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Gluten Often Plays the Gut-Health Patsy
Does gluten frequently take the fall for a growing cause of similar symptoms?

01/18/2018 By Kimberly Day with Craig Weatherby

Gluten-free diets are surrounded by a halo of health.

That halo appears unjustified, unless gluten causes you real problems.

Nonetheless, growing concerns about gluten — even among people without apparent symptoms — have fueled fast-growing demand for gluten-free options.

Bestsellers like Wheat Belly and Grain Brain —  which link gluten and modern wheat to many health conditions — have helped put gluten- and wheat-free diets on a pedestal.

But are many folks blaming gluten for problems caused by a different, far more common food factor?

Gluten is guilty — sometimes
Celiac disease is caused by an autoimmune reaction to the grain-source protein called gluten.

Gluten is found in wheat, barley, rye, and oats — but not in corn, millet, rice, sorghum, amaranth, buckwheat, or quinoa.

This potentially crippling disorder affects about one out of every 140 Americans, and that proportion has risen in recent decades.

Importantly, people free of celiac disease can suffer symptoms of gluten sensitivity, which for unknown reasons has become more common.

Even a mild-to-moderate case of gluten sensitivity can produce one or more of these problems:

  • Inflammation
  • Cognitive impairment
  • Headaches/migraines
  • Digestive issues

However, if you suffer symptoms and suspect gluten sensitivity, eliminating gluten from your diet may be fruitless — an adjective that hints at the actual cause of many stomach and other symptoms.

Of course, efforts to erase stomach symptoms by avoiding gluten will fail — or at least fall short — if gluten gets blamed for symptoms from another common food factor.

And gluten-avoidance can have unintended health consequences — see Do Grains Get a Bum Rap?.

Meet fructans and other FODMAPs, for which gluten often plays the patsy
Gluten typically takes the blame for wheat-related gas, bloating, and stomach upset.

But frequently, the real culprit is fructose — and/or the fiber-like chains of sugar molecules called FODMAPs: an acronym for “Fermentable Oligo-, Di-, Mono-saccharides And Polyols”.

Common FODMAPS in the American diet include inulin and fructoligosaccharides — better known as fructan or FOS.

Fructans consist of short chains of fructose molecules, and they occur in wheat, onions, beans, bananas, and many other foods — see the list below.

Inulin is a longer-chain sugar compound that falls into the polysaccharide (sugar polymers) category.

FOS and inulin are both soluble fibers that serve as “prebiotic” food for beneficial, “probiotic” bugs like lactobacilli and Bifidobacteria — as well as for some bad actors like Klebsiella, E. coli, and Clostridium.

Why can fructans and other FODMAPs cause problems?
Our bodies lack the enzymes needed to break down FODMAPs, and most people don’t absorb them very efficiently.

And if any FODMAPs escape unscathed through the small intestine, they get digested (fermented) by bacteria in the large intestine — producing gas, bloating, and flatulence.

However, most people have little or no problem handling FODMAPs, unless they overdo especially rich food sources at a single sitting.

People with irritable bowel syndrome (IBS) and similar syndromes have by far the worst problems with FODMAPs.

But — as with gluten — it seems that more people are reporting symptoms that may be caused by these fibrous sugar molecules.

That said, it's critical to differentiate gluten-sensitivity from FODMAPs-sensitivity.

If you unnecessarily avoid non-grain foods rich in FODMAPs you may reduce the gut population of beneficial lactobacilli and Bifidobacteria bacteria.

Recent clinical trial tested fructans vs. gluten
Gluten rich grains like wheat also feature fructans, so it’s been unclear whether — and how often — gluten takes the rap for symptoms actually caused by fructans.

Researchers from Norway and Australia decided to take up the challenge and recruited 59 celiac-free volunteers.

All the participants had adopted gluten-free diets, having presumed that gluten was guilty for their symptoms.

The participants were randomly assigned to one of three groups, each of which was assigned to eat a different kind of muesli (granola-like) bar every day for a week:

  • Gluten-added bars
  • Fructan-added bars
  • Bars free of any fructan or gluten.

Over the next several weeks, each group of participants switched to eating one of the other muesli bars, with a one-week washout period in between, and recorded their symptoms (if any) throughout the study.

Almost twice as many participants suffered the worst IBS and bloating symptoms after eating the fructan-added muesli bars, compared with either the fructan-free or gluten-added bars.

At the end of the trial, 24 participants had reported suffering the worst symptoms after eating the fructan-added muesli bars, versus just 13 people who suffered the most after eating the gluten-added bars.

In other words, the muesli bars with added fructan created GI distress in almost twice as many people, compared with the bars to which gluten had been added.

These findings echo ones we reported in The Healthy Skeptic: Is Gluten Really so Guilty?.

Finding fructans and other FODMAPs
Fortunately, going gluten-free automatically cuts your fructan consumption.

That's because both potential problems occur in wheat, rye, and barley — the richest and most common sources of gluten.

But fructans and other FODMAPs occur in many foods, at levels either lower or higher* than the levels in grains.

This list includes foods that may be low or high in FODMAPs. You'll find a table identifying foods that are relatively low or high in them at the FODMAPs website of Australia's Monash University:

• Fennel 
• Bananas
• Grapefruit
• Artichoke
• Asparagus 
• Mushrooms
• Watermelon
• Chicory root
• Milk and yogurt
• Wheat, barley, rye
• Beans, peas, lentils
• Cashews and pistachios
• Onions, garlic, leeks, scallions
• Dried fruit — dates, figs, and prunes
• Fructose, corn syrup, and honey
• Apples, pears, cherries, stone fruits

*The very richest fructan sources commonly sold in America — blue agave, Jerusalem artichoke, jicama, and yacón — are chiefly popular among certain Hispanic cultures.

If you think fructans may be guilty of causing your stomach symptoms, take a break from these foods, as well as from gluten-rich grains.

But before you go gluten-free, you’d be wise to tap the brakes a bit.

Don’t avoid gluten unnecessarily
if you think you suffer from a significant gluten sensitivity, it makes sense to experiment with going gluten-free.

But if going gluten-free doesn’t help, staying on that diet has potentially significant downsides.

Whole wheat provides fiber, essential vitamins and minerals — iron, magnesium, selenium, manganese, phosphorus, copper, vitamin B6, and folate — and considerable amounts of beneficial antioxidants.

For more on the benefits of whole grains, see Do Grains Get a Bum Rap? and Is Whole Wheat Better than White Bread?, which addresses the effects of each type on microbes in the human gut.

By comparison — with some exceptions — gluten-free alternatives to whole wheat, barley, or rye products tend to fall short from a nutritional standpoint.

Conduct your own clincial trial
What to do if you suffer seemingly food-related gastric symptoms but don’t have celiac or a gluten sensitivity?

Try eliminating sources of FODMAPs that you commonly consume — one by one for a few weeks at a time — and see how you feel after each “trial”.


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