Gluten May NOT Be Causing the Problems

More and more people are going gluten-free -- but I've found most people, including those who join the gluten-free bandwagon, don't know much about gluten, or why, precisely, they should avoid it.

Others, however, are very clear why they are avoiding gluten -- eating gluten, a protein found in grains, including wheat and rye, causes uncomfortable bloating, gas and diarrhea. Going off gluten seems to fix these problems.

But what if the culprit is not actually gluten? New research suggests that the offending substance may actually be fructan.

To be sure, there are individuals who MUST avoid gluten. Even a grain of gluten hidden in food can cause adverse reactions to those with celiac disease. Accidentally consuming even the smallest amount of gluten can cause long-term damage to the gastrointestinal system. For those with celiac disease, avoiding ALL gluten is imperative.

However, many people who identify as  "gluten sensitive" or "gluten intolerant" follow a gluten-free protocol, but have only temporary symptoms and discomfort when they consume foods with gluten.

Or is it really the gluten?

Gastroenterologists and nutritionists are increasingly convinced of two key things: First, very few people are truly non-celiac gluten sensitive, and second, those who feel better on a gluten-free diet are more likely sensitive to another substance in wheat called fructan.

Fructan is one of the carbohydrates that now known as FODMAPS – a group of fermentable oligo-di-monosaccharides and polyols that can cause gas, bloating, diarrhea  and other uncomfortable symptoms in those predisposed.  In addition to fructan in wheat (and other foods such as garlic,  artichokes and carob), FODMAPs include fructose (found in some fruit), lactose (found in some dairy products) and galactans (found in some legumes).

While most people can digest FODMAPs with no problem, for many with chronic gut disorders like irritable bowel syndrome, they're poorly absorbed by the small intestine and then fermented by bacteria to produce gas, which leads to those unpleasant symptoms. 

Determining which FODMAPs you are sensitive to can be a difficult and time consuming process. This is because responses vary depending on the amount of the food eaten and whether your meal (or food) contains only one, or more, of the FODMAPs.

For instance, breading on your chicken at a meal may not cause a problem. Unless you also consume black beans. In which case, you may have a reaction. Or not. Unless perhaps you also have carob for dessert, and then whammo, you’ve got a problem.  

Determining the exact cause of your symptoms takes some sleuth work. However, the Low-FODMAP Diet has been shown to be as effective as the drugs on the market, so it may be worth the effort.

First, you must eliminate most FODMAPs from your diet, then go through several challenge phases where these foods, and groups of foods, are slowly reintroduced.

But whereas wheat may be a culprit, many factors come together to determine the functioning of the digestive tract. For instance, what you eat influences your microbiome, and your microbiome influences how you ferment carbohydrates like the FODMAPs that reach your colon.

For instance, if you have taken antibiotics, or even nonsteroidal anti-inflammatory drug (NSAID)your gut microbiome may be compromised. Perhaps you are wheat intolerant due to a history of medications which has negatively impacted your gut. Make sure you investigate the impact the medications you are prescribed may have on your gut.

If you are struggling with eating problems, be careful about implementing a Low-FODMAP Diet, as it is fairly restrictive and can trigger disordered eating symptoms. You may want to work with a dietitian/nutritionist skilled in intuitive eating and eating disorders while you work through the Low FODMAP Diet and it's challenge phases.

For more information, check out this study published in 2013 in the journal Gastroenterology .  The results showed that only 8 percent of the participants had gluten-specific effects from the gluten diets, while all participants had significantly improved symptoms on the low-FODMAP diet.

In another study, researchers found that some people who put themselves on a gluten-free diet still had symptoms, which suggests they could be sensitive to FODMAPs other than the ones in wheat.

Perhaps you actually have a sensitivity to fructan rather than gluten! 

 

About Karin Kratina, PhD, RD, LDN, SEP

Karin can help you escape food and body angst and learn to manage your eating and weight naturally. Visit www.EatingWisdom.com for free handouts, online courses and more tips on mindful, intuitive eating and healing disordered eating.

© 2014 Karin Kratina, PhD, RD, LD/N