Abstract
Background/Aims: In a prospective study, we evaluated fructose absorption capacity in 17 healthy female volunteers aged 16–27 years. Methods: All volunteers underwent analysis of their daily food intake diary and standardized breath tests. The volunteers were challenged consecutively with oral intake of 50, 25 and 15 g of fructose. Results: The average daily ingestion of fructose (19.54 ± 14.95 g) was not different between volunteers with positive and negative breath tests. On day 1, 53% of subjects exhibited a significant (≧20 ppm) increase in breath hydrogen and gastrointestinal symptoms upon challenge with 50 g of fructose. Moreover, 37.5% of the volunteers with a negative breath test became positive upon a second challenge with 50 g of fructose but remained asymptomatic. On day 2, 1 of the 9 volunteers (12.5%) with a positive breath test on day 1 exhibited an asymptomatic positive breath test upon exposure to 25 and 15 g of fructose on day 3. The 8 volunteers with a negative test (25 g of fructose) remained negative after a second exposure to 25 g of fructose. Conclusion: The results of this study indicate that hydrogen breath tests with fructose challenge of 50 g of fructose are inappropriate to characterize clinically significant fructose malabsorption.
Journal Section:
Original Paper
References
1.
Shepherd SJ, Gibson PR: Fructose malabsorption and symptoms of irritable bowel syndrome: guidelines for effective dietary management. J Am Diet Assoc 2006;106:1631–1639.
[PubMed]
2.
Duffey KJ, Popkin BM: High-fructose corn syrup: is this what’s for dinner? Am J Clin Nutr 2008;88:1722S–1732S.
[PubMed]
3.
Park YK, Yetley EA: Intakes and food sources of fructose in the United States. Am J Clin Nutr 1993;58(suppl 5):737S–747S.
4.
Born P, Zech J, Lehn H, Classen M, Lorenz R: Colonic bacterial activity determines the symptoms in people with fructose-malabsorption. Hepatogastroenterology 1995;42:778–785.
[PubMed]
5.
Rumessen JJ: Hydrogen and methane breath tests for evaluation of resistant carbohydrates. Eur J Clin Nutr 1992;46(suppl 2):S77–S90.
[PubMed]
6.
Stone-Dorshow T, Levitt MD: Gaseous response to ingestion of a poorly absorbed fructo-oligosaccharide sweetener. Am J Clin Nutr 1987;46:61–65.
[PubMed]
7.
Rumessen JJ: Fructose and related food carbohydrates. Sources, intake, absorption, and clinical implications. Scand J Gastroenterol 1992;27:819–828.
[PubMed]
8.
Spiller R: Role of motility in chronic diarrhoea. Neurogastroenterol Motil 2006;18:1045–1055.
[PubMed]
9.
Madsen JL, Linnet J, Rumessen JJ: Effect of nonabsorbed amounts of a fructose-sorbitol mixture on small intestinal transit in healthy volunteers. Dig Dis Sci 2006;51:147–153.
[PubMed]
10.
Gibson PR, Newnham E, Barrett JS, Shepherd SJ, Muir JG: Review article: fructose malabsorption and the bigger picture. Aliment Pharmacol Ther 2007;25:349–363.
[PubMed]
11.
Fernandez-Banares F, Esteve M, Viver JM: Fructose-sorbitol malabsorption. Curr Gastroenterol Rep 2009;11:368–374.
[PubMed]
12.
Rumessen JJ, Gudmand-Hoyer E: Absorption capacity of fructose in healthy adults. Comparison with sucrose and its constituent monosaccharides. Gut 1986;27:1161–1168.
[PubMed]
13.
Ravich WJ, Bayless TM, Thomas M: Fructose: incomplete intestinal absorption in humans. Gastroenterology 1983;84:26–29.
[PubMed]
14.
Truswell AS, Seach JM, Thorburn AW: Incomplete absorption of pure fructose in healthy subjects and the facilitating effect of glucose. Am J Clin Nutr 1988;48:1424–1430.
[PubMed]
15.
Ladas SD, Grammenos I, Tassios PS, Raptis SA: Coincidental malabsorption of lactose, fructose, and sorbitol ingested at low doses is not common in normal adults. Dig Dis Sci 2000;45:2357–2362.
[PubMed]
16.
Rao SS, Attaluri A, Anderson L, Stumbo P: Ability of the normal human small intestine to absorb fructose: evaluation by breath testing. Clin Gastroenterol Hepatol 2007;5:959–963.
[PubMed]
17.
Kyaw MH, Mayberry JF: Fructose malabsorption. True condition or variance from normality. J Clin Gastroenterol 2011;45:16–21.
[PubMed]
18.
Simrén M, Stotzer PO: Use and abuse of hydrogen breath tests. Gut 2006;55:297–303.
[PubMed]
19.
Montonen J, Järvinen R, Knekt P, Heliövaara M, Reunanen A: Consumption of sweetened beverages and intakes of fructose and glucose predict type 2 diabetes occurrence. J Nutr 2007;137:1447–1454.
[PubMed]
20.
Fernández-Bañares F, Rosinach M, Esteve M, Forné M, Espinós JC, Maria Viver J: Sugar malabsorption in functional abdominal bloating: a pilot study on the long-term effect of dietary treatment. Clin Nutr 2006;25:824–831.
[PubMed]
21.
Rumessen JJ, Gudmand-Hoyer E: Functional bowel disease: malabsorption and abdominal distress after ingestion of fructose, sorbitol, and fructose-sorbitol mixtures. Gastroenterology 1988;95:694–700.
[PubMed]
© 2011 S. Karger AG, Basel
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