Is gluten bad for me?

The difference between gluten & fructans…

A confusing aspect of the Low FODMAP Diet is that gluten free products are sometimes recommended – but is gluten a FODMAP?

The short answer to this is no. Gluten is a protein, while FODMAPs are carbohydrates.

In the case of diagnosed Coeliac Disease, a strict gluten free diet is required.

This is because the protein actually causes damage to the gastrointestinal tract – whether or not an individual experiences symptoms. For this reason, the most recommended treatment of Coeliac Disease is removing all gluten from the diet – including avoiding traces which can occur by cross contamination (for example, something as small as using butter containing crumbs of regular bread).

What about ‘non-coeliac gluten sensitivity’?

There is little evidence behind ‘gluten intolerance’ or ‘gluten sensitivity’ in the absence of Coeliac Disease, and no substantial evidence to suggest any benefit from a gluten free diet for people without Coeliac.

Instead, what is more likely is non-coeliac gastrointestinal symptoms being caused by fructans, which are (you guessed it) a FODMAP (Oligosaccharides)!

The confusion between gluten and fructans may come from the fact that most gluten containing foods do in fact contain fructans also.

We know FODMAPs can be the cause of IBS symptoms (in up to approx. 75% of us!) – so it makes sense that this could be the culprit.

FODMAPs are not damaging to our bodies as gluten is in Coeliac Disease

They simply cause symptoms and the Low FODMAP Diet is about minimising or controlling these symptoms. It is a LOW FODMAP Diet, not a NO FODMAP Diet – small amounts should be included in our diets (within individual tolerance levels) and an ongoing, strict limitation of foods is not recommended if other medical conditions are not present.

So if gluten isn’t the issue, why are gluten free products often recommended on a Low FODMAP Diet?

Since gluten and fructans go hand in hand, it can simplify things in the elimination phase of the diet to look for gluten free options. This is especially handy when ordering at a restaurant. Something to be aware of is other sneaky frutan ingredients that may be present – so always check the ingredient list.

Take away points:

• Gluten should not cause gastrointestinal upset outside of Coeliac Disease – chat to a dietitian if you are unsure of what is causing your syptoms
• If you are Coeliac, a strict gluten free diet is recommended
• FODMAPs do not cause damage to our bodies as gluten does in Coeliac Disease
• Many gluten containing foods also contain fructans
• If you have IBS (with the absence of Coeliac Disease), it is best to identify your triggers with the help of a dietitian and work together to formulate a plan for symptom control
• Gluten free options can make life a bit easier in the elimination phase, or if fructans are determined to be a trigger for you –just remember to check for other ingredients

References:
https://www.ncbi.nlm.nih.gov/pubmed/23648697
https://stephanieclairmont.com/low-fodmap-is-not-gluten-free/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388522/