Specific Food Questions

[webb]

Hi all,

I'm new to this board and although I don't believe I have HFI, I do certainly suspect fructose malabsorption. I want to try a fructose-free elimination diet to see how I feel but I'm having difficulties finding fructose-free diet guides on the net. I have found some limited sources but with seemingly contradictory information.

This seems to be the most accurate representation I have came across based on my own research: www.bu.edu/aldolase/HFI/treatment/

My main concerns are vegetables, grains, nuts/seeds or other sources of fat, and which of each contain the least amount of fructose and could be acceptable on an elimination diet.

Could anyone help clear up my confusion and suggest foods that I can most likely tolerate? Are the vegetables listed in that link (asparagus, cauliflower, cabbage, green peppers, green beans, lettuce, spinach, celery) the ones that contain the least amount of fructose? Other information I've read from other sites seems to conflict saying that these vegetables such as asparagus, cauliflower and cabbage should actually be avoided if looking to eliminate fructose. What about brussels sprouts, kale, mustard greens and swiss chard which to me seem to fit in with the initial list? Any others vegetables? How should they be prepared/cooked?

What about grains such as buckwheat, quinoa, millet?
All natural nuts and seeds allowed?

Thanks very much for any help offered, all is appreciated!
And if anyone has any other links or dietary guides to offer that would be great.

[colormist]

Hi Webb,
When dealing with unfamiliar/uncommon foodstuffs, we normally visit a nutrition website and try to analyze whether or not it's safe. With your situation, it might be a bit different, but for HFIers, we subtract the glucose amounts from the fructose amounts. If there's more glucose, it's usually safe. If there's more fructose, it's not safe.
www.nutritiondata.com/

Here's the Kale: Raw data - www.nutritiondata.com/facts-C00001-01c20dh.html
It doesn't have any data entered into the field for sugar. That either means there isn't any, or maybe it hasn't been calculated.

Here's Kale: Boiled data -
www.nutritiondata.com/facts-C00001-01c20di.html
It has two grams of sugar, but the site doesn't break down what kind of sugar. It could be sucrose or glucose. As HFIers, we probably wouldn't eat cooked kale, as it has the potential to make us ill.

[julienc]

Gosh Webb, you're asking the million dollar question that can't seem to be answered by anyone, including nutritionists.

Colormist gave you a good resource.

My nutritionist told me no nuts of any kind. That leads me to believe that there is some fructose in all of them. I tend to do okay with raw almonds, but not much else in the nut family.

I can only really speak from my own experience and what I seem to "do okay" with (meaning not get sick), which is usually related to fructose content. Asparagus, cauliflower, cabbage are all fine with me. Again, I don't sit down and eat 10 pounds of them all at once, but a typical serving is fine, cooked or raw. I wouldn't necessarily avoid them, as your other source mentioned. However, it's worth noting that we do have one HFI'er who cannot tolerate asparagus, so that would lead me to believe that there is more fructose in it than the other items I mentioned.

I love spinach and eat oodles of it. I think any of the dark green leafy foods are fine. Again, raw or cooked. I can eat cooked green beans (from a can) but can't seem to tolerate fresh ones. I don't like brussel sprouts or green pepper, but that may be a taste thing rather than a fructose thing.

I've done fine with sunflower seeds in the past, but I haven't ever had large quantities of them.

Can't help you at all on the grains. This is still a big source of confusion for me.

As you can see, there just aren't that many answers out there. The only veggie I'd add to your list is broccoli. This is a once-a-week veggie for me, as it does contain a higher level of fructose than the others mentioned here.

Hope this helps. The link you posted from Dr. Tolan's site is a good resource - it's the same thing my nutritionist gave me when I was diagnosed.

[millan]

My personal experience is that when it comes to vegetables I can eat lettuce, spinach and cucumber in any amount without feeling sick.
I can eat the occational serving of asparagus, green peppers, radishes and celery without any problem.
I don't like (and reason that it would therefore make me sick since I have a very strong aversion to sweet tastes) broccoli, cauliflower, cabbage, brussel sprouts.

For nuts/grains/etc, I just love sunflower seeds.
I do have a mild allergy to normal nuts and don't eat them (maybe one nut during christmas and then my throat start to itch) so can't say anything about their fructose content.
I don't like quinoa and think that there's just a little bit too much fructose in it.
I eat bulgur a couple of times every week but think maybe not everyone could tolerate it. I have rice and pasta in any amount without any problem.
I am not very fond of boiled potatoes, but I like them raw or fried. ;D
Just as julienc noted, it's not really simple and "by the book/lists", we all have slightly different things that we can tolerate.

I would suggest that you look up different items on the nutrition site colormist linked to (with the list from dr Tolan's site as a start) and then make a list with three groups.
1. Food that should be ok.
2. Food that might be ok.
3. Food that probably aren't ok.
Then you can start trying the food from the first group - and really listen to your body while you do that.
When you have a grasp on whether all of those things are good and how you feel if anything aren't, you can slowly try the second group.

Good luck!

[lisa]

The beginning is really difficult, but it gets a lot easier over time. I remember when grocery shopping used to take over an hour because I did not have the general understanding of what was an appropriate food and label reading can be confusing.

My son was diagnosed with fructose malabsorption rather than HFI, but we stuck to the HFI guidelines to start out with. Unfortunately, there is not one concise diet list to work from, so it is a bit of trial and error. Millan and Colormist have made good suggestions for a starting point.

Nate can have some things that HFI cannot (limited straw, blue & black berries for example) and other HFI safe are not OK (cocoa, spinach/lettuce), though that is probably a separate issue.

For nuts, Nate can eat peanuts, walnuts and sunflower seeds, but not almonds or cashews. He eats lots of peanut butter and jelly sandwiches. Smuckers makes a SF strawberry with Nutrasweet that has worked out well for us, but if you can find rhubarb there is a very tasty recipe for rhubarb jelly on this board.

Cereals he can have a few times a week - maybe every other day. His favorite is Grapenuts, but he also likes puffed rice, puffed millet, Purely O's, and shredded wheat. He used to eat oatmeal, but not as much anymore. He does like the scones recipe listed on the U of Iowa website which contains oats.

For veggies, Nate eats snow peas, celery, and a limited amount of broccoli (a sprig or two once or twice a week). Every once in a while he will eat a sprig of cauliflower or a radish. He eats all veggies raw. I think he could eat more kinds, but kids are picky.

Eggs were a very big part of the diet in the beginning. Also, he CRAVED yogurt in the beginning and ate it several times a day. We flavored it with vanilla extract (watch, some use sugar) and stevia. SF jello or drink mix also works well for flavoring yogurt if you want something sweet, though it is good when eaten plain. Nate's desire for yogurt and eggs have dropped off some, but he continues to crave cheese and milk. Constipation issues were solved when we started him on the cereals.

Hope that helps some. Are you seeing a doctor at all and do you plan to be tested for FI or just try the diet to see if it works?
Just curious, what part of the world are you in?

[webb]

Hello again everyone,

Wow! Thanks so much for all the response, this forum has been very helpful indeed.

I have just today cut out fructose from my diet so I guess I'll see what happens. I have not thought much about getting diagnosed from a medical professional as I've had bad experiences with doctors in the past, although perhaps that would be the best way to know for sure. For now I'm going to try things on my own and go from there.

What a confusing and complex situation it must be to suffer HFI. I guess the majority of the diet revolves around meat, eggs, milk, potatoe, oils, and then the odd vegge/seed/nut?

Are potatoes basically the only carbohydrate source that most can tolerate? Does anyone eat rice? Seems that some people do well with oatmeal, right? Are there any specific ways to cook certain foods that you know of that make that food more tolerable than it would be otherwise?

Thanks again for all the suggestions!! Very much appreciated.
And I live in Ontario, Canada by the way.

[julienc]

My diet does consist of a lot of meat, tons of dairy, and eggs.

As for carbohydrates, I eat lots of plain white rice, plain pasta (not the new fancy stuff that is made of whole wheat and lentils), and french/sourdough breads. I do eat oatmeal as well.

I've been eating this way my whole life, so I'm used to eating relatively bland food. I could see how it would be difficult for someone like you to all of a sudden switch to eating bland/plain food.

There are some pasta sauce packets out there that do not have sugar in them. Usually pesto/alfredo based. Fred may have more insight to what is available in Canada.

Good luck!

[colormist]

You learn to make lots of things pretty quickly. I tend to have my house overstocked on pasta. Mostly, we do okay on grains. I haven't had any problems with cream of wheat, corn meal, flour, whole grain flour, rices, couscous (well, not the box of couscous, but the homemade stuff).

I've always said I hate food. It has to be something pretty special to make me get excited about eating it (and it's usually something I shouldn't be eating). I had Chicken Hyderabadi this weekend (Indian food) and my kidneys were boycotting. I didn't get sick though (aside from the mild kidney pain), so it wasn't that bad.

Now I'm just rambling. I guess I don't want to do my work.

[webb]

Thanks for the suggestions. The picture is beginning to become more focused!!

I did correspond with Fred through email and his assistance was certainly appreciated and very helpful, thanks Fred!

So I'm looking to buy unenriched white rice, any grain length? And plain pasta! OK, sounds like a start anyhow...

Your diets may be bland, but at least to me they seem as if they would be healthy. Thanks again, all

[colormist]

Any grain length.

Oh, they're not healthy once you add all that butter and oil.