June 10, 2015

You May Want to Think Again about Giving up Gluten

By cancerconnect

If you’re trying to avoid gluten in addition to a low-FODMAPs diet in an effort to manage symptoms of irritable bowel syndrome (IBS), you may want to think again: recent research suggests that the frequently maligned protein may not be the culprit behind your digestive troubles.

A low-FODMAPs diet may ease IBS troubles, but avoiding gluten in addition to following the low FODMAPs protocol may not increase benefit. The term FODMAPs is an acronym for specific dietary carbohydrates: fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These include:

  • Gructose, lactose (dairy)
  • Fructans (such as wheat, garlic, onion, inulin)
  • Galactans (legumes such as beans, lentils, soybeans)
  • Polyols (sweeteners containing isomalt, mannitol, sorbitol, xylitol; stone fruits such as avocado, apricots, cherries, nectarines, peaches, plums)

If you’re sensitive to FODMAPs, you might experience symptoms of IBS—including diarrhea, constipation, gas, bloating, or cramping—when you eat these carbohydrates in excess. A diet low in FODMAPs is therefore often recommended to manage IBS, and many people also add gluten avoidance to their dietary restrictions. However, according to researchers with study recently conducted in Rome and presented at Digestive Disease Week 2014 (May 3–6, 2014 in Chicago), nixing gluten may not be the key to improved digestive health.

A low FODMAPs diet is already low in gluten because it calls for restricted intake of the carbohydrate fructan, which is found in wheat. It hasn’t been well understood, however, whether gluten itself is a significant trigger of IBS symptoms and to what extent avoiding it might help.

This recent study in Rome evaluated three diets among IBS patients: low FODMAPs and no gluten; low FODMAPs and normal gluten; and normal FODMAPs and normal gluten (control). Patients first reported their symptoms and were then put on one of the three diets for a period of four weeks. They began reporting symptoms again after two weeks on their respective diets.

Patients on both low-FODMAPs (no gluten and normal gluten) diets had improved symptoms compared with patients on the normal FODMAPs diets. In other words, low FODMAPs seemed to be the key to reducing IBS symptoms, whereas avoiding gluten didn’t seem to have an impact.

In addition to guidelines from your doctor, diet is ultimately a personal choice. If you find that your digestive system functions best with no and very little gluten, a gluten-free diet might be your best choice. If, on the other hand, you genuinely enjoy foods containing gluten, have no medical reason to avoid it, and don’t feel any adverse affects, then you can likely enjoy it without worry.


Reference: Piacentino D, Rossi1 S, Alvino V, et al. Effects of Low-Fodmap and Gluten-Free Diets in Irritable Bowel Syndrome Patients. A Double-Blind Randomized Controlled Clinical Study. Paper presented at Digestive Disease Week 2014. Abstract 374.

Tags: Nutritional Know-How