Fructose malabsorption may be gender dependent and fails to show compensation by colonic adaptation.
Fructose malabsorption is linked to gastrointestinal and other unusual symptoms. Polymers of fructose are also recognized prebiotics. While some prebiotics can self-adapt when consumed regularly (resulting in decreased breath hydrogen and symptoms), we wondered whether self-adaptation occurs with basic fructose. We evaluated 90 subjects (61 females). Each completed a diet questionnaire and underwent a fructose challenge. Breath hydrogen and quantified symptom scores were recorded. Group comparisons for sum of breath hydrogen and total symptom scores were evaluated with the Mann-Whitney U test. Spearman's correlation coefficient and chi(2) or Fisher's exact test were used as appropriate. Malabsorption occurred in 29 patients (32.2%) and low-grade symptoms without malabsorption in 30 (33%). Women complained of symptoms more frequently (p = 0.04) and exhibited more fructose malabsorption (p = 0.0527). Breath hydrogen correlated with symptoms (r = 0.516, p = 0.0037). Adaptation with increasing pretest fructose intake was absent. We conclude that gender may influence fructose malabsorption and there is no adaptation to regular consumption.
Szilagyi
Andrew
A
Division of Gastroenterology, Department of Medicine, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal, Quebec, Canada. aszilagy@gas.jgh.mcgill.ca
Malolepszy
Paula
P
Yesovitch
Samara
S
Vinokuroff
Christina
C
Nathwani
Usha
U
Cohen
Albert
A
Xue
Xiaoqing
X
D000220:Adaptation, Biological / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000378:metabolism*; D004040:Dietary Carbohydrates; D005260:Female; D005500:Follow-Up Studies; D005632:Fructose / Q000493:pharmacokinetics*; D005633:Fructose Intolerance / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013549:Sweetening Agents / Q000493:pharmacokinetics*
D004040:Dietary Carbohydrates; D013549:Sweetening Agents; D005632:Fructose