Sucrose Intolerance: Test, Food List, and More
Sucrose is a disaccharide or double sugar composed of fructose and glucose.
A sucrose intolerance means you lack enough of the sucrase enzyme to break down sucrose for absorption.
The only treatment for sucrose intolerance is to limit or restrict it from your diet.
This article explains everything you need to know about sucrose intolerance, including how to test for it and what foods to eat and avoid.
What is sucrose intolerance?
Sucrose — also known as table sugar — is composed of two simple sugars — fructose and glucose.
Before it can be absorbed, your body must break down sucrose into these simple sugars using an enzyme called sucrase.
However, if you have no or low sucrase levels, sucrose passes through your digestive tract unabsorbed, causing various uncomfortable digestive symptoms.
Symptoms of sucrose intolerance include (1):
- stomach pain
- diarrhea
- excessive gas
- nausea
- constipation
The severity of these symptoms depends on your level of sucrase enzymes and the amount of sucrose you consume.
Sucrose intolerance symptoms overlap with other digestive conditions like IBS and SIBO, causing sucrose intolerance to often go underdiagnosed (1).
Sucrose intolerance can be acquired or present from birth (congenital).
Acquired or secondary sucrose intolerance can be caused by inflammatory conditions that affect the small intestine like celiac disease, H. Pylori, SIBO, and Crohn’s disease (1).
These inflammatory conditions damage the cells that line the walls of the intestine where the sucrase enzyme is found.
Congenital sucrase-isomaltase deficiency (CSID) is the congenital form.
CSID is a rare condition caused by a mutation in the sucrase-isomaltase (SI) gene that leads to a deficiency in sucrase and another enzyme called isomaltase, which the body needs to digest starch.
CSID is present at birth but it can go undiagnosed into adulthood.
Acquired sucrose intolerance is much more common than sucrose intolerance due to CSID.
Summary
Sucrose intolerance is the inability to digest sucrose due to no or low levels of sucrase. It can occur due to inflammatory digestive conditions or be present at birth due to a genetic defect.
How to test for sucrose intolerance
The gold standard for diagnosing sucrose intolerance involves taking a biopsy or sample of the small intestine and running a test to determine sucrose enzyme activity (1).
However, this test is invasive, requires sedation, and is expensive.
Alternatively, sucrase intolerance can be tested through a carbon-13 breath test (1).
This test uses sucrose enriched with carbon-13 — a stable atom — to trace the path of sucrose through your digestive tract to determine the amount of sucrase activity in your small intestine based on the level of carbon dioxide in your breath (2).
The test involves drinking a sucrose solution enriched with carbon-13 and then providing breath samples into a collection tube after 30, 60, and 90 minutes.
The breath collection tubes are then sent to a lab for analysis.
A different type of test called the hydrogen breath test can also be used but it is less specific and sensitive for diagnosing sucrose intolerance since there are many factors that affect hydrogen production (2).
Many companies online offer hydrogen breath tests but not carbon-13 sucrose breath tests, so you may need to talk with your doctor or dietitian about ordering one if you want to determine whether you’re sucrose intolerant.
Summary
The gold standard for diagnosing sucrose intolerance is with a small intestine biopsy to assess your sucrase activity. However, due to its disadvantages, a sucrose breath test is a better alternative for most people.
Foods to eat and avoid with sucrose intolerance
Sucrose is ubiquitous in foods.
It’s both naturally found in most foods and added to others to enhance flavor, texture, and color, and prolong shelf life.
Thus, completely avoiding dietary sucrose is challenging and can be overwhelming.
Because everyone has different sucrase activity levels — some higher or lower than others — there is no set daily sucrose limit to which you must restrict yourself.
Instead, it’s best to determine how much sucrose you can consume at once and over the course of the day before triggering your symptoms.
To make your next grocery shopping trip easier, here’s a list of low- and high-sucrose foods.
Low sucrose foods to eat
Here’s a low-sucrose food list (3):
- Fruits: avocado, berries, grapes, kiwifruit, pomegranates
- Vegetables: artichoke, arugula, asparagus, broccoli, brussels sprouts, cabbage, cucumbers, mushrooms, spinach, sweet pepper zucchini
- Poultry: fresh chicken breast, turkey, eggs
- Meats: fresh beef, pork, lamb
- Seafood: fresh fish and shellfish
- Oils: canola and olive oil
- Beverages: black coffee, unsweetened tea, water, sucrose-free sports drinks, diet soda
Milk is free of sucrose but many people with acquired and congenital sucrose intolerance are also lactose intolerant (4).
High sucrose foods to limit or avoid
Reading the nutrition label is the best way to identify foods that contain added sucrose.
Look for any ingredient that contains the word sugar, such as beet sugar, brown sugar, confectioner’s sugar, and cane sugar.
Limit or avoid these high-sucrose foods (3):
- Fruits: plantains, tangerines, pineapple, apricots, peaches, cantaloupe, nectarines, oranges, syrup-packed canned fruit,
- Vegetables: corn, peas, carrots, sweet potatoes
- Refined grains: cookies, cakes, pastries, muffins, biscuits, sugary cereals, etc.
- Snacks: granola bars, puddings, dried fruit, crackers, peanut butter
- Dairy: ice cream, flavored milk, sweetened yogurts
- Other: pasta mixes, Chinese chicken, corn dogs, baked beans, many fast food items
- Candy and chocolate
- Condiments: sugar, syrups, barbecue sauce, peanut butter, jelly, and most dressings, including coleslaw, thousand island, and French.
- Beverages: lemonade, sports drinks, juice, soda, sweetened coffee and tea
Summary
Many foods naturally contain sucrose or have it added during manufacturing. Reading the ingredient list is the best way to identify sucrose in foods.
Sucrase replacement enzyme
Restricting or avoiding sucrose is the primary treatment for sucrose intolerance to improve symptoms.
However, a prescription medication called Sucraid (sacrosidase) is a safe and effective treatment option for people with CSID.
Sucraid is an enzyme replacement for sucrose, replacing what your body doesn’t naturally make.
As such, Sucraid allows you to liberalize a CSID diet and worry less about experiencing uncomfortable symptoms.
Sucroad is an enzyme replacement for sucrose only — it doesn’t contain isomaltase, an enzyme that people with CSID also lack and have difficulty digesting starch as a result.
Sucriad has not been tested in people with acquired sucrose intolerance but it likely offers the same benefits.
However, Sucraid is expensive and likely requires a CSID diagnosis to be covered under eligible insurance plans.
Learn more about Sucraid for CSID here.
Summary
Sucraid (sacrosidase) is an enzyme replacement for sucrose. It’s approved for the treatment of CSID, but it hasn’t been tested in people with acquired sucrose intolerance.
The bottom line
Sucrose intolerance is the inability to break down and absorb sucrose.
It can be present at birth (CSID) or occur due to an inflammatory digestive condition like celiac disease or Crohn’s disease.
Obtaining a biopsy of the small intestine to test your sucrase activity is the gold standard for testing for sucrose intolerance.
However, a sucrase breath test may be a better alternative.
Restricting sucrose from your diet is the only treatment for sucrose intolerance, but for people with CSID, taking Sucraid replaces sucrase to allow a more liberalized diet.
