Monday, 3 August 2015

Gluten-free or FODMAPs, the culprit? [Gluten-free: 1/2]



It has been long observed that patients on a gluten-free diet often reported improvement in gastrointestinal symptoms. This led to the underlying belief that gluten in wheat to be the culprit causing all these gut conditions.

However, findings from studies conducted at Monash University had found that:
  • Gluten-free grains & cereal products interestingly had lower FODMAPs (mostly fructans & GOS) compared to gluten-containing products [1]
  • Gluten specifically had no effect on gut symptoms in patients - even though they reported to be sensitive to gluten at the start of the study [2]
  • Additional reductions in gut symptoms were observed when patients were placed on a low-FODMAP diet [2]
So what are the implications of these and other, independent studies?
It is more likely that gut symptom improvement seen in patients is due to a foods’ FODMAP content than gluten itself.

Take home message:
FODMAPs appear to be the culprit and not gluten.  
Individuals avoiding foods based on gluten content, alone, will be eating other FODMAP-rich foods, resulting in continued gastrointestinal symptoms.

We strongly advise that you seek professional guidance before starting any dietary therapy treatments, including the low FODMAP diet, as there are many factors that can cause these symptoms.

Interesting fact: Did you know?  Despite a prevalence of approximately 0.5-1% of the global population being diagnosed with coeliac disease, healthy people in the western world are unnecessarily adopting a gluten-free or wheat-avoidance lifestyle! 10% of Australians are now following this trend needlessly!


Other reading suggestions:
Click here to read our other blog instalment on Gluten-free vs FODMAPs:

Extracted from:
Muir, J & Gibson P. The Emerging story of dietary fibre & gut health. Food Australia 2014: 34-37. Click here to learn more about FODMAPs.



[1] Biesiekierski JR, Rosella O, Rose R, Liels K, Barrett JS, Shepherd SJ, Gibson PR, Muir JG. Quantification of fructans, glacto-oligosaccharides and other short-chain carbohydrates in processed grains and cereals. J Hum Nutr Diet 2011;24:154-76.

[2] Biesiekierski JR, Peters SL, Newnham ED, Rosella O, Muir JG, Gibson PR. No effects of gluten in patients with self-reported non-celiac gluten sensitivity following dietary reduction of fermentable, poorly-absorbed, shortchain carbohydrates. Gastroenterology 2013 Aug;145(2):320-8
           


3 comments:

  1. That may be true in terms of symptom improvement, but that doesn't automatically mean it's unnecessary if the gluten-zonulin-leaky gut/intestinal permeability issue is part of what's causing bodily symptoms linked to gluten sensitivity (nerve and muscle pain, autoimmune symtpoms, etc). Reducing symptoms is not the same as healing the gut or the body.

    When I initially gave up gluten, I had amazing bodily pain relief in 5 days. And that was while eating a vegan, high FODMAP grain-fruit-veg-bean diet. I was later diagnosed with SIBO and FM.

    I just don't think there can be any blanket statement that everybody who gives up gluten is an idiot doing so needlessly.

    ReplyDelete
    Replies
    1. Hi downfromtheedge,
      yes dietary treatment of many conditions, including IBS, needs to be individualised. What works for one person, will not work for another, i.e. the culprit(s) for one for person will be different from one person to another.
      Kindest regards, Peta

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  2. "10% of Australians are now following this trend needlessly!"

    I'm sort of glad they are, because it's made it easy to find gluten-free bread while in the elimination phase of the low FODMAP diet. Most cafes offer it. If it wasn't a trend, it'd be much harder to find.

    As awareness of FODMAPs increases, I hope that soon I'll be able to tell a waiter "no oligos please", and they'll know just what I mean!

    ReplyDelete