Fructose intolerance manageable with proper diet

My son has been complaining recently about tummy aches after eating certain fruits like grapes and watermelon. Lately, he can’t seem to tolerate apple juice even though it’s his favorite drink. Could the fruit be causing his pain? I thought that feeding him fruits was a healthy choice?

Generally, fruits and vegetables are a healthy choice for children. In fact, according to the U.S. Department of Agriculture, it is recommended that children ages 2-3 eat 1 cup of fruit per day, those ages 4-8 consume 1-1.5 cups, those ages 9-13 consume 1.5 cups, and those 14-18 consume 1.5-2 cups of fruit per day.

Fruits, fruit juices and some vegetables, however, contain a naturally occurring sugar known as fructose. Fructose is also found in honey, table sugar and high-fructose corn syrup used to sweeten many processed foods and beverages. Some people may suffer from fructose intolerance, a condition in which the body’s digestive system doesn’t absorb fructose properly. This can result in abdominal pain, bloating, constipation, diarrhea and gas for some.

According to a 2010 study by the American College of Gastroenterology (ACG), fructose intolerance is common in children with recurrent or functional abdominal pain, but the condition can be effectively managed with a low-fructose diet. It seems the condition is more prevalent in teenage girls who suffer from chronic abdominal pain, the study’s authors said.

According to the study, “Fructose Intolerance/Malabsorption and Recurrent Abdominal Pain in Children,” fructose intolerance in children is typically diagnosed by exclusion, meaning other gastrointestinal conditions like Crohn’s disease and ulcerative colitis are ruled out as the cause of the abdominal pain.

Once these have been ruled out, your doctor can test your son for fructose intolerance by administering a fructose breath test, which measures the rise in hydrogen in a person’s breath after an oral dose of fructose, according to the Cleveland Clinic Children’s Health Team.

If your child is diagnosed with fructose intolerance, you should see a registered dietitian to determine foods that are OK to eat and those that should be avoided. Generally, people with fructose intolerance should limit their intake of high-fructose foods such as juices, apples, grapes, watermelon, asparagus, peas and zucchini, according to the Mayo Clinic.

While it may be difficult to both find foods with low fructose and get your son to not eat foods with high fructose, there is good news for those with fructose intolerance: The ACG study found that more than half of patients who are fructose intolerant are able to maintain a low-fructose diet and are able to notice an immediate improvement in their symptoms.

Chow Line is a service of the College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, OSU Extension and the Ohio Agricultural Research and Development Center.  Send questions to Chow Line, c/o Tracy Turner, 364 W. Lane Ave., Suite B120, Columbus, OH 43201, or turner.490@osu.edu.

Editor: This column was reviewed by Irene Hatsu, state specialist in food security for Ohio State University Extension.

An apple a day OK, but enjoy other fruit as well

chow_100915-467347290Although a lot of my health-conscious friends push me to try produce that I’ve never even heard of before, I’m partial to the good old-fashioned apple. What can I tell them about the apple’s health benefits that will get them off my back?

First, there’s a lot to be said for eating a wide variety of produce. No matter how much you prefer an apple over, say, a persimmon, different types of fruits and vegetables offer different benefits. Your body will thank you for eating a broad range of red, orange, yellow, green, white, blue and purple fruits and vegetables on a regular basis.

That said, apples are nothing to sneeze at. A small apple (about 5 ounces, or about 2.5 inches in diameter) is considered one cup of fruit, which puts you well on your way toward the 1.5 to 2 cups of fruit that the Dietary Guidelines for Americans recommends that everyone enjoys each day.

A small apple has just 75 calories. An added bonus: It has 4 grams of fiber, including both the soluble and insoluble types that provide different health benefits. Apples also provide a good helping of vitamin C as well as some potassium. Not a bad package for something you can easily hold in your hand and chew on.

In addition, the polyphenols in apples have generated quite a bit of interest within the scientific community. Polyphenols are a group of micronutrients present in fruits, vegetables, tea, coffee, and some other plant-based foods and beverages. Although similar to each other, they have slight variations in their chemical structures that affect how they work in the body.

Polyphenols in apples have been studied for years, but a study published earlier this year suggests a way that one type of polyphenol in apples can benefit your health. The study, published in Molecular Nutrition and Food Research, focused on something called “vascular endothelial growth factor,” or VEGF. When present in large concentrations, VEGF can increase the risk of both tumors and blood vessel plaques. The researchers found that apple polyphenols called procyanidin oligomers directly interact with VEGF, potentially blocking it from causing damage.

In addition, apples provide the antioxidant quercetin, which helps protect the cardiovascular system and is associated with lung health.

As with most fruits and vegetables, much of the good stuff in apples lies within and just beneath the skin, so don’t peel. And, it appears that different apple varieties have varying levels of micronutrients, with a 2005 study identifying Red Delicious and Idared apples among the top performers that were studied.

For more about apples, see the Farm to Health resources page of Ohio State University Extension’s Local Foods website, localfoods.osu.edu/resources. It offers information on a variety of fruits and vegetables, including apples.

But remember, even though apples provide a host of health benefits, they can’t offer everything. Every once in a while, take your friends up on their offer and try something new. Whatever it is, it might become your next favorite fruit.

Chow Line is a service of the College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Martha Filipic, 2021 Coffey Road, Columbus, OH 43210-1043, or filipic.3@osu.edu.

Editor: This column was reviewed by Dan Remley, Ohio State University Extension field specialist in Food, Nutrition and Wellness.

For a PDF of this column, please click here.

Stomach pain after eating apples?

454181323Sometimes when I eat an apple, I get a stomachache afterward. Could it be from pesticide residues?

It’s highly unlikely that your stomach pains are coming from pesticide residues. In fact, there’s no evidence to support that notion.

It’s true that apples tend to land high on the list of the highly publicized Environmental Working Group’s annual Shopper’s Guide to Pesticides in Produce. In fact, in its 2014 report, the organization said nearly all apples it tested were positive for at least one pesticide residue.

Although that sounds alarming, the report doesn’t say much about the levels of pesticides detected. The organization uses data gathered by the U.S. Department of Agriculture to come up with its listings. In the data the group used for its 2014 guide, 743 of the 744 apples tested had residues lower than the government limits, most of them much, much lower. Remember, just because something is detected in minuscule amounts doesn’t mean it’s harmful. As with any substance, it’s the dose that makes the poison.

A 2011 study in the Journal of Toxicology — written in direct response to the advocacy group’s annual listings — analyzed the data and found that exposures to commonly detected pesticide residues pose a negligible risk — so low, in fact, that substituting organic produce for conventionally grown “would not result in any appreciable reduction of consumer risks.”

Avoiding apples and other produce is a bigger risk: Their health benefits are well-documented.

Still, the stomach pains you describe are not uncommon after eating apples. So, what’s going on?

A food intolerance is possible. A set of carbohydrate intolerances are suspected to play a role in some types of abdominal pain. If the problem is severe, you’ll want to check with your doctor to get a diagnosis.

The organization Food Intolerances Diagnostics suggests people with this type of intolerance avoid foods with a fructose content of more than 3 grams per serving, or a fructose-to-glucose ratio greater than 1. A fresh apple has 6 grams of fructose per 100-gram serving (or 3.5 ounces), and a fructose-to-glucose ratio of about 2.

If this is what’s going on, only you can decide if you enjoy eating a fresh, crisp apple enough to endure any resulting discomfort.

Finally, as with all fresh produce, don’t forget to rinse it thoroughly under running water first, preferably just before eating. That will dislodge any surface dirt and bacteria and wash it away.

Chow Line is a service of Ohio State University’s College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Martha Filipic, 2021 Coffey Road, Columbus, OH, 43210-1043, or filipic.3@osu.edu

Editor: This column was reviewed by Sanja Ilic, food safety specialist for Ohio State University Extension, the outreach arm of the College of Food, Agricultural, and Environmental Sciences.

Apples: A Guide to Selection and Use

57576191Apples are a versatile and appealing fruit of widespread popularity. Many enjoy growing their own apples in backyard planting, while other prefer to purchase quality apples grown by professional fruit growers. Whether you plan to grow your own apples or purchase them from someone else, it is desirable to have information descriptive of the various types enjoying popularity today. Such information can be used to make important decisions concerning the type of trees to buy for planting or fruit to purchase for family use.

Ohio’s Leading Apple Varieties

The trend today is toward red apples, especially when the apples are grown for sale to others through commercial marketing channels. In cases where the apples are being grown primarily for home use, yellow apples such as yellow Transparent, Lodi and Grimes Golden may be used. Golden Delicious, the most popular yellow variety today, in not only well suited to the home fruit planting, but to commercial as well. The popular red varieties of apples at the present time in order of number of trees in the state are Red Delicious, Rome Beauty, Jonathan, Stayman and McIntosh. Red apples becoming increasingly popular as people try them and like them are the varieties Franklin and Melrose.

Franklin is a cross between McIntosh and Delicious and has a fine flavor and aroma. Harvest is normally during late September. Melrose is a cross between Jonathan and Delicious. The fruits are large with good flavor and texture. They ripen around the middle of October. Other newer apples growers may want to try are Ruby, Holiday and the various strains of Red Delicious. Also worth trying are Tydeman’s Red, Paula Red, Prima, Priscilla, Surprize (yellow) and Empire. At present, there is a trend to plant trees on dwarfing rootstock, both in commercial orchards and in backyard planting. By planting small trees, the home gardener can get several trees of different cultivars (varieties) in the same space that one or two large trees would require.

Most of the popular varieties, including those mentioned above, are now available on dwarf and semi-dwarf rootstocks. Dwarf trees, normally do not get much over 10 to 12 feet tall at maturity, while semi-dwarf trees may grow to be 15 to 18 feet tall. Dwarf trees begin to bear earlier than the larger, standard trees. Dwarfing does not affect fruit size or quality.

Apples for Specific Use

Apples are a favorite fruit of many people for eating out of hand or in fresh salads. The fruit of many apple varieties are also excellent for making a wide variety of cooked products. Apples best suited to particular uses are indicated below.

Fresh

  • McIntosh
  • Cortland
  • Jonathan
  • Red Delicious
  • Golden Delicious
  • Stayman Winesap
  • Melrose
  • Franklin
  • Prima

Applesauce

  • Golden Delicious
  • Melrose
  • Yellow Transparent
  • McIntosh
  • Cortland
  • Jonathan
  • Grimes Golden
  • Stayman Winesap
  • Rome Beauty
  • Lodi

Pies

  • Cortland
  • Jonathan
  • Grimes Golden
  • Melrose
  • Rome Beauty
  • Yellow Transparent
  • McIntosh
  • Golden Delicious
  • Stayman Winesap
  • Lodi

Baking

  • Jonathan
  • Golden Delicious
  • Stayman Winesap
  • Rome Beauty
  • McIntosh
  • Cortland
  • Grimes Golden
  • Melrose
  • Stayman Winesap

Freezing for Slicing

  • Jonathan
  • Golden Delicious
  • Stayman Winesap
  • Red Delicious
  • Grimes Golden
  • McIntosh

Freezing for Sauce

  • Yellow Transparent
  • Wealthy
  • Cortland
  • McIntosh

Freezing for Baking

  • Baldwin
  • Northern Spy

Cider

The best cider is usually made from a blend of different varieties of apples. Varieties are grouped into four groups according to their suitability as cider material.

Sweet Subacid*

  • Rome Beauty
  • Delicious
  • Grimes Golden
  • Cortland

Astringent (Crab apples)

  • Florence Hibernal
  • Red Siberian
  • Transcendent
  • Martha

Aromatic

  • Red Delicious
  • Golden Delicious
  • McIntosh

Mildly Acid to Slightly Tart

  • Stayman Winesap
  • Jonathan

General Use

  • Jonathan
  • Golden Delicious
  • Stayman Winesap
  • Melrose

* Usually furnish the highest percentage of total stock used for cider.

Written by Richard Funt, Professor Emeritus, Horticulture and Crop Science, College or Food, Agricultural, and Environmental Sciences.
Originally prepared by James D. Utzinger, Extension Horticulture, The Ohio State University.