Just One Bite

Just One Bite

I recently spoke with a client who ironically has both a sweet tooth and sucrose intolerance, also known as Congenital Sucrase-Isomaltase Deficiency (CSID). Brian is a 45-year-old man with CSID who can’t resist the dessert table at parties and festive occasions. He knows he needs to stay away from sugary sweets and decadent desserts, but there are specific items like key lime pie that he simply can’t resist. He knows he is going to pay for it later due to his diagnosis of CSID, but he’s willing to because at the time it seems worth it. Just one or two bites satisfy his tastes. Here are some of Brian’s questions about CSID and having “just one bite.”

Do certain foods cause you to experience gas, bloating, and chronic diarrhea?

Is just one bite of a “forbidden food,” such as pie or cake, acceptable for people with sucrose intolerance?

It’s difficult to provide a blanket answer to that question because the answer depends on the individual. Due to their shorter digestive tract, infants and children with CSID tend to have more severe reactions to eating a food with sucrose , so they should stay away from taking even one bite. Children are at greater risk for suffering from long-term consequences due to CSID symptoms.

On the other hand, adults may not have as severe a reaction after just one bite, but the discomfort of symptoms such as gas, bloating, and diarrhea may lead you to decide that bite is just not worth it. The answer depends on you, your age, and the severity of your symptoms. A good way to figure out what works for you is to keep a food-and-symptom record, so you can work with your doctor or dietitian to figure out which foods are best for you specifically.

Is there a tolerance threshold for sucrose?

Likely, yes, but once again it depends on each individual’s tolerance. Having CSID means you have a reduced number of enzymes required to digest sucrose and isomaltose, two common forms of carbohydrates in the diet. Most people with this condition still have some of the enzymes needed to digest these two carbohydrates; therefore, they may be able to tolerate a small amount of sucrose or isomaltose in their diet. But how much of the enzyme is available and exactly how this impacts a patient with CSID varies among individuals and can even fluctuate over a lifetime.

What are the potential long-term consequences of taking just one bite of a high-sucrose food?

For children in particular, the long-term consequences of symptoms related to sucrose consumption can be severe. That bite can result in severe abdominal pain, diarrhea, or, in some cases with young infants, failure to thrive. Failure to thrive can severely impact a child’s growth long-term. The diarrhea could be severe enough to lead to dehydration and hospitalization. For adults, multiple factors can contribute to the severity of symptoms, such as bacterial activity in the colon, absorptive capacity of the digestive tract, and small bowel transit time.

How often can patients with CSID go off their diets?

Children should go off their diets as little as possible. Adults, on the other hand, can make their own decisions and likely know their bodies better than children do. They can also handle the consequences of eating something “not allowed” in a more rational way. If your symptoms are severe, you are having extreme diarrhea, abdominal pain, or weight loss after eating even a small amount of foods containing sucrose, it is recommended that you avoid them completely and discuss your symptoms with a gastroenterologist.

If you, like Brian, are struggling with sweets in particular, there are many desserts that use sugar alternatives and are allowed for people following a sucrose-intolerance diet. A few favorites include One Minute Flourless Chocolate Cupcakes, Berry Berry Cheesecake Parfait, and Chewy Chocolate Peanut Butter Cookies. Note that these can make great hostess gifts for any party.

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Sucrose Intolerance May Be More Common Than You Think