So you’ve given up bread and pasta and feel great! Your tummy is less bloated, the cramping has subsided, your using the toilet normally and even that annoying wind has almost gone away. It must be the gluten, right?
Well not necessarily. Current research is indicating that, in the absence of Coeliac Disease, its the Fructans (a group of short chain carbohydrate molecules)
that are actually at the root of the problem. Fructans are part of a group of molecules that make up the FODMAP acronym and are collectively found in many foods including apples, dairy, wheat, garlic and onion, just to name a few.
As you can see below, when you eliminate the gluten containing grains, you also eliminate fructans, making it difficult to discern exactly which molecule is causing the problem. This is exactly what the researchers at Monash University’s department of Gastroenterology are trying to evaluate. At this point they are finding that, in the absence of coeliac disease, removing the fructans and not the gluten gives the best symptom relief for people who have previously reported non-coeliac gluten sensitivity.
But you feel better not eating gluten, so what does it matter if you chose to just exclude it from your diet?
After working in healthcare for the last 20 years, I am well aware that effective and safe treatment occurs when the cause of the issue is pinpointed.
While there is some cross over in a gluten free diet and a low FODMAP diet, since they are excluding or limiting different molecules not all gluten free foods are low FODMAP and not all low FODMAP foods are gluten free. From a nutrition point of view this is important, our bodies need a variety of nutrients to function well and keep us healthy, and by eating a variety of foods from different food groups, we give our body the best chance of meeting these needs. Being restrictive with your food choices unnecessarily can lead to:
It stands to reason that it is mentally and physically healthiest to only limit or restrict specific foods based on your diagnosed needs, and that a correct medical diagnosis is the best way to identify what your needs are.
In this case is is Coeliac Disease or is it FODMAPs and where is the difference?
If you think that gluten may be causing you symptoms get tested properly for coeliac disease BEFORE you stop eating gluten containing grains. You can read more about what getting tested involves and what considerations to take for the test to give an accurate result here. It is necessary to be eating gluten at the time of being tested, an accredited practising dietitian (APD) can help you choose foods that may be more tolerable during this phase.
You can find a qualified dietitian who has a special interest in coeliac disease via the Dietitians Association of Australia website here.
Beware of unorthodox testsThere are numerous tests for food allergies and intolerances, many of which are expensive and are unreliable. They may be misleading, delay correct diagnosis and lead to ineffective or even dangerous treatment. The Australasian Society of Clinical Immunology and Allergy (ASCIA) advise against the use of such tests for diagnosis or to guide medical treatment. For more information, visit the ASCIA website here.