Friday, March 15, 2013

Food intolerances

edit from 07/05/2013: Instead of doing a series of articles, I have decided to make a big one.

In this article, I intend to describe the most common food intolerances that IBS patients suffer from. Which food to avoid, useful tricks, what to eat instead...

What is a food intolerance?

Food intolerance describes the inability to correctly digest one type of ingredient. Fructose, lactose, gluten, histamine are the most common. 

It is important to notice that this is not an allergy. Meaning the only problem you get is a rough digestion, with pain, gas or diarrhea. A food intolerance is not dangerous. If you observe some other allergic reaction, this is a whole new deal: food allergies are very dangerous, and you need to consult your doctor right away to get diagnosed!

Let's also point out that some of you out there think they suffer from IBS, but just have a food intolerance instead. Even if you got tested, the result is not 100% sure. So by tweaking your diet, you might become symptom-free very rapidly.

What is fructose intolerance?

Fructose intolerance (or malabsorption) is the inability to digest the fruit sugar "fructose". This is very often due to a limited amount of digestive enzymes required to break this sugar. 

Actually, everyone has a limit to the amount of fructose they can eat every day: so by over eating some fruits, everyone will need a few bathroom visits. To define fructose malabsorption, scientists simply agreed on a value of pure fructose that a normal person should be able to digest: 25g in one sitting. Anyone unable to do this suffers from fructose malabsorption, and it represents a surprising 30% of the population in western countries!

Of course the intolerance can range from mild, where you won't actually notice it, to very severe, where you will pay the slightest mistake in diet dearly.

You can get tested for fructose malabsorption, or you can try following the advice in this article for a week, and see how it goes. For IBS sufferers, I recommend getting rid of fructose, lactose and gluten for at least a few months.

What not to eat

An important point with this intolerance is that fructose is actually fairly easy to digest when accompanied by glucose. This is why, when analyzing a food, we need to look at the fructose amount, but more importantly at the fructose to glucose ratio (we divide the fructose quantity by the glucose quantity). The ratio you are able to support depends on the severity of your intolerance. Personally, I can manage ratios up to 1.2 without problems.

The best list I could find on the internet is this one:
fructose food list

Here are some general guidelines:

  • No apples, no pears
  • Careful with dried fruits, the ratio is good but the quantities of fructose are huge! Eat with caution!
  • No fruit juice! (see exceptions below)
  • Common mistakes: artichoke, melon
  • Careful with honey as well
  • For very intolerant people, avoid tomatoes too
  • No sweet wines

What to eat instead

Seems harsh, right? You can try the following instead:
  • Berries are awesome
  • Bananas, plums
  • Jams are very high in sugar, but the fructose to glucose ratio is close to 1, so you may want to try.
  • For juices, pineapple and grapefruit should be no problem.
  • You may want to try grape juice as well, high in sugar, but good fructose to glucose ratio.
  • Dry wines and champagne should be no problem
Fortunately, it is very easy to check if a food is okay for you in this internet age. Fructose malabsorption is no fun at all, but the good news with this intolerance is that it's very easy to identify dishes that are not for you when eating out. Lactose and gluten intolerant people do not have that chance!


What is lactose intolerance?

Lactose intolerance is the inability to digest the mil sugar "lactose". This is due to a limiting amount of lactase in the digestive tract, the enzyme needed to break down this sugar into smaller,  simpler ones. 

It's important to notice that this intolerance can be genetic. In some asian countries, up to 90% of the population are lactose intolerant. So if you think you are lactose intolerant, this can be because of your IBS, or it can be from birth. You may never get rid of it.

What not to eat

This one is in my opinion the worst to live with, because lots of restaurants will add cream to their sauces without mentioning it on the menu. Only option: always ask if there's cream in the dish.
Of course milk is a big no. Milk derived products like cream, creme fraiche, yoghourt and the likes as well. Some cheeses are to be avoided as well. Here is a list. Anything below 2% lactose should be ok. 

What to eat instead

Fortunately for us cheese lovers, the fermentation process in cheese is based on bacteria eating lactose. So some cheeses can actually become almost lactose free. That's the case for camembert and brie for example.

Here's an good tip: if you want to buy "pure cheese", without anything added, you can have a look at the information on the packaging. Sometimes the amount of proteine/carbs/fats is mentioned. If this is pure cheese, the only source of carbohydrate is lactose, the only sugar available in milk. So if the packaging says that this particular cheese contains less than 0,5g of lactose per 100g, you can go ahead and buy it. As a big cheese eater, this helped me a lot!


1 commentaires:

Anonymous said...

Testing for food allergies can be complicated. There are many tests available and some of them just don't measure anything useful. There is an article about the various kinds of tests at http://www.ibstreatmentcenter.com/Newsletters/Aug13.pdf

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