glucose. What is fascinating yet poorly understood is that when fructose is consumed with glucose, it is absorbed better by people with fructose intolerance. Therefore, the goal in someone with inability to absorb fructose is to reduce or avoid fructose by itself. That means reducing foods and beverages sweetened with high-fructose corn syrup, which is present in many products; eating high-fructose fruits only with meals; and reducing honey intake.
Sorbitol, a sugar alcohol used as a sweetener in “diet” or “sugarless” foods, tends to worsen fructose intolerance and should be avoided.
A vegetarian diet is very healthy for most people, and you shouldn’t have to give up your fruits. Just following some simple rules should reduce or eliminate your symptoms.
DEAR DR. ROACH: Does BPH increase the possibility of prostate cancer? — A.L.
ANSWER: Benign prostatic hypertrophy is a common condition in men. About half of men in their 50s have an enlarged prostate, and the proportion gets even higher as men age. The major symptoms of enlarged prostate are difficulty with urine flow, a sensation of decreased emptying, difficulty initiating urination, and increased frequency of urinating, including at night. As symptoms worsen, incontinence can occur and even kidney damage may result due to the high pressure in the bladder.
The first word in “BPH” is “benign”: It is not a cancerous condition. It does not protect against developing cancer, but there does not appear to be an increased risk for cancer among men with symptoms of BPH, according to the most recent studies.