What is Fructositis?

Fructositis is a term that has been used to describe a set of symptoms including episodes of repeated dry cough not associated with a cold or flu that often last through the night; mucus hypersecretion of the airways; chronic bronchitis; asthma; and inflammation that are associated with consumption of a diet high in excess free fructose (EFF) and high fructose corn syrup (HFCS). The condition is often associated with gas and abdominal discomfort. Anecdotal and case report evidence link high EFF and HFCS consumption to incidence of chronic bronchitis and asthma. The condition is thought to be associated with fructose malabsorption.[3] While a high fructose diet has been scientifically linked to diabetes, metabolic syndrome and obesity,[53][41][42][43][48][49][50] the link between EFF and HFCS consumption, and incidence of asthma and potentially other auto-immune diseases remains medically unrecognized and unresearched. The recent CDC report linking soda intake with asthma is a first step towards greater awareness and future research.

Fructositis.org Mission

  • Raise awareness about the link between HFCS, EFF and asthma, chronic bronchitis, auto-immune disease
  • Raise funding for research to learn more about the mechanisms involved and how to diagnose it
  • Establish a forum to share up-to-date facts and information about the disease
  • Promote the need for food labels that contain details of excess free fructose levels.
  • Promote the need for HFCS-free, EFF-free food labeling.

Fructositis in Context

A Silent Epidemic

The inability to adequately absorb excess free fructose is a medically recognized disease known as Fructose Malabsorption. Research indicates that it affects 10 - 30% or more of average adults, when fructose is consumed in relatively higher proportion to glucose as occurs in high fructose corn syrup, apple juice, and fruit drinks with a high apple juice content.[20] [21] [22] [5] Limited research has been done to establish the precise prevalence of fructose malabsorption in children, though limited testing shows them to be at higher risk. Existing research suggests that more than 40% of children don't adequately absorb excess free fructose. Rates of malabsorption are thought to be highest among children under 4 years of age. The root cause and scientific basis behind why some individuals are able to adequately absorb EFF whereas others cannot remains unknown.[55] [20] [54] [9] [10] [21] [22] Summary findings of these studies published in 1993 and again in 2005 suggest that this condition potentially affects a high number of individuals, yet research into the root causes and other ill effects of fructose malabsorption remain stalled and unknown. Despite these reports, in 1996, the FDA reaffirmed HFCS as a Generally Recognized as Safe (GRAS) food. HFCS per capita consumption is now estimated at just under a pound a week. This is down from its 1999 peak of over a pound a week. Recent industry reports estimate annual sales of HFCS is $4 Billion.

When challenged with 1 gram of fructose per kg of body weight, 25 of 57 (44%) children ages 0.1 to 6 years showed incomplete absorption. In children aged 1-3 years, incomplete absorption was significantly higher.[9][10]

The Link to Fructose Malabsorption

When fructose malabsorbers ingest more excess free fructose than their bodies can absorb, fructose concentrations increase in the digestive tract and may cause symptoms of abdominal and stomach pain, gas, bloating, and fatigue.[51][52][21][22] According to the recently proposed fructositis disease hypothesis, unabsorbed and highly reactive fructose may participate in the formation of immunogenic biomolecules in the digestive tract known as FruAGE. Once formed these biomolecules may gain access to the bloodstream. Chronic bronchitis and asthma are thought to result when FruAGE bind pro-inflammatory receptors[3] (RAGE) known to be highly concentrated in the lungs, inner ears, heart, lymph nodes, and connective tissues.[2] These receptors have been implicated in inflammation; mucus hypersecretion of the airways; bronchial hyper-responsiveness; tissue damage; aberrant repair; and airway constriction, obstruction, and remodeling which can eventuate in compromised lung function. [18]These receptors have been found to be elevated in a number of auto-immune conditions. This gives rise to the possibility that this condition is associated with other idiopathic auto-immune diseases including arthritis, psoriasis, chronic fatigue syndrome, and others.

In 1970, sugar [sucrose] was the most available and used U.S. sweetener. Since then, the American diet shifted to include more HFCS and less sugar.[36][37][35] This shift is significant both for the large percentages of fructose malabsorbers and for those with chronic respiratory disorders including asthma and chronic bronchitis that may be attributable to fructositis disease.

An Interactive Timeline. Click Dates.

HFCS and Asthma Timeline

The Unexplained Dramatic Rise in Childhood Asthma

According to the Asthma and Allergy Foundation of America (AAFA), asthma prevalence increased among school children by 80 percent and among preschool children by 160 percent between the years of 1980 to 1994. In 2005, 8.9% of children in the United States had asthma. In 2007, 29% of children who had a food allergy also had asthma. A November 2007 report from the American Lung Association titled, Trends in Asthma Morbidity and Mortality, cites that an average of one out of every 10 school-aged child has asthma. [34]


This trend has affected black children much more significantly than children of other races and ethnicities. In 2009, according to a May 2011 Vital Signs Report from the Centers for Disease Control (CDC) and Prevention, about 1 in 6 (17%) of non-hispanic black children had asthma, the highest rate among racial/ ethnic groups. They cite the greatest rise in asthma rates was among black children (almost 50% increase) from 2001 through 2009.

These dramatic increases are not without consequences as asthma is the third-ranking cause of hospitalization among children under 15.[4] The current annual economic cost of asthma amounts to more than $56 billion annually.[34]

Rising Rates of Asthma Parallel Rising Rates of HFCS Consumption

This dramatic rise in asthma amongst children during the period from 1980 to 1994 that continues to present day, coincides with another trend occurring during this same time frame.

Between 1980 and 1994 asthma prevalence amongst preschool children climbed 160 percent. [1]

It is a parallel trend not typically discussed in the context of rising rates of asthma. According to the United States Department of Agriculture's (USDA) September 2008 report by Haley et al titled, Sugar and Sweeteners Outlook, the early 1980's also coincides with when the US food industry began a steady increase in their use of high fructose corn syrup (HFCS) as the preferred sweetener.[37]


According to the USDA, since 1985, the rise in sugar demand, although strong, has been moderate compared with the growth of corn sweeteners. In 1980, annual per capita consumption of HFCS was 16.9 pounds; by 1999 it had grown to 56.7 pounds. Thus by 1999 per capita consumption had grown by 235% from its 1980 levels. By 1999 Americans were consuming more than a pound per week of HFCS.

While the biochemical processes linking aero- allergens and asthma have been studied extensively and are well understood, the mechanisms that link excess free fructose to chronic bronchitis and asthma are poorly understood. Despite case report evidence linking episodes of chronic bronchitis and asthma to consumption of high fructose corn syrup, the disease remains medically unrecognized and unresearched.[3]

Between 1980 and 1994, average HFCS consumption climbed 196% to nearly a pound per person per week.

Research is needed.

These parallel trends when considered in the context of existing epidemiology and case report evidence linking consumption of a high fructose diet and HFCS to chronic bronchitis & asthma, dictate that scientific research is overdue.

Research is needed to confirm and clarify the mechanisms involved. Learn about our awareness campaigns and what you can do to help support our efforts to promote scientific research.

You can help by: