It may seem like everyone you know is on a gluten-free diet. In fact, nearly a third of a American adults say they actually are trying to avoid gluten — that is, products that contain wheat, barley or rye. But what if gluten isn’t the problem? What if it’s something else that causes the gassiness and bloating many people say they feel after eating foods with gluten?
In the Nov. 3 issue of “The New Yorker,” writer Michael Specter suggests a little-known group of complex carbohydrates called FODMAPs may play a bigger role in gastrointestinal distress than realized. FODMAPs are fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. FODMAPs include high-fructose foods such as honey, watermelon, or dairy products.
Most people aren't bothered by FODMAPs, but Kristin Kirkpatrick, manager of wellness nutrition services at Cleveland Clinic’s Wellness Institute, says more research is needed to determine their role in tummy troubles. "I haven't seen [them included] in a tremendous amount of research," she says.
At least three million Americans suffer from celiac disease, which is triggered by eating foods with gluten. The condition can cause abdominal pain, bloating and diarrhea. Celiac disease is on the rise, with more cases diagnosed that 50 years ago, according to research. Up to 18 million people experience gluten intolerance and while they don't have celiac disease, they report feeling better without gluten in their diets.
But the research surrounding gluten-sensitivity can be confusing — and many people are self-diagnosing a difficulty with gluten when it can actually be difficult to medically determine or screen for intolerance for processed wheat products.
“We need a lot more research to determine whether or not [gluten sensitivity] is a problem,” says Kirkpatrick. “The benefit I see with people [going gluten-free] has nothing to do with the lack of gluten. It is because they are more interested in their health."
A 2011 study questioned gluten sensitivity. Peter Gibson of Monash University in Melbourne identified what he called non-celiac gluten sensitivity. But he completed subsequent studies that seemingly indicate that gluten sensitivity might not exist.
According to Specter’s article, one of Gibson’s recent studies looked at FODMAPs.
Gibson put 37 people, who seemed to be unable to tolerate gluten, on a diet that was gluten free and also free of FODMAPs carbohydrates.
After two weeks everyone reported feeling less gastrointestinal distress. Then Gibson secretly gave half the participants food with gluten in it. Those eating the hidden gluten did not report new symptoms. It could mean the FODMAPs might be contributing to the discomfort.
“Once they introduced the gluten back in … the symptoms didn’t come back,” says Kirkpatrick. “I am not quite sure we have enough to definitively say there is … a connection between gluten and these symptoms.”
It could also be that when people decide to go gluten-free they pay more attention to their health, meaning they eliminate junk food, fried foods, dairy, and fatty foods.
“When they stop eating these foods … they feel better because they’re eating better,” says Bonnie Taub-Dix, owner of BTD Nutrition Consultants in New York City and author of the book “Read It before You Eat It.”
But it is also important to eat the right gluten-free foods. Some food makers load gluten-free foods with sugar and sodium.
“Read the labels,” Taub-Dix says.