Product Feature: Fructose Malabsorption Allergies

In this, our Fructose Malabsorption Allergy product feature, we will briefly examine the Fructose Malabsorption Allergy and its symptoms.  We will also discuss the cooking tricks that we use here at Silly Yaks to make products which are safe for people with Fructose Malabsorption Allergies and the labelling of those products in our range.  The feature concludes with a list of products from the Silly Yaks 100% wheat free, 100% gluten free bakery range which are suitable for people with Fructose Malabsorption Allergies (and hence "Fructose Friendly™").

What is a Fructose Malabsorption Allergy?

A person who suffers from a Fructose Malabsorption Allergy is unable to properly digest foods which have an unbalanced fructose:glucose load.  Fructose is a fruit sugar which is found in a wide variety of plant foods, including many commonly consumed fruits and vegetables.  It is also added to a wide variety of processed foods, either directly as an ingredient or as a component part of a number of very popular food ingredients.  People who suffer from Fructose Malabsorption Allergies may also have difficulty in digesting fructans, which are long chain fructose molecules.  One of the most common food in which fructans are found is wheat.

Fructose Malabsorption Symptoms

Sufferers from Fructose Malabsorption Allergies exhibit a wide variety of symptoms which may include:

• Projectile vomiting.
• Explosive diarrhoea.
• Constipation.
• Flatulence.
• Abnormal weight gain or weight loss.
• Abdominal bloating and pain.
• Specific nutrient deficiency associated with constant upsets to the digestion and consequently impaired ability to process and break down nutrients.
• Mood swings, depression and other "psychological" symptoms.

Key Dietary Concerns for Fructose Malabsorption Allergies

A person with a Fructose Malabsorption Allergy must avoid all foods which are particularly high in fructose or which have a high ratio of fructose to glucose.  In addition, most sufferers are also advised to avoid foods which contain long chain fructans.  While there are some food preparation or dietary tricks that can be practised in order to render some of these foods safe to eat by people with Fructose Malabsorption Allergies (some of these techniques are described below), in the main sufferers are advised to avoid them.

Specific foods which should be avoided by Fructose Malabsorption sufferers include:

• Wheat;
• Onions and most members of the onion family (including leeks, shallots, spring onions, etc);
• Garlic is also an issue for many sufferers, although some individuals with Fructose Malabsorption Allergies are able to tolerate garlic - our advice is to avoid garlic unless you have been advised by your dietician that it is ok for you to eat;
• Asparagus, artichoke, eggplant, green capsicum;
• Concentrated forms of tomato, including tomato paste, sundried and semi-dried tomatoes, etc.;
• Chicory, including chicory root extracts (see The Issue with Inulin, below);
• Many sweet sauces, including chutneys, BBQ sauce, many of the Oriental sauces, etc.
• Apples, pears, grapes, cherries;
• A lot of the more exotic fruits, such as guava, honeydew, lychee, mango, nashi fruit, papaya, pawpaw, persimmon, quince;
• Watermelon;
• Dried fruits, including apple, apricot, currant, date, fig, pear, prune, raisin, sultana, etc.;
• Coconut milk and coconut cream;
• Honey;
• Many beans and legumes can also be a problem.

Food Technology Concerns for Fructose Malabsorption Allergies

A number of the commonly used food additives or "enhancers" are problematic for people who suffer from Fructose Malabsorption Allergies.  While to some extent you will need to be guided by your symptoms or reactions to specific food additives or ingredients, the following are some common food ingredients which are likely to aggravate a Fructose Malabsorption Allergy.  All of these ingredients are widely used in the Australian food market and many of them are not classed as "Food Additives", meaning that they do not have food additive numbers, may not be clearly marked on food labels, and may well be present in food products which are marketed as "Additive Free".

Note the Silly Yak Foods does not use any of these ingredients in any of the products in our range.

Fruit Juice Concentrate

Fruit juice concentrates are often used in "health foods" as an alternative sweetener to either cane sugar or artificial sweeteners.  Unfortunately for Fructose Malabsorption Allergy sufferers, most fruit juice concentrates contain high levels of fructose.  The most common, and cheapest, fruit juice concentrate on the Australian market is made from apple juice, which is highly problematic.

Fructose

Refined fructose is also often used as a sweetener.  Obviously, if you suffer from a Fructose Malabsorption Allergy, this is a sweetener to be avoided at all costs.

High Fructose Corn Syrup

More commonly used in North America, high fructose corn syrup is employed as a sugar substitute and preservative in many processed foods, including soft drinks, yoghourts, breads, biscuits and a variety of other products.  Once again, a food ingredient such as this which is very high in fructose, is to be avoided by Fructose Malabsorption Allergy sufferers.

The Issue with Inulin

Inulin, or chicory root extract as it is often called, has come into favour in recent years as a cheap food ingredient which allows manufacturers to boost the dietary fibre content of processed foods.  It can also be used as a fat or sugar substitute and can be used to achieve improvements in the taste, texture and mouth feel of processed food.  Due to these characteristics, the use of inulins in gluten free foods has become increasingly popular.

Inulins are fructans - long chain fructose molecules - and, as such, will aggravate a Fructose Malabsorption Allergy.

For more detailed information on inulins and why we do not add them to any of our products, please refer to our Frequently Asked Questions page.

Food Preparation Tricks

It is often said that the diagnosis of a Fructose Malabsorption Allergy condemns the sufferer to a lifetime diet of bland food.  However, it doesn't have to be that way.  Here at Silly Yaks we use a number of nifty tricks in the preparation of our recipes in order to maximise the flavour and enjoyment of our "Fructose Friendly™" products.  Some of these are tricks and techniques which you can use at home and are described below.

Using "Onion Water"

Almost the first thing that you are told when you are diagnosed with a Fructose Malabsorption Allergy is "Onions are your enemy - you can't eat them, you can't use them in cooking; just STAY AWAY FROM THEM!".  The problem with this is that once you start to flip through your cookbooks and rule out all of the recipes that contain onions, there's not a lot left - certainly not a lot left that tastes good!  It is even worse if you are a vegetarian, as onions, garlic, shallots, leeks, etc., are routinely used as flavour bases in vegetarian recipes.  Cooking without onions, and the other members of the onion family, will certainly be much more difficult and much less tasty!

There is a simple way, however, to get the flavour of the onion into a dish without the fructose.  The key is in understanding that the fructose in the onion is contained in the flesh of the onion and that this fructose is not liberated by soaking, boiling, etc., but remains in the flesh.  It is therefore possible to make an "onion water" by taking a couple of large onions, quartering them and then tying them tightly into a mid-sized muslin bag.  The bag can then be boiled in water, or as part of a more complex stock.  So long as the flesh of the onion remains in the bag and is removed from the pot once it has cooled, the resulting stock or "onion water" will have all of the taste of the onion without the fructose.

It is this method that we use to render our Meat Pie, Meat Shepherd's Pie, Steak & Mushroom Pie and our Beef & Bacon Pie "Fructose Friendly™", which is to say safe for consumption by people who suffer from Fructose Malabsorption Allergies.

Adding Glucose (Dextrose Monohydrate) to Foods

As discussed above, a person with a Fructose Malabsorption Allergy is unable to properly digest foods with an unbalanced fructose:glucose load.  One way to resolve this problem is to balance the excess fructose in problem foods with a similar (or greater) quantity of glucose (dextrose monohydrate).  By cooking a food with excess fructose with a carefully determined quantity of dextrose monohydrate, we facilitate a chemical reaction whereby the fructose and dextrose bond to form sucrose (table sugar) which is a sugar that will not stimulate a Fructose Malabsorption Allergy.

The big problem with using this method in an ad-hoc fashion to neutralise the effects of high fructose foods is that it is difficult to determine how much glucose to consume without detailed chemical analysis of the foods being consumed.  As a cooking method, especially in an industrial environment such as the Silly Yaks bakery, this method can be very valuable.

It is this method that we use to render our Apple Tart and our Apricot Tart "Fructose Friendly™", which is to say safe for consumption by people who suffer from Fructose Malabsorption Allergies.

Labelling

Historically, products from the Silly Yaks range of 100% wheat free, 100% gluten free bakery goods which are safe for consumption by people who suffer from a Fructose Malabsorption Allergy have been rather inconsistenly labelled.  We have experimented with using the terms "Onion Free" (too narrow in its meaning and requires the reader to understand quite a lot about the dietary strictures imposed by a Fructose Malabsorption Allergy - also tends to be subject to suspicion when applied to a product the ingredients list of which includes "onion water"), "Safe for People with Fructose Malabsorption Allergies" (makes specific reference to a medical condition and is too long to fit on our labels!), "Fructose Free" (technically untrue in the case of products like the Apple Tart and the Apricot Tart, which contain fructose but have had it neutralised using dextrose monohydrate) and "Fructose Friendly™".

We have decided to standardise on the use of the phrase "Fructose Friendly™" to denote products from our range which are safe for consumption by people who suffer from a Fructose Malabsorption Allergy.  We have chosen the term "Fructose Friendly™" because it meets the following criteria:

• It is generic and does not reference the name of a medical condition, and hence meets the criteria of Food Standards Australia & New Zealand for terminology relating to specific health claims on food labels.
• It is short, catchy and reasonably well understood by the existing community of Fructose Malabsorption Allergy sufferers.
• It does not require a detailed knowledge or understanding of the dietary strictures imposed by a Fructose Malabsorption Allergy and therefore can be easily understood both by sufferers and by people who may purchasing products for sufferers but who may not have a detailed understanding of the condition themselves.

List of "Fructose Friendly™" Products

The following products from the Silly Yaks range of 100% wheat free, 100% gluten free bakery goods are safe for people with Fructose Malabsorption Allergies.

Disclaimer: The information about fructose malabsorption allergies provided here is of a general nature and is intended as background information only. It is not intended as medical or dietary advice. If you think that you may have a fructose malabsorption allergy you should consult your doctor for medical advice and you should consult a qualified dietician for advice on maintaining an appropriate diet.