Gluten-sensitive? It may actually be a carb making you ill

Full article at https://www.newscientist.com/articl...tive-it-may-actually-be-a-carb-making-you-ill

 

I agree that wheat really isn't worth the trouble but .. onions and garlic? nooooooo! ha ha. I might experiment with cutting them out but they're my base for...everything

 

Your breakfasts must be interesting experiences...

 

@Andy You don't eat an onion for breakfast?

 

I guess it must be where I'm going wrong

 

I think it would be interesting to see the exact mechanics of the sensitivity they are proposing for this theory.

Oligofructans have been used for a while in the food industry as a source of fibre and sometimes as a sweetener mainly because they are not actively absorbed by the gut. Inulin is also used to help improve beneficial bacteria as a prebiotic for the same reason ( supposedly to increase the "beneficial bacteria")

I assume this theory is debunking the prebiotic and gluten sensitivity approach by saying that IBS is due to the interaction of microbes in the gut with the oligofructans?

I wish some of these papers would actually postulate a full explanation rather than publish sound bites based on a limited 50 person study ....presumably using self reported outcomes. I guess taking on the gluten free and prebiotic industry would be a big battle?

On the face of it this sounds like it is too early to publish these sort of claims. it's just feeding more misconceptions about elimination diets.

 

I know what you mean — seems like every day there's a different claim being made about the gut, and I'm not convinced that anyone knows anything much about it yet — but this one does interest me.

I'm very gluten intolerant — or thought I was till I read this! — but I also can't take probiotic mixes with inulin in. I've also tried taking multiple oligofructan supplements in an attempt to improve gut health but they also made me pretty unwell. I've learnt that bananas, chickpeas and asparagus are all irritants for my gut but only just found out that they're high in fructans. I had no idea that onions were in the same category. This article does tempt me to do a 7-day low fructans diet and see if it helps. Gut issues are a major issue for me and I'm willing to try anything that might help.

 

Yes It does seem that when it comes to gut flora research is a minefield of loose theories. It would be good for long term studies to show what happens over the medium term, also the effect of stomach acidity etc. I suspect that it may be a case for a lot of folk that they can just reduce the amount they eat rather than elliminate altogether or eliminate for a period and then switch back to a lower but controlled amount?

In the mean time it's just suck it and see. Onions and garlic are tricky ones to avoid. Good luck

 

I eat plenty carbs but no gluten. Most of my gut issues got better since I stopped gluten.

I've read an article about remnants of glyphosate causing the issues with wheat not the gluten. I'm fed up and confused. I'm simply off gluten, whenever I eat (very rarely) I seem to get sick. Too risky for me.

 

The low FODMAPs diet has made a huge difference to my IBS symptoms. I used to eat gluten-free, but don't bother anymore. Reducing the FOMDAPs has meant I can tolerate a bit of gluten here and there. I've been on it for a few years now, and am only just reintroducing foods, very slowly. I know the whole point is to reintroduce food, but I've not had the energy to deal with that, so I've stuck with what was working for me. I wish more would try low FODMAPs.

 

This is what I did with gluten. I very obviously had some issue with gluten, at a guess, 20 years ago, although was never tested for celiac disease. I cut as much gluten out of my diet as possible for the best part of 10 years, and then noticed that my gut didn't have the same reaction to it that it had previously. So now I seem to have a limited tolerance of it but I've not gone back to a diet with the "standard" amount of gluten in it.

 

I did something similar...ketogenic for 8 weeks which significantly reduced my total carbs. I can now eat around 150g a day no problem.

 

I look forward to supermarkets' expensive new Fructan free ranges....

 

Fructans are simply short chains of fructose molecules and are one type of FODMAP. The article claims they are difficult to digest. Actually we can't digest them at all, we are not meant to digest them. They are important food for our colonic bacteria and we should be seeking them out.

Problems with these foods simply indicates some type of dysbiosis - an unfavourable balance of gut bacteria.

Reduction or removal of FODMAPS is an important way of reducing discomfort for some people but this should be a temporary solution. Eventually the goal is to improve digestion and flora balance so these valuable foods are again tolerated.

It is certainly possible to do but it might take quite a few years. Fifteen or so years ago I could eat very little and had multiple sensitivities, including to FODMAPs.

Elimination diets were very helpful in reducing discomfort but were also the problem. I became frightened of food and stayed on a very restricted diet way longer than I should have. Things like digestive enzymes and bile salts helped greatly and eventually gave me the courage to start expanding my diet.

Eventually I got to a point where I could tolerate pretty much any food and then started introducing concentrated prebiotics, including inulin which is a fructan. Gut symptoms had pretty much disappeared by this time with the exception of long term loose BM's and mild diarrhoea. The concentrated prebiotics fixed this too.

Articles like this one and by various nutritionists expanding on FODMAP diets seem to miss the essential point of what these substances actually do.

 

There are also increasing numbers of studies that suggest specific probiotic strains may help reduce or prevent gluten/gliaden-related issues:

http://cmr.asm.org/content/27/3/482.short

https://www.ncbi.nlm.nih.gov/pubmed/24483336

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2453197/

 

I live in Melbourne, which is where the research for the FODMAPs diet was developed. There is at least one low FODMAP cafe, a couple which cater to low FODMAPs and a home delivery service.

 

Here is another article

https://www.foodnavigator.com/Artic...N_NId&c=ctnELE8k8Ttzl6ewjLTt3XCFnrLU2YG6&p2=#

which has a bit more detail on the study with a link to the research paper:

http://www.gastrojournal.org/article/S0016-5085(17)36302-3/pdf?cc=y=

Fructan, Rather Than Gluten, Induces Symptoms in Patients With Self-reported Non-celiac Gluten Sensitivity
Email the author Gry I. Skodje
,
PlumX Metrics
DOI: http://dx.doi.org/10.1053/j.gastro.2017.10.040

Article Info

• Abstract

Abstract
Background & Aims
Non-celiac gluten sensitivity is characterized by symptom improvement after gluten withdrawal in absence of celiac disease. The mechanisms of non-celiac gluten sensitivity are unclear, and there are no biomarkers for this disorder. Foods with gluten often contain fructans, a type of fermentable oligo-, di-, monosaccharides and polyols. We aimed to investigate the effect of gluten and fructans separately in individuals with self-reported gluten sensitivity.

Methods
We performed a double-blind crossover challenge of 59 individuals on a self-instituted gluten-free diet, for whom celiac disease had been excluded. The study was performed at Oslo University Hospital in Norway from October 2014 through May 2016. Participants were randomly assigned to groups placed on diets containing gluten (5.7 g), fructans (2.1 g), or placebo, concealed in muesli bars, for 7 days. Following a minimum 7-day washout period (until the symptoms induced by the previous challenge were resolved), participants crossed over into a different group, until they completed all 3 challenges (gluten, fructan, and placebo). Symptoms were measured by gastrointestinal symptom rating scale irritable bowel syndrome (GSRS-IBS) version. A linear mixed model for analysis was used.

Results
Overall GSRS-IBS scores differed significantly during gluten, fructan, and placebo challenges; mean values were 33.1±13.3, 38.6±12.3, and 34.3±13.9, respectively (P = .04). Mean scores for GSRS bloating were 9.3±3.5, 11.6±3.5, and 10.1±3.7, respectively, during the gluten, fructan, and placebo challenges (P = .004). The overall GSRS-IBS score for participants consuming fructans was significantly higher than for participants consuming gluten (P = .049), as was the GSRS bloating score (P = .003). Thirteen participants had the highest overall GSRS-IBS score after consuming gluten, 24 had the highest score after consuming fructan, and 22 had the highest score after consuming placebo. There was no difference in GSRS-IBS scores between gluten and placebo groups.

Conclusions
In a randomized, double-blind, placebo-controlled crossover study of individuals with self-reported non-celiac gluten sensitivity, we found fructans to induce symptoms, measured by the gastrointestinal symptom rating scale irritable bowel syndrome version.Clinicaltrials.gov no: NCT02464150

 

So the big questions really are ...if Fructans are responsible for some cases of perceived "gluten sensitivity" how many people are affected and what is the mechanism for the sensitivity? This last question would tell us a lot more about whether this is something that could be treated by FODMAP diets etc.

The study although small certainly highlights that elimination diets (which by their nature are often not balanced) and prebiotic treatments with inulin can do more harm than good if they are applied purely on the basis of generic IBS symptoms.