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Lesser known intolerance to fruit and vegetables affects one in 10,000 people

KANIKA SINGH RATHORE, 11/11/202511/11/2025

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For most people, a variety of food Fruit And vegetables It is the cornerstone of a healthy diet.

But for people with hereditary fructose intolerance, even a few pieces of juicy watermelon or a few sun-dried tomatoes in a salad can cause serious health problems.

This rare condition is not food Allergies Or sensitivity.

But if it is not identified and managed properly, it can cause serious health problems.

What is hereditary fructose intolerance?

Hereditary fructose intolerance is a rare genetic condition that affects how the body manages the sugar fructose.

Fructose is not on the bus FruitIt’s in the honey, some vegetablesSweetened beverages, and many packaged foods, such as cakes, cookies, sauces, and some breads. Fructose may also be added during processing of some meats (deli meats and sausages) and dairy products (chocolate milk).

Fructose isn't just in fruits

Fructose isn’t just in fruits ,Getty/iStock,

Sucrose (table sugar) and sorbitol (a sugar substitute often used in chewing gum, toothpaste, and medications) also contain fructose or are converted to fructose during digestion. This means that people with hereditary fructose intolerance are also intolerant to these sugars.

People with this condition do not have aldolase B, the key enzyme needed to break down fructose.

This means that fructose is made in the liver, kidneys and intestines. This excess fructose can cause serious health problems, such as seizures, coma and, in some cases, death from liver and kidney failure.

How common is this?

Hereditary fructose intolerance is passed on to a person if both of his or her parents have this gene. It is considered a rare condition affecting one in 10,000 people.

This usually becomes noticeable when babies start eating solid foods Fruit, vegetables Or sweet baby foods that contain fructose.

In adults, hereditary fructose intolerance may be overlooked or misdiagnosed as other conditions such as glycogen storage disease, eating disorders, or recurrent hepatitis.

Because of this overlap in symptoms, hereditary fructose intolerance in adults may remain undiagnosed for years.

How is it different from a food allergy or sensitivity?

Hereditary fructose intolerance is clearly different from food allergy. In food allergy the immune system reacts to the food – for example, cow’s milk protein – as if it is harmful to the body. This can cause symptoms like hives and pimples, swelling in the mouth or trouble breathing.

Hereditary fructose intolerance is also different from food sensitivity, like lactose intolerance or non-celiac Gluten sensitivity. It does not involve the immune system but may still cause discomfort such as bloating, altered bowel habits or stomach pain.

Hereditary fructose intolerance can cause discomfort such as bloating, altered bowel habits or stomach pain.

Hereditary fructose intolerance can cause discomfort such as bloating, altered bowel habits or stomach pain. ,Getty/iStock,

Hereditary fructose intolerance is a genetic condition that causes food intolerance and is not immune related.

This condition is also distinct from fructose malabsorption (previously informally referred to as “dietary fructose intolerance”). This is a mild digestive condition where the small intestine does not absorb fructose well, and causes symptoms such as abdominal pain, bloating and gas.

How do you know if you have it?

In infants and young children, symptoms may include vomiting, abnormal sleep or irritability, refusal of food, and failure to gain weight.

Some children instinctively avoid sweet foods, which may mask the condition until later in childhood or adulthood.

About the authors

Lauren Ball is Professor of Community Health and Wellbeing at the University of Queensland.

Emily Birch is an accredited practicing dietitian and lecturer at Southern Cross University.

Mackenzie Derry is a nutritionist, dietitian and PhD candidate at the University of Queensland.

This article is republished from Conversation Under Creative Commons license. read the original article,

In adults, symptoms may include chronic stomach pain, fatigue, and unexplained low blood sugar (sugar) levels. Doctors may notice subtle signs such as a swollen liver, abnormal liver tests, or signs of fatty liver disease.

Confirmation of the condition requires genetic testing or a special glucose (sugar) tolerance test. But for many people, diagnosis comes only after years of confusion, frustration, and diet trial and error.

How is it managed?

There is no cure for hereditary fructose intolerance. But this can be managed by strictly avoiding fructose, sucrose and sorbitol. Reading labels becomes essential in daily life, as sauces, medicines and even toothpaste can contain these sugars.

People with this condition need to pay attention to the following things:

  • Fruits: Avoid all fruits, juices, canned Fruit and others Fruit products
  • Cereals/Cereals: Avoid added sugar, honey, jaggery, dry cereals Fruit Or sweet taste. Pasta, rice and other plain grains like quinoa or buckwheat are generally safe but avoid flavored or pre-prepared varieties.
  • vegetables: most vegetables Peas, corn, beets, onions, pumpkin, sweet potatoes, carrots and zucchini are fine, except for sweet potatoes.
  • Bread: Only bread made without sugar or sweeteners is fine.
  • Sweets and dairy: Avoid sweet desserts or flavored yogurt (natural yogurts are usually fine). Be wary of plant-based milks, such as almond milk, which often contain added sugars.
  • Protein: Unsweetened or flavored red meat, chicken, turkey, fish, beans and lentils, eggs, tofu and tempeh are generally safe. But avoid processed meats, like sausage/deli meats, or marinated meats
  • Other foods: Be careful of sauces, dressings and condiments as they contain hidden sugars or sorbitol. Choose a homemade version using safe ingredients.

awareness matters

If someone avoids certain foods or if he becomes unwell after eating fruit, don’t assume he’s being fussy or dieting – he may have hereditary fructose intolerance.

Greater awareness of this rare condition could mean earlier diagnosis and better support for those affected.

For parents, noticing a sudden or severe aversion to sweets, frequent vomiting or slow growth in a child can be an important clue.

And for doctors considering hereditary fructose intolerance as a possible cause of unexplained digestive problems, low blood glucose or liver changes could be life-altering.

More information about hereditary fructose intolerance is availableIncluding recipes, tips and support on how to read food labels.

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