Article about Fructose and the Small Intestine

[Stefanie (Ziba)]

My husband found this journal article, and we both found it interesting. Curious to know your thoughts...

www.sciencenews.org/article/small-intestine-not-liver-first-stop-processing-fructose

[colormist]

I wonder if the small intestine still uses aldolase B to process fructose to glucose? If so, then I think HFIers would still be SOL.

I did a search on this wiki article about Aldolase B. Looks like the small intestine uses Aldolase B as well. en.wikipedia.org/wiki/Aldolase_B

When Fred has his diagnosis, the doctors said he could only safely process 10mg of fructose a day. I would presume this is not some arbitrary number and actually based on trialling various amounts to discover what amount showed a reaction in his body. If his small intestine could process up to 5g of fructose, I would think his doctors would have limited his diet to 5 grams instead of 10mg. I know this discovery was recent (in regards to the small intestine), but Fred's labs should have reflected this data. The fact that they didn't mirror this discovery suggests that HFI small intestines also cannot process fructose.

[ukbill]

I need to spend some time reading this and thinking about it.
When people drink say apple Juice or coke upto 25% of the sugars contained in the drink are absorbed through the mouth and throat directly into the bloodstream.
The Human system has never evolved to deal with such massive doses of sugar.. naturally this will not happen.
Will update this when I have time.

[antonia]

I have also read that the intestines do produce a small amount of Adolase B. Although never read anywhere exactly how much. I’ve heard a lot of people on this board say it’s also produced by the kidneys, but have never come across that in the literature myself.

I would think rate of digestion would have a lot to do with whether the small intestine was able to process any fructose. Colormist, do you know how Fred’s tolerance was tested? Was he given fructose orally or intravenously?

I know from my husband who has diabetes that fructose is a better sugar for him than glucose and sucrose because it takes longer for it to absorb, therefore entering the blood stream at a slower rate or being lower on the glycemic index. But maybe if it’s being processed in the small intestine as well this is another reason it’s considered low glycemic index (for a sugar).

I’ve also always felt that for my daughter (the HFI like one) that her reactions to sucrose were more severe than her reactions to foods with free fructose such as fruit. This never made sense to me, thought it would be the other way round. However maybe because sucrose is absorbed more quickly than fructose the small intestine doesn’t have a chance to work on it? I also learned early on not to feed her fruit unless it was part of a full meal. I never feed her fruit as a snack by itself and could not make sense of why it made me so nervous. The more food eaten with sugars the slower its absorption rate as well. More time for the small intestine to work on it? Not saying it could be safe for HFIers to eat any amount of fruit. Just things that make you go hmmm.

[colormist]

Antonia, this is what Fred wrote about how the dietitian came about with the fructose restriction for his HFI diet:

"The special Dietician, Miss M. Heaslop, developed a fructose restricted diet for me and I went on it immediately. After the first few days on this diet, I was asked to record on paper the time of day and how I felt for anything that was bothering me. Unbeknown to me, they were slipping controlled amounts of fructose into my food in order to establish my tolerance. The dietician told me that 100mg daily was all I could tolerate without some reaction."

I keep quoting 10mg for children (due to the weight differences between Fred and a child).

[Stefanie (Ziba)]

Interesting extrapolation, Colormist. Curious to know your thoughts, Bill.

Sugar is clearly linked to so many health issues. Fatty liver is not uncommon, and these patients do not have HFI. Contrary to popular belief, it is not fat that is causing these fatty livers.

[antonia]

I’m really shocked they conducted this experiment on Fred without his consent. A lot of unknown variables there as well that could have affected the accuracy of that 100mg/day value. Personally I hope it’s not true because I think it’s pretty easy to exceed that amount eating foods that are generally regarded as HFI safe.

[antonia]

Clearly nobody’s body was designed to handle the hit of sugar consuming the processed foods of today will give you. Or even the amount of fruit and vegetables we eat simply because they are available all the time, from all over the world, year round. However I wonder if our ability to process fructose could vary depending on our heritage, or the diets of our ancestors. I think about warm and wet climates where fruit and vegetables are abundant verses those where they’re available for a very short period of time or not at all.

[ukbill]

The tests were done on Fred many years ago when Doctors were allowed to experiment on patents because they were "god" and above the law in almost every situation.
I thought Fred has said 75Mg.. that's the figure I have always used anyway.. It's better to error on the safe side

Yes Fructose is a major problem and a certain killer as bad if not more than smoking.

The only time most humans used to encounter sugar and Fructose in particular was once a year in the Autumn/ fall when there is fruit about.

At this time of year it is important to put on as much body fat as posible to get through the winter period.

Today we can get sugar and fructose 24/7/365 and find it even in foods that have no reason to be sweet. like pork pies and sausages!

LIttle wonder there is an obesity crisis!

I wonder how many of those with fatty livers turn out to be Fructosemic but on one of the so far undiagnosed 31 types that possibly exist?

We may be very much more common than currently understood to be.

[gerri]

In 2007 I had a liver biopsy - my Endocrinologist at the time - diagnosed me with NASH and with inflamation of the small intestine. After much craziness from the Endocrinologist and her saying she wanted to do a gastro bypass - I told her I didn’t eat much - she also didn’t believe that I wasn’t an alcohol or drug abuser. She countinued to tell me to only eat my fruit and vegetables - to limit my carbs and meats. After that appointment I didn’t go back to see her. I tried to follow the diet she recommented - but continued to get sicker - but followed a low fructose diet - until 2015-2016, when I became violently ill. I was giving my service dog away - preparing for my end of life. I decide to drop all fructose - sucrose - all sugar that were causing me problems. Over the last two years I loss 70/lbs of bloat (it came off fast) - now within normal weight, for my height and age - no longer diagnosed with NASH. Triglycerides are normal, my severe sleep apnea now normal, my liver enzyemes all normal except my ALP (which is just above normal). My health has improved. Fructose in my diet has caused much damage to my body - autoimmune diseases - osteopenia and much more. If the first gastro had known anything about HFI - I think in 2007 I would have been diagnosed back then. I don’t think my body would have deteriated as badly as it has, since 2007.

[colormist]

How many years did you go undiagnosed, Gerri?

I'm so sorry you had to go through all this. I know the feeling of wanting to "eat healthy" all the while your body is telling you "this is not healthy". I am glad you were able to find your diagnosis, but I'm sorry you had to go through so much>

[ukbill]

Apparently even though there are 4 or more genes that can cause Fructosemia / HFI one is a total deletion gene.

If you have that error then no valid Aldob B is going to be made anywhere in the body.. Or so I currently understand.

I will let you all know when I have had my genetic tests done (another opportunity to pick an experts brains )

[nancy]

I believe this is the actual journal article that the science news article is referring to.

www.ncbi.nlm.nih.gov/pmc/articles/PMC6032988/

Anyway, it just makes a lot of sense because all of us have gastrointestinal issues first. Is it possible, I wonder,
if there are some organisms or lack thereof in our intestinal microbiome to blame for the loss of the aldolase b in our intestines and possibly also in our liver. It's amazing how the intestinal microbiome is being implicated in more and more diseases.