Navigating the Sucrose Intolerance Diet - AKA Sucrase-Isomaltase Deficiency Diet

Navigating the Sucrose Intolerance Diet

Most of us are familiar with lactose intolerance.  And you may also even be familiar with fructose intolerance.  But what about SUCROSE intolerance?  Yup; that’s a thing! Getting diarrhea after eating sugar is more common than you realize, and it’s often caused by a sucrase-isomaltase deficiency.  If this is the case for you, a sucrose intolerance diet may be worth trying (with guidance from a CSID-informed gut health dietitian as needed).

Read on to learn the ins and outs of a low-sucrose + low maltose diet (aka a “sucrase-isomaltase deficiency diet”).

Disclaimer: This isn’t medical or nutrition advice; the information in this article is educational and generalized, NOT customized to your individual needs!  Some or lots of the information in this article may or may not apply to you. Make sure you’re working with a registered dietitian and doctor who specialize in sucrase-isomaltase deficiency to receive custom clinical guidelines and the right protocols for YOU.

Affiliate disclosure: This article contains affiliate links*. As an Amazon Associate, I may earn a commission on qualifying purchases at no extra cost to you!

What is sucrose?

Sucrose is the chemical name for “table sugar.”  Chemically, sucrose is a disaccharide which is made up of equal parts glucose + fructose.

Sucrose in the diet

There are three main ways to consume sucrose in the diet:

  1. Adding sucrose-based sweeteners to coffee, tea, or recipes
  2. Consuming foods naturally high in sucrose (i.e. carrots, pineapple, starchy foods)
  3. Consuming processed foods made with high-sucrose sweeteners

(Get a comprehensive list of high-sucrose foods here.)

What is sucrose intolerance?

Much like a lactose intolerance or fructose intolerance, a sucrose intolerance is the inability to naturally break down sucrose in your intestines, because you’re lacking an intestinal brush border enzyme called sucrase-isomaltase. (1, 2)

This condition is a little-known underlying root-cause of irritable bowel syndrome (IBS) symptoms such as diarrhea, gas, bloating, nausea, and abdominal cramping.

If you have a sucrase-isomaltase deficiency and you consume table sugar (or any foods high in sucrose), your symptoms may be comparable to someone with lactose intolerance who just drank a big glass of regular milk.

To boot, a sucrose is also often accompanied by a starch intolerance, due to an inability to break down maltose (the sugar molecules found in starchy foods).

Sucrose intolerance and starch intolerance tend to fly under the radar, because there’s a lot of focus and hype on the low FODMAP diet for IBS.  But since the low FODMAP diet tends to be naturally higher in sucrose, a tell-tale sign of a sucrose intolerance is feeling worse on a low FODMAP diet.

Why and how can someone develop a sucrose intolerance?

A a sucrose intolerance (which often occurs alongside a starch intolerance) is caused by an underlying sucrase-isomaltase enzyme deficiency in your intestines.

There are two sub-types of a sucrase-isomaltase deficiency:

  1. Genetic, aka “congenital sucrase-isomaltase deficiency” (CSID)
  2. Acquired, or secondary sucrase-isomaltase deficiency (ASID)

CSID

When your sucrose intolerance is caused by CSID, you usually start developing symptoms in infancy because it’s caused by a genetic mutation which blocks sucrase-isomaltase enzyme production in your gut.

There’s no cure for CSID, but dietary modification and enzyme replacement therapy can go a long way to improve your quality of life.

Learn more:  Understanding Congenital Sucrase-Isomaltase Deficiency (CSID): Causes, Symptoms, and Treatment

ASID

The secondary or acquired form of a sucrase-isomaltase deficiency is caused by another condition such as small intestinal bacterial overgrowth (SIBO), celiac disease, Crohn’s disease, or ulcerative colitis.

These conditions may wreak havoc on your intestinal brush border (the hub for digestive enzyme production) if left unchecked for too long.

  • For example, SIBO means bacteria have migrated into your intestines and are damaging the brush border of your intestinal tract. (This leads to an insufficient production and secretion of the sucrase-isomaltase enzyme over time.)
  • Celiac disease, Crohn’s, and colitis are all types of inflammatory bowel disease which may also potentially interfere with the brush border enzyme production in your intestines.

Learn more:  Acquired Sucrose Intolerance: How to Navigate Sucrase-Isomaltase Deficiency in Adults

Sucrose intolerance signs and symptoms

Unfortunately, sucrose intolerance is a lot more difficult to pinpoint than lactose intolerance, since sucrose is found in so many foods.

As a result, you may end up spending many years suffering unnecessarily, due to a lack of clarity around what’s really going on in your body.

Physical symptoms

While everyone’s case is unique, the most common signs and symptoms of a sucrose intolerance may include:

  • Frequent diarrhea (especially after eating sugar or real maple syrup)
  • Stomach aches / abdominal pain / cramping
  • Gas and bloating
  • Nausea/vomiting
  • Indigestion
  • Feeling worse on a low FODMAP diet (3)

Mental/emotional symptoms

Symptoms of this debilitating food intolerance typically also go beyond physical, impacting you on a mental/emotional level:

  • Anxiety and fear around food
  • Confusion and overwhelm
  • Depression
  • Hopelessness
  • Frustration
  • Embarrassment
  • Feeling misunderstood/invalidated
  • Isolation and loneliness

Common Sucrose Intolerance Symptoms (Physical and Mental / Emotional) - Infographic

While the symptoms of a sucrose intolerance are no picnic, the good news is it’s figureoutable, and you’ve got options.

Sucrose intolerance treatment

Once you’ve determined (with help from your treatment team) that you do in fact have a sucrose intolerance, the next step is to move forward with sucrose intolerance treatment.

If you’re working with a functional dietitian (or CSID dietitian), you’ll likely move through a variation of the 5R protocol for gut repair, with a sucrose intolerance diet (alongside special digestive enzymes such as Sucraid®) being a primary intervention in the “Remove” and “Replace” phases of the 5R’s.

What’s a sucrose intolerance diet?

A sucrose intolerance diet is a type of IBS diet specifically intended for people with a sucrase-isomaltase deficiency.

This diet entails reducing/limiting your intake of high sucrose foods (which can’t be properly digested in your gut, leading to unwanted symptoms), while simultaneously leaning on more low sucrose foods in your diet.

Below are some general guidelines and a sample meal plan for those prescribed a sucrose intolerance diet.  This is meant to be used as a resource, alongside working with a doctor and registered dietitian who specialize in sucrose intolerance – to make sure you’re getting everything you need from a nutritional standpoint!

Sucrose intolerance diet: general guidelines

  1. Before starting, even after a sucrase-isomaltase deficiency has been identified, make sure you have a healthy relationship with food, self-care, and body image to ensure that this diet does not spiral into disordered eating and/or a slew of nutritional deficiencies. (Work with an intuitive eating / Health at Every Size dietitian for this type of work.)
  2. The first/next step is to gradually start removing and replacing foods high in sucrose with lower sucrose alternatives. (Refer to the chart and sample meal plan below as a guide!)
  3. Make sure to continue eating a balanced diet and including every food group, so you’ll get enough macro- and micronutrients.  Use the MyPlate as a visual if you aren’t sure where to start when it comes to food groups, ratios, and portion sizes.  Your dietitian will also be able to help you in this department. 😉
  4. Log your food intake and track your symptoms, to get a better idea of which foods your body is tolerating best. (Have you checked out this CSID Elimination Diet Workbook* created by my CSID dietitian colleague yet?)
  5. Lean on digestive enzymes, probiotics, and other functional foods/ herbs / nutraceuticals as needed, to support your gut holistically.
  6. When your symptoms are under control and you’re having bowel movements that resemble mostly 3’s and 4’s on the Bristol Stool Chart, work with your dietitian to start gradually reintroducing foods higher in sucrose to see if you’ll be able to tolerate them in small to moderate quantities.

Sample Images of Free Downloadable Sucrose Intolerance Food List PDF - Learn More Here

Sucrose intolerance diet: sucrose and maltose foods list

(Adapted from CSID Cares Food Composition Database & my clinical experience)

Food Group / Category

LEAN ON THESE

(Low Sucrose + Low Maltose  / Generally Well Tolerated Foods)

LIMIT / MODERATE / TEST

(Moderate Sucrose / Variably Tolerated Foods)

REDUCE / AVOID (High Sucrose / Not Well Tolerated Foods)

Fruits

Avocado

Blackberries

Blueberries

Boysenberries

Cherries

Cranberries (fresh)

Currants

Figs (raw)

Gooseberries

Grapes

Kiwifruit

Lemons

Limes

Loganberries

Olives

Papaya

Pears

Pomegranates

Prunes

Raspberries

Rhubarb

Strawberries

Plums
Raisins (unsweetened)Watermelon
Apples

Apricots

Bananas

Cantaloupe

Citrus:  oranges, grapefruit, clementines, tangerines, mandarin oranges, tangelos, etc.

Dates

Guava

Honeydew melon

Mango

Passion fruit

Pineapple

Peaches

Passion fruit

Veggies

Alfalfa sprouts

Artichokes

Arugula

Asparagus

Bamboo shoots

Bell peppers (red, yellow, green)

Bok choy

Broccoli

Brussels sprouts

Cabbage

Cauliflower

Celery

Chard

Chicory

Chives

Collard greens

Cucumber

Eggplant

Endive

Green beans

Kale

Lettuce

Mung bean sprouts

Mushrooms

Mustard greens

Radishes

Rutabaga

Spaghetti squash

Spinach

Tomatoes

Turnips

Watercress

Yellow squash (“summer squash”)

Zucchini

Jicama

Leeks

Okra

Pumpkin

Snow peas

Yellow wax beans

Beets

Butternut squash

Carrots

Green peas

Onions

Parsnips

Pumpkin

Grains / Starches

Amaranth

Barley pearls

Buckwheat soba noodles

Brown rice

Coconut flour (for baking)

Millet

Quinoa

Rolled oats / unsweetened oatmeal

Spaghetti squash

Wild rice

Whole rye bread

All-purpose flour

Cassava

Corn / corn flour products

Breads, pastries (muffins, bagels, croissants, coffee cake, etc.)

Commercially made crackers, croutons, breadcrumbs

Cereals

Granola, granola bars

Mainstream pancakes/waffles

Popcorn

Potatoes

White rice

Sweet potatoes

Tapioca starch

Wheat flour / whole wheat

Yams

Fats

Avocado

Avocado oil

Butter / ghee

Canola oil

Chia seeds

Coconut oil

Corn oil

Cream cheese

Flaxseed (ground)

Flax oil

Oils (all kinds)

Olives

Olive oil

Peanut oil

Sesame oil

Soybean oil

Sunflower seed oil

Peanuts

Peanut butter

Nuts

Nut butters

Nutella

Proteins (vegetarian)

Cheeses (all)

Cottage cheese

Cows’ milk

Goat milk

Plain yogurt

Eggs

Edamame

Tempeh

Tofu

Black beans

Black-eyed peas

Chickpeas (“garbanzo beans”)

Kidney beans

Lentils

Lima beans

Navy beans

Pinto beans

Soybeans

Split peas

Proteins

(Non-vegetarian)

Beef

Bison

Chicken

Fish/seafood

Cod

Halibut

Salmon

Seabass

Swordfish

Tilapia

Trout

Tuna

Lamb

Pork

Shellfish

Clams

Crab

Lobster

Mussels

Scallops

Turkey

Venison

Herbs / Spices

(Anecdotally)

Salt

Basil

Oregano

Rosemary

Thyme

Parsley

Ginger

Garlic,  onion powder (not usually well tolerated; when in doubt, listen to your body!)

Drinks

Water (regular or carbonated)

Milk (cow’s, goat, Lactaid milk)

Cream

Coffee

Black tea

Green tea

Oolong tea

Herbal tea

100% tomato juice

Green juice made with cucumber, spinach, ginger + lemon

Homemade lemonade/limeade sweetened with fructose/honey

Diet soda

Soda made with high fructose corn syrup

Anything processed (check the ingredient list), for example:

Commercially-made coffee drinks / coffee creamers

Commercially-made meal replacement drinks/supplements (i.e. Boost, Ensure)

Juices made with high-sucrose fruits/veggies/sweeteners

Energy drinks or iced tea sweetened with high-sucrose sweeteners

Sodas or sports drinks with high-sucrose sweeteners

Sweetened nut milks

Sugars and sweeteners

Aspartame

Dextrose

Fructose

Glucose

Lactose (milk sugar)

Monk fruit extract

Stevia leaf extract

Agave nectar

Asulfame-K

Honey

Corn syrup

Equal®

High fructose corn syrup

Hydrogenated starch

hydrosylates (HSH)

Inverted sugar syrup / “invert sugar”

Maltose (malt sugar)

Sucralose (Splenda®)

Sugar alcohols (sorbitol, mannitol, maltitol, xylitol, erythritol, lactitol)

PureVia®

Truvia®

Coconut palm sugar / “coconut sugar”

Confectioner’s sugar

Beet sugar

Cane sugar

Brown sugar

Dates

Date sugar

Date syrup

Maple sugar

Domino sugar

Granulated sugar

Real maple syrup

Turbinado sugar

Sugar in the Raw®

Miscellaneous

Cacao powder

Coconut flakes

Shredded coconut

Primal Kitchen Mayonnaise

Any food containing starch (flour), and/or “sugar” or “sucrose” or “maple syrup” or “coconut sugar” as an added ingredient:

Mainstream/commercial candy and chocolate

Most commercially made “health foods” – i.e. flavored yogurt, protein bars, protein shakes, protein powders

Coffee cake

Desserts

Maltodextrin (starch additive)

Mainstream cookies

Ice cream

Mainstream condiments: ketchup sweet relish, barbeque sauce, bread & buter pickles, tomato sauce with added sugar

Commercially made salad dressings with added sugar

Commercially-made jams/jellies

Processed meats cured with sugar (check ingredient list)

Nutella

Sample low sucrose & low maltose meal plan

(Reminder: this is just a SAMPLE meal plan of what a balanced day of low sucrose meals and snacks can look like.  This is NOT customized to meet your individual needs and preferences. That is where a 1:1 dietitian comes into play!)

Breakfast

  • Scrambled eggs with 1/2 cup cooked broccoli/spinach/mushrooms, 1 ounce cheese, and 1/4 to 1/2 fresh sliced avocado
  • Side of 2 kiwifruit or other 1 serving of low sucrose fruit of choice
  • Coffee or tea with optional drop of stevia leaf extract / monk fruit extract, splash of cream

Snack

  • 1 cup full-fat plain yogurt with a dollop of raw honey, 1 to 2 tablespoons ground flaxseeds, and 1 cup strawberries

Lunch

Snack

  • ½ cup cottage cheese or 1 ounce hard cheese
  • 1 cup cherries and/or 1 cup sliced cucumbers

Dinner

  • 2 cups cooked spaghetti squash
  • 1/3 cup of this simple homemade tomato sauce (replace the onion with 1 bell pepper)
  • 1/4 lb. grass-fed ground beef or ground turkey
  • 1/2 cup cooked broccoli/spinach/mushrooms or other low sucrose veggie of choice

Dessert (optional)

Sucrose intolerance diet meal plan & recipes

If you’d like to try out some (generally) CSID-friendly recipes and/or you’re looking for more tasty CSID-friendly meal ideas, I highly recommend the following recipe resources:

CSID Made Simple Cookbook with Amazon affiliate link

Sucrose Intolerance 7-Day Meal Plan + 21 Sucrose Intolerance Recipes - PDF

One size doesn’t fit all

Keep in mind: gut health is complex!  Your gut microbiome is as unique as your fingerprint. (Read more about “bio-individuality” here!)

Not everyone is going to react the same way to foods high/low in sucrose, so you’ll likely still require some level of customization on your sucrose intolerance diet.

  • For example, people with lactose intolerance may need to find alternatives to dairy that contains lactose.
  • Or if you’re vegetarian, you’ll need to work with a dietitian to make sure you’re getting enough protein.
  • Or maybe, you just don’t like some of the foods listed in the above sample meal plan…

To figure out exactly how your body tolerates or reacts to foods on a bio-individual level, I highly recommend leaning on this CSID Elimination Diet Workbook* which was designed and published by my amazing dietitian colleague who is thriving with CSID!

CSID Elimination Diet Workbook - with Amazon affiliate link

Additional resources

To learn more about how to navigate sucrose intolerance, you may want to check out the following articles:

Recap

The sucrose intolerance diet / “sucrase-isomaltase deficiency diet” is very restive, since so many foods contain natural or added sources of sucrose.  This diet is meant only for those with a diagnosed sucrase-isomaltase deficiency and subsequent sucrose intolerance.

The fundamental backbone of this diet is to plan balanced meals using mostly all low sucrose foods, while avoiding foods higher in sucrose.  However, dietary restriction and avoidance of trigger-foods is only one component of a holistic nutrition protocol for gut health.

Tracking your food intake and symptoms will also help you and your treatment team  to determine your body’s unique tolerance thresholds to foods containing varying amounts of sucrose.

Working with a functional dietitian to receive custom nutritional & supplement guidance (and to possibly run other types of functional nutrition tests, as needed) is not optional!

Next steps

I get it… this is a LOT to process, and probably a lot of new information to learn & remember, if you’re in the early stages of navigating a sucrose intolerance diet!

In case you’re feeling *slightly* or VERY overwhelmed,  I created a convenient printable list of low sucrose foods & high sucrose foods for you to refer back to as needed.

Just click on the link above, or the image below, to sign up & snag your copy fo’ free!

Sample Images of Free Downloadable Sucrose Intolerance Food List PDF - Learn More Here

Sharing is caring!

Knowledge is power, so please share this post with others in your world who are navigating sucrase-isomaltase deficiency and would like to learn more.

XO – Jenna

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