Do you love bread—but bread doesn’t love you? Do you find that the pleasure you get from eating several delicious, warm, fresh-out-of-the-oven rolls at your favorite restaurant is quickly followed by uncomfortable abdominal bloating and cramping, and/or headaches, stuffy sinuses and joint pain?  Then you might be one of the eighteen million Americans who are sensitive to gluten. 

What is Gluten?

The word gluten comes from Latin and means “glue.” Gluten is a protein that gives elasticity to dough and helps it to rise and keep its shape.  It is found in wheat, rye, barley, and any foods made from these grains. Avoiding gluten can be difficult because it is found in many common foods in the American diet:

  • Pasta
  • Cakes
  • Beer
  • Croutons
  • Couscous
  • Muffins
  • Oats (commercially processed)
  • Bread
  • Pastries
  • Gravy
  • Soy sauce
  • Flour tortillas
  • Cereal
  • Salad dressings
  • Broth in soups

Despite this long no-no list, there are a variety of many gluten-free foods that you can enjoy, including the following:

  • Quinoa
  • Buckwheat
  • Corn
  • Lentils
  • Potatoes
  • Soy
  • Rice
  • Cassava
  • Tapioca
  • Amaranth
  • Millet
  • Arrowroot
  • Sorghum

The History of Gluten Intolerance

With the popularity of gluten-free foods—approaching $15 billion in annual sales—you might think gluten sensitivities have been well-recognized for quite some time. However, gluten-intolerance—also referred to as “non-celiac gluten sensitivity” (NCGS)—was first documented just a few years ago in 2011 by Peter Gibson, a professor of gastroenterology in Monash University and director of the GI Unit at the Alfred Hospital in Melbourne, Australia. In a double-blinded, randomized, and placebo-controlled experiment, Dr. Gibson identified gluten, not only as the source for celiac disease—an autoimmune disorder—but also as the reason for gastrointestinal distress in patients without celiac disease. This study is credited for the spectacular rise in the gluten-free industry.

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However, two years later in 2013, Dr. Gibson surprisingly announced in a follow-up study that gluten actually causes no specific responses; and, therefore, is not responsible for causing adverse symptoms. Instead, his research team discovered that poorly absorbed short-chained carbohydrates, also known as FODMAPS (Fermentable Oligo-Di-Monosaccharides and Polyols), are the real culprits.

According to Stanford University, FODMAPs in the diet include:

  • Fructose, including fruits, honey and high-fructose corn syrup (HFCS)
  • Lactose found in dairy
  • Fructans, (a carbohydrate found in many types of plants) including wheat, garlic, onion and inulin
  • Galactans, including legumes such as beans, lentils and soybeans
  • Polyols, found in sweeteners containing isomalt, mannitol, sorbitol and xylitol
  • Stone fruits such as avocado, apricots, cherries, nectarines, peaches and plums

Effects of FODMAPs

FODMAPs are osmotic, meaning they pull water into your intestinal tract. When eaten in excess, they may not be digested or absorbed well and the bacteria in your stomach can ferment them, causing irritable bowel syndrome (IBS) symptoms such as:

  • Diarrhea
  • Constipation
  • Gas
  • Bloating and/or cramping

More than 250 symptoms of “gluten sensitivity” or what is now thought to be “FODMAPs-sensitivity” have been reported. The most common include the four gastrointestinal issues mentioned above. Extra-intestinal symptoms also occur frequently including headaches, “brain fog,” tingling and/or numbness in the hands and feet, fatigue, muscular disturbances, and bone and joint pain.

Probiotics May Counteract the Harmful Effects

A number of studies show that taking probiotics can help to counteract or prevent the negative effects of FODMAPs. For example, a study published in the journal Clinical & Experimental Immunology in 2008 found that live probiotic Bifidobacterium lactis inhibited the toxic effects on intestinal cells by wheat gliadin. In another study published in 2012, probiotics were found to prevent the gastrointestinal symptoms associated with gluten/FODMAPs intolerance.

If you suffer frequently with bowel symptoms such as diarrhea, constipation, gas, bloating and/or cramping; or have any of the extra-intestinal symptoms discussed above, try eliminating the foods listed in the high FODMAPs chart for ten days and see if your symptoms go away. If they do, start taking probiotics daily and continue on the low FODMAPs diet. After several weeks on probiotics, you could try adding one of the foods with higher FODMAPs and see if your symptoms return, or not. If you don’t have any problems with that food, then add another food. One by one, try another food to see if you can tolerate it or not. If a low FODMAPs diet doesn’t resolve all of your issues, be sure to see your doctor for a thorough evaluation.