Medical Nutrition Therapy: Low Sucrose Diet

What is Sucrose?

Pure sucrose is a natural sweetener that we commonly call table sugar. There is some natural sucrose in honey, molasses, syrup, fruits, and vegetables. Sucrose is also added to many processed foods like hot dogs, sweetened fruit juices, fruit drinks, canned fruits, ham, sweetened, soda, ketchup, and spaghetti sauce.

Why is the Diet Necessary?

Normally, sucrose from the food we eat is broken down in the body by an enzyme named sucrase. Enzymes are like the key that starts the engine of a car, they are proteins that begin reactions in the body. A lack of the enzyme sucrase in the gut prevents the breakdown of sucrose from the diet into the simple sugars, glucose and fructose. Too much sucrose in the gut causes gas, abdominal pain, cramping, and diarrhea. The sensitivity of each person with sucrase deficiency is different. Some people can tolerate more sucrose in the diet than others. If high amounts of sucrose and fructose are consumed, even a person without

a sucrase deficiency may experience symptoms of gas, abdominal pain, cramping, and diarrhea.

Children with these symptoms may be diagnosed with toddler’s diarrhea. Drinking too much fruit juice (particularly apple juice, which has lots of fructose and natural sorbitol) is a common problem that brings on these symptoms in children. Using less sugar in the diet will help to improve the symptoms.

Label Reading

Check all food labels for the presence of sugars, syrup and other sucrose-containing foods. At first, avoid foods that list sugars as one of the first four ingredients. If you are not sure about the product, contact the manufacturer. Most products list a manufacturer’s telephone number on the label that you can call for further questions.

Talk with your doctor or pharmacist about whether your medicines contain sucrose. You may need some medicines to be specially made without sucrose. Allow extra time for this custom preparation. Many lozenges, cough and vitamin syrups contain sucrose.

Nutritional Adequacy

Following a low sucrose diet does not require any special nutritional supplementation. Eating a healthy, well-balanced diet will ensure that the appropriate nutrients are consumed.

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Foods Allowed

Bread

Breads made with white, wheat or other whole grain flours

Flour, Cereals

Wheat and rye flour, corn flour, oatmeal, rice, sago, pearl barley, tapioca

Use whole grain cereals, breads, and crackers in moderation.

Desserts, Cakes, Biscuits

Homemade ice cream and milk pudding using allowed sweeteners instead of sugar

Custard powder, unsweetened jelly crystals, gelatin, unsweetened pastry

Homemade biscuits, muffins and cakes made with allowed sweeteners

Sweeteners

Glucose, corn syrup, artificial sweeteners

(NutraSweet®, Equal®, Sweet’n Low® or

Stevia) *

Jams, Sweets, Spreads, Nuts

In children over 2 years: whole peanuts, salted

Soups

Homemade soups using foods allowed, meat extracts, soup cubes

Fats

Butter, margarine, oils, cream, lard

Beverages

Milk, plain cocoa powder

In moderation: sugar-free Kool-Aid

, sugarfree soda, sugar-free lemonade, sugar-free tea, sugar-free coffee

Condiments

Pure spices, herbs, essences, food coloring, salt, pepper, dill, curry powder, mustard

Milk or Milk Products

Whole, 2%, 1% or skim milk, evaporated milk, plain yogurt, sugar-free yogurt, buttermilk

Cheese, eggs

All cheese and eggs, except those to avoid.

Meat, poultry, fish

Meat, poultry, fish, eggs

Foods to Avoid

Bread products with sugars as one of first 4 ingredients, or those containing soy.

Sugar- coated or honey-coated cereals that contain or added sugars as one of first 4 ingredients. Avoid soy.

Sweetened and diet commercial ice cream or sherbet, ices, canned or packaged puddings, desserts and mixes.

Purchased cookies, graham crackers, biscuits, muffins, cakes, pies, sweetened pastry

Cake, muffin, sweet bread or biscuit mixes

Sugar: table, granulated, powdered, brown, raw, turbinado, lump, demarara icing, honey, treacle molasses, syrup, maple syrup

*Artificial sweeteners such as sorbitol, xylitol and mannitol should be avoided as they can cause diarrhea.

Honey, whipped toppings, jam, diabetic jam, candy, chocolate, nuts, peanut butter, carob, crystallized fruit, fruit leather, fruit snacks

Canned or dehydrated soups

Mayonnaise, salad dressings

All milk flavorings, milk shakes, sweetened

Kool-Aid

, or pre-sweetened Kool-Aid

 crystals, sweetened soda

Sauces, chutneys, ketchup, pickles, gherkins

Powdered milk, chocolate milk, sweetened condensed milk, malted milk, sweetened fruited yogurt

Some processed cheese spreads

Check all commercially prepared meats and fish including pasties, sausage, ham and frankfurters/hot dogs for ingredients to avoid.

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Foods Allowed

Vegetables, legumes

All vegetables except those listed to avoid

(fresh, canned or frozen)

Carrots: not more than 1 small carrot a day

Limit to 2 Tablespoon portions: green peas, parsnips, turnips, sweet potatoes, rutabaga, beets, or onion

Fruit

Limit up to 2 servings per day (raw, canned in water, or cooked with allowed sweeteners) and serve with meals:

Apricots, 1 small

Grapefruit, ½ small

Cantaloupe, ½ cup, diced

Cherries ½ cup

Watermelon, ½ cup, diced

Plums, 1 small

Peaches, 1 small

Raspberries, Blackberries, Blueberries, ½ cup

Kiwi ½ fruit

Pineapple ½ cup chunks

Strawberries ½ cup sliced

Orange, ½ medium

Dried Fruit, 1 ounce

Small amounts of lemon juice for flavor.

Foods to Avoid

Commercial spaghetti sauce, all dried beans, lentils, soy beans, all baked beans, gherkins, and sweet pickles.

Avoid fruit juices. Fruit canned or frozen in syrup or cooked with added sugar.

Banana, grapes, mango, persimmons, apples, pears should not be tried until patient is symptom free.

Do I have to stay on this diet?

If symptoms get better or go away on the diet, a slow increase in sucrose may be tried. Introduce only one new food no more than once per day to see how the new food is tolerated. Increase sucrose slowly by adding one of the following foods per day and wait for symptoms:

▪ Add a third serving of fruit

▪ Try ½ of a small banana, grapes, mango, persimmons, apple, or pear.

▪ Allowing foods that list sugar as the 3 rd or 4 th ingredient or lower on the label.

If you remain symptom-free, continue to try new foods. If symptoms restart, restrict diet to where you are symptom-free.

If you have more questions please contact UW Health at one of the phone numbers listed below.

Nutrition Clinic

University Station

2880 University Avenue

Madison, WI 53705

(608) 263-5012

Nutrition Clinic

UW Health West Clinic

451 Junction Road

Madison, WI 53717

(608) 265-7526

Nutrition Clinic

UW Health East Clinic

5249 East Terrace Drive

Madison, WI 53718

(608) 265-0963

Copyright  1/2013. University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the

Clinical Nutrition Services Department. HF#338

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