IBS and sugar intolerance

It can sometimes feel that Irritable Bowel Syndrome (IBS) has a mind of its own. Some fruits, vegetables and dairy products irritate your gut, while others don’t. What’s going on?

The culprits are likely to be the naturally occurring sugars, particularly disaccharides, that are found in many foods.

The following are the most common disaccharides in nature and in our diet. Each has unique properties and roles in human nutrition and metabolism.

1. Sucrose: This is common table sugar and is found in many foods, particularly sweet fruits and vegetables, and is often added to processed foods. It is formed by linking glucose and fructose molecules.
2. Fructose: A naturally occurring fruit sugar. Almost all fruits contain fructose, making it a key component of their sweetness. Syrups may use concentrated versions of fructose to make sweeteners such as corn syrup.
3. Lactose: Also known as milk sugar and is present in milk and other dairy products. It is made up of a glucose molecule and a galactose molecule.
4. Maltose: Found in malted drinks and other foods and is produced when starch is broken down. This sugar is composed of two glucose molecules.
5. Trehalose: Found in certain types of fungi and plants, this disaccharide consists of two glucose molecules.
6. Cellobiose: This is not typically found in the human diet. Cellobiose is composed of two glucose molecules.
7. Isomaltose: Present in some foods and is a result of starch digestion. This disaccharide is composed of two glucose molecules.

The lactose, fructose, and maltose components of carbohydrates can all irritate our gut. This is more likely to occur when we have an imbalance of gut bacteria and lack digestive enzymes.

The Lactose Link

Lactose intolerance can be difficult to spot, as many people believe it’s a reaction to milk and milk products. While dairy foods are a source of lactose – it is ultimately down to how they are produced, that will affect their lactose content. This is why you may find that taking milk is intolerable, but certain cheeses are fine.  Here is a breakdown of the average lactose content of foods:

The Fructose Link

Like lactose, different fruits and vegetables contain varying amounts of fructose, which is why you may experience different reactions when eaten. It may be that a small amount of high-fructose food is tolerable, but having this understanding of the variations should help you to decide.  

Fructose intolerance is a condition that prevents our body from properly digesting this common type of sugar which is found in a wide variety of foods, including fruits, some vegetables, and honey. 

There are two main types of fructose intolerance: dietary fructose intolerance (also known as fructose malabsorption) and hereditary fructose intolerance. The former is a digestive disorder where the absorption of fructose is impaired because of a deficiency in the fructose carriers in our small intestine. This results in an increased concentration of fructose which can generate bloating, abdominal pain, and diarrhoea, especially after consuming foods high in fructose.

Hereditary fructose intolerance is a more severe condition that affects our ability to digest fructose. This is due to a genetic deficiency in an enzyme called fructose-1-phosphate aldolase, which is crucial for the metabolism of fructose. When fructose is consumed, it accumulates in our liver, kidneys, and small intestine, which can cause severe metabolic disturbances, including hypoglycaemia (low blood sugar), lactic acidosis, and hypophosphatemia (low phosphate in the blood).

This chart shows the relative quantities of fructose found in different food groups and can help explain the cause of various digestive problems relating to fructose intolerance.

The Maltose link

Maltose is a disaccharide sugar found in various foods, particularly grains e.g. barley or wheat and cereals. Malted foods go through a germination process known as “malting” where the starches in the grains are converted into sugars, making them easier to digest.

Malt is any cereal grain that has been made to germinate by soaking in water and then stopped from germinating further by drying with hot air. Malted grain is used to make a variety of products, including beer, whisky, malted milk, malt vinegar, and confections such as Maltesers and Whoppers.

Malted milk food is a product containing milk solids, malt extract, and cereal grain flour. Other malt-based foods include various health drinks that are manufactured using powdered gruel, which is processed with a mixture of malted barley, whole milk, and wheat flour.

In addition to their use in beverages and confections, malted foods are also used in other food products to add flavour and nutrients. 

The use of malt in food products dates back to ancient times and is still prevalent today due to its natural properties and benefits. The exact maltose content can vary depending on the specific product and preparation method, but here is a list of foods that are likely to contain maltose:

1. Pancakes: Pancakes, especially those made with malted flour
2. Sweet Potatoes: Sweet potatoes contain maltose, especially when cooked, as the cooking process can increase the maltose content
3. French Bread: French bread, like many breads made from wheat
4. Fried Onion Rings: Fried onion rings, particularly those made with a batter
5. Bagels: Bagels, especially those made with malted flour or malted barley
6. Pizza: Pizza, particularly the crust made from wheat
7. Hamburgers: Not just the burger itself, but also the accompanying bun if it’s made from wheat
8. Edamame: Edamame, or young soybeans
9. Malt-O-Meal Cereal: As the name suggests, Malt-O-Meal cereal contains maltose 
10. Wheat, Corn, Barley, and Rye: These grains and cereals contain varying amounts of maltose, and cooking can increase the maltose content 
11. Khorasan Wheat: Khorasan wheat, also known as Kamut
12. Spelt: Spelt, an ancient grain
13. Honey: Honey naturally contains maltose 
14. Pretzel: Pretzels, especially those made with malted ingredients

 Foods containing Trehalose

Trehalose is a naturally occurring sugar found in a variety of foods. Its use as an additive has increased significantly in the last 20 years due to the development of inexpensive extraction technologies. As a result, it's now found in a wider range of processed foods and used as a preservative to prolong shelf life, prevent discolouring and improve texture.

Here are some examples of foods that can contain Trehalose:

1. Mushrooms: Mushrooms are a natural source of trehalose
2. Seaweed - Seaweed also contains this sugar
3. Honey: Honey is another natural source of trehalose
4. Yeast: Yeast contains trehalose, which contributes to its ability to survive in harsh conditions
5. Shellfish: Shellfish are another source of trehalose, although the dietary contribution is relatively low compared to the added sugars in processed foods
6. Baked Goods: Trehalose is used in a variety of baked goods as a sweetener and stabiliser
7. Cereals: Some cereals may contain trehalose
8. Fish in Pouches: Trehalose is used in some packaged fish products to add flavour
9. Frozen Shrimp: Frozen shrimp is another food product where trehalose is used to make them more flavourful
10. Sweets: Trehalose is added to sweets like cakes and cookies to enhance their sweetness
11. Ground Beef: Trehalose is sometimes added to ground beef to improve the flavour to
12. Sushi Rice: Sushi rice is another food where trehalose is used, likely for its stabilising properties

Cellobiose

Cellobiose is not generally used directly in food production, but it can become present in foods as a result of the breakdown of cellulose during food processing. However, this is more likely to occur in the production of certain types of alcohol, such as beer, where cellulose breakdown can occur during the fermentation process. Here are some examples of foods that may have high cellobiose content as a result of their production methods

1. Honey: Honey can contain cellobiose, although the exact amount can vary depending on the variant
2. Corn Syrups: Some types of corn syrup may contain cellobiose
3. Fermented Meat and Sausage Products: Cellobiose can be used in the production of fermented food preparations, including fermented meats and sausages such as pastrami, parma ham, salami and chorizo.  

Isomaltose

Isomaltose is a disaccharide sugar that consists of two glucose molecules. It's not typically found in large amounts in the human diet, but it can be derived from certain foods and is used widely in the food industry. Here are some examples:

1. Corn Syrup: Corn syrup contains isomaltose, among other sugars 
2. Confectionery: Isomaltose has potential applications in the food industry, such as in sweets, chocolates and snacks
3. Processed Fruits and Vegetables: Isomaltose can be used in processed fruits and vegetables to create jams, pickles, and other sweet fruit flavours.

4. Canned and Bottled Food: Isomaltose is also used in canned and bottled food as a sweetener and preservative.

Even though many foods contain naturally occurring sugars, many more, especially processed foods, increasingly add sugars for enhancement reasons. 

If you are finding that you can’t tolerate foods that are high in naturally occurring sugars, consider adding an intolerance enzyme and a probiotic to help reduce the intensity of your reaction, expand the range of foods that you eat and try and consume fewer processed foods.

A suitable enzyme product like Cura Nutrition’s CuraZyme Tolerance, plus Cura Sporebiotics may be beneficial.