High fructose intake fails to induce symptomatic adaptation but may induce intestinal carriers

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Debra Heilpern
Rateb Nabil Abbas
Stephanie Gladman
Maryse Menard
Byong H Lee
Andrew Szilagyi *
(*) Corresponding Author:
Andrew Szilagyi | aszilagy@gas.jgh.mcgill.ca

Abstract

Fructose has several interactions in man, including intolerance and promotion of some diseases. However, fructose in fruits and in prebiotics may be associated with benefits. Adaptation to regular fructose ingestion as defined for lactose could support a beneficial rather than a deleterious effect. This study was undertaken to evaluate symptomatic response and potential underlying mechanisms of fecal bacterial change and breath hydrogen response to short term regular fructose supplementation. Forty-five participants were recruited for a 3 day recall diet questionnaire and a 50 g fructose challenge. Breath hydrogen was measured for 4.5 hrs and symptoms were recorded. Thirty-eight subjects provided stool samples for analysis by selective culture of 4 groups of bacteria, including bifidobacteria and lactobacilli. Intolerant subjects returned a second time 15 days later. Ten of these served as controls and 16 received 30 g fructose twice a day. Ten of the latter returned 27 days later, after stopping fructose for a third challenge test. Student’s paired, unpaired t-tests and Pearson correlations were used. Significance was accepted at P<0.05. After fructose rechallenge there were no significant reductions in symptoms scores in volunteers in either the fructose supplemented or non supplemented groups. However, total breath hydrogen was reduced between test 1 and test 2 (P=0.03) or test 3 (P=0.04) in the group given fructose then discontinued, compared with controls. There were no statistically significant changes in bacterial numbers between test 2 and 1. This study shows that regular consumption of high dose fructose does not follow the lactose model of adaptation. Observed changes in hydrogen breath tests raise the possibility that intestinal carriers of fructose may be induced potentially aggravating medical problems attributed to fructose.

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Author Biographies

Debra Heilpern, Jewish General Hospital McGill university

Medical student McGill university

Rateb Nabil Abbas, Department of Microbial Biotechnology, Genetic Engineering and Biotechnology Research Institute (GEBRI), Minufiya University, Egypt.

Currently at McGill university Microbiogy

 

PhD

Stephanie Gladman, Jewish General Hospital, McGill university

PDT Department of Dietetics

Maryse Menard, Jewish General Hospital, McGill University

PDt department of dietetics

Byong H Lee, Microbiology, Mcgill University

Proffessor microbiology PhD

Andrew Szilagyi, Jewish General Hospital, McGill University

Division Gastroenterology, Department of Medicine

Assitant Proffessor Medicine