What Is Fructose Malabsorption?

Fruit is a usually healthy choice, but for those with fructose malabsorption, the wrong kind of fruit (or too much of it) can cause painful consequences. Nutrition Diva explains how to deal with fructose malabsorption.

Monica Reinagel, MS, LD/N, CNS
4-minute read
Episode #286

Despite what you may have read on the Internet, fructose is not harmful or toxic when consumed in moderation—especially when it comes from whole foods such as fruit.

However, there is a limit to how much fructose your body can process at one time. Could fructose be a hidden cause of your digestive distress? Today, I have some tips on how to diagnose and deal with fructose malabsorption.>


A friend of mine once sent me a huge crate of plump, ripe cherries from his family’s orchard in Washington state as a gift. They were so good—and it was such a rare treat—that I couldn’t stop eating them, and I ended up with a righteous stomachache. Most likely, the discomfort I experienced was caused by over-loading my system with too much fructose, one of the naturally-occurring sugars in fruit.

See also: Ask the Diva: Is Fructose Bad For Your Liver?


For those with fructose malabsorption, even a single serving of fresh fruit can cause problems.

Most of us can only absorb between 25-50 grams of fructose at a sitting—a bit more or less, depending on what other sugars are present in the meal. Unless you’re being immoderate (as I was that night), you’re unlikely to consume that much at a meal. Some people, however, have a much lower threshold. For those with fructose malabsorption, even small amounts of fructose, such as the amount in a single serving of fresh fruit, can cause problems.

Any fructose that isn’t absorbed remains in the large intestine, where the bacteria that normally reside there will start to digest it. This produces carbon dioxide gas, which can lead to bloating, belching, or flatulence. Fructose also pulls water into the intestines through the process of osmosis, which can cause cramping and diarrhea.

How to Tell if You Have Fructose Malabsorption

With any sort of food intolerance, half the battle is figuring out which food or foods trigger problems. This often takes quite a bit of detective work because we tend to eat lots of different foods at a given meal and symptoms can take anywhere from a couple of hours to a couple of days to appear. If you know you have fructose malabsorption, however, it is fairly easy to avoid the foods that will trigger problems for you. You can even still enjoy some fruit!

Fructose malabsorption can be definitively diagnosed by your doctor with a hydrogen breath test. However, you can do a simple experiment: Follow the dietary prescription recommended for people with fructose malabsorption. If you have a noticeable improvement in gas, bloating, and other symptoms, it may be that you have some degree of fructose malabsorption.


About the Author

Monica Reinagel, MS, LD/N, CNS

Monica Reinagel is a board-certified licensed nutritionist, author, and the creator of one of iTunes' most highly ranked health and fitness podcasts. Her advice is regularly featured on the TODAY show, Dr. Oz, NPR, and in the nation's leading newspapers, magazines, and websites. Do you have a nutrition question? Call the Nutrition Diva listener line at 443-961-6206. Your question could be featured on the show.