Fructose and sorbitol reported as contributing in some to IBS depression etc

[R.B.]

IBS poor digestive distrubance etc is a magor problem.

You can eat as well as you want but if all that good food just passes through it is of limited benifit.

Poor fat metabolism and absorbtion are reported in those with poor digestion, which links to my current interest in omega threes sixes, reflects in depression etc.

Inflamation in the intestines leads to higher levels of intestinal mucus to protect the mebranes but the mucus stops the membrane getting at the food.

The food is only partially absorbed creating products which agrrevate the iintestines which produce mucus - go back to start do no pass go.

In additon IBS etc is a form of inflamation so can trigger low level whole body inflamation which is exacerbated by omega three six imbalance etc.

I like many others had heard of wheat diary etc but never fructose (and less but maybe also sucrose) until recently. There is a good book by Elaine Gotterschall "Breaking the Viscous Cycle" which deals with the subject in a wider way, but this seems a good starting point.

Fructose is used heavily in the food industry as a sweetener.

Sorbitol is used as a sugar free sweetener.

I attach a trial, two Wikipedia free encyclopedia references, and a test provider which it appears is covered by US health insurance, but obvioulsy you would need to check with your advisor.

As with all things diet you should dicuss significnat changes wtih your medical advisor.

And it is a case of balance in all things. Whole fruit etc is more complicated as they have other sugars that assist digestion of fructose, it is not concerntrated etc. But it does make one wonder how much fruit juice is good, and if one should dilute.

More thought and research required at some point for me too.


RB





http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

1: Scand J Gastroenterol. 2000 Oct;35(10):1048-52. Related Articles, Links
Click here to read
Fructose- and sorbitol-reduced diet improves mood and gastrointestinal disturbances in fructose malabsorbers.

Ledochowski M, Widner B, Bair H, Probst T, Fuchs D.

Dept. of Clinical Nutrition, Institute of Medical Chemistry and Biochemistry, University of Innsbruck, Austria.

BACKGROUND: Fructose malabsorption is characterized by the inability to absorb fructose efficiently. As a consequence fructose reaches the colon where it is broken down by bacteria to short fatty acids, CO2 and H2. Bloating, cramps, osmotic diarrhea and other symptoms of irritable bowel syndrome are the consequences and can be seen in about 50% of fructose malabsorbers. We have previously shown that fructose malabsorption is associated with early signs of mental depression and low serum tryptophan concentrations. It was therefore of interest whether a fructose-reduced diet could not only improve gastrointestinal complaints but also depressive signs seen in fructose malabsorbers. METHODS: Fifty-three adults (12 males, 41 females), who were identified as fructose malabsorbers according to their breath-H2 concentrations, filled out a Beck's depression inventory-questionnaire, and a questionnaire with arbitrary scales for measurement of meteorism, stool frequency and quality of life for a 4-week period before dietary intervention and 4 weeks after dietary change as for fructose- and sorbitol-reduced diet. RESULTS: Depression scores were reduced by 65.2% after 4 weeks of diet (P < 0.0001), and there was a significant reduction of meteorism (P < 0.0001) and stool frequency (P < 0.01). Improvement of signs of depression and of meteorism was more pronounced in females than in males. CONCLUSION: Fructose- and sorbitol-reduced diet in subjects with fructose malabsorption does not only reduce gastrointestinal symptoms but also improves mood and early signs of depression.

Publication Types:

* Clinical Trial


PMID: 11099057 [PubMed - indexed for MEDLINE]



http://www.metsol.com/fructose_malabsorption.htm


Understanding Fructose Malabsorption






Fructose malabsorption is the inability to digest fructose, a common sugar found in many prepared foods and soft drinks. It causes cramping, bloating, gas or diarrhea when foods containing fructose are eaten. Fructose malabsorption occurs due to the body's lack of fructase, an enzyme normally produced by the small intestine. In IBS patients, there is evidence to suggest that more rapid small intestinal transit could deliver unabsorbed nutrients to the colon and hence lead to an increased gas production, causing pain and diarrhea. This may explain the reduced capacity to absorb free fructose in IBS patients. The fructose malabsortion breath test is a quick way to discover if a patient has fructose malabsorption.
The Fructose Malabsorption Breath Test offered by Metabolic Solutions is a version of the hydrogen breath test. It can be performed in a doctor's office or given to patients to do at their convenience and in their own homes. It provides a safe, non-invasive, and cost effective solution to diagnose fructose malabsorption.
Fructose malabsorption can be indirectly determined using the Fructose Breath Test. If fructose is malabsorbed, large quantities of fructose reach the colon, where bacteria break down fructose into fatty acids, carbon dioxide, methane, lactic acid and hydrogen gas. This test seeks to quantify the changes in breath-hydrogen concentration prior to and after the ingestion of fructose. Normally, very little hydrogen is detectable in the breath. In a patient suffering from fructose malabsorption the hydrogen is absorbed from the intestines, carried through the blood stream to the lungs and exhaled. In this test, the patient drinks a fructose-loaded beverage, and the breath is analyzed at regular intervals over several hours. Raised levels of hydrogen in the breath indicate that the fructose was malabsorbed. In a healthy subject the difference (measured in parts per million) in H2 production between baseline and post fructose ingestion measurements will be small.
The majority, but not all people produce H2. In most cases, non-hydrogen producing patients when exposed to fructose will generate methane (CH4). These patients will be properly diagnosed by measuring for CH4. As a result, each breath specimen is measured by Metabolic Solutions for H2 and CH4.


Metabolic Solutions, Inc., 460 Amherst Street, Nashua, NH 03063



http://en.wikipedia.org/wiki/Fructose

Fructose
From Wikipedia, the free encyclopedia


http://en.wikipedia.org/wiki/Fructose_malabsorption
Fructose malabsorption
From Wikipedia, the free encyclopedia

[R.B.]

A quote from the Gottschall book

"What a patients takes beyond his ability to digest does harm" (Gee)

"Digestion is the great secret of life" (Go and Sumerskill )

Maybe "You are what you eat" should be changed to "You are what you digest"

Until I started this long running wander on the subject of fats I had no idea how fundamanetally important digestion is to general health.

From this it looks as if it is an issue in a significant number of the populaton if the intake is high enough, but not so much at lower levels.

I have not looked at how much various foods/ products contain.

RB





http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum

1: Dig Dis Sci. 2000 Dec;45(12):2357-62.Click here to read Links
Coincidental malabsorption of lactose, fructose, and sorbitol ingested at low doses is not common in normal adults.

* Ladas SD,
* Grammenos I,
* Tassios PS,
* Raptis SA.

Second Department of Internal Medicine, Athens University, Evangelismos Hospital, Greece.

Normal subjects may incompletely absorb either lactose, fructose, or sorbitol and may therefore have abdominal symptoms. The frequency of coincidental malabsorption of these sugars is not known. This is clinically important, since we often ingest them during the same day and malabsorption may cause abdominal symptoms. To shed light on this issue we studied 32 normal subjects. Volunteers drank in random order the following solutions: 20 g lactulose, 50 g sucrose, 50 and 25 g lactose, 50 and 25 g fructose, 20 and 10 g sorbitol. Semiquantitative carbohydrate malabsorption was estimated with lactulose standards. Frequency of 50-g lactose (69%), 50-g fructose (81%), and 20-g sorbitol (84%) malabsorption was not significantly different (P = 0.3). The estimated median fraction of the ingested high dose malabsorbed was 42, 19, and 68% for lactose, fructose, and sorbitol, respectively. At low challenging doses, 63% of the volunteers absorbed two of three or all three sugars, and 88% were asymptomatic to two or all three sugars. In conclusion, the frequency of coincidental malabsorption of lactose, fructose, and sorbitol and intolerance to these sugars is not common, when normal adults ingest them at low doses.

PMID: 11258556 [PubMed - indexed for MEDLINE]