What's a FODMAP?

An Explanation of Gluten and FODMAPs and Their Connections to Health

From pasta, to bread, and even to cupcakes, gluten-free foods are suddenly the rage. In the past five years, sales of gluten-free products have more than doubled, with an estimated 24% of consumers currently eating, or living with someone who eats, gluten-free foods. There are several reasons why a person might opt for a gluten-free lifestyle, but it’s not always necessary to ditch gluten permanently. Here we’ll discuss what gluten is, why some people can’t eat it, and a group of sugars called FODMAPs (Fermentable, Oligo-, Di-, Monosaccharides, and Polyols) that might actually be causing discomfort for others.

Gluten is a protein found in wheat, rye, and barley. It provides structure and elasticity to breads and dough and is a component of many packaged foods. There are a few different conditions in which a person would benefit from gluten-free diet.

Celiac disease is a genetic, autoimmune condition triggered by gluten that affects about 1% of the population worldwide. When a person with celiac disease ingests gluten, the small intestine inflames, leading to intestinal damage and possible complications. A person could also have a wheat allergy. With this, a specific immune response in reaction to proteins in wheat (maybe gluten, but maybe a different wheat protein) can lead to abdominal pain, nausea, vomiting, and skin rashes. Both of these conditions can be diagnosed by a doctor through testing.

From here it gets a little confusing. In some cases, autoimmune or allergic reactions to gluten-containing grains have been ruled out, but people still feel poorly after eating gluten. Doctors call this non-celiac gluten sensitivity. These people might have similar symptoms as those with celiac disease or wheat allergy, but symptoms can vary. One day they might have stomach pains after eating gluten, and the next day it might be a headache. There is no exact answer as to why symptoms might occur after eating foods with gluten, but abstaining from gluten might improve well-being.

Doctors are now looking at a different condition that might be mixed up with gluten sensitivity: FODMAP intolerance. FODMAPs are a group of sugars found in certain foods that, when eaten in excess, pull water into the intestine, may not be digested or absorbed well, and are fermented by bacteria in the intestinal tract. People who are sensitive to FODMAPs may experience cramping, gas, bloating, or diarrhea after eating foods high in these sugars.

A 2013 Australian study in the journal Gastroenterology found some patients with self-reported non-celiac gluten sensitivity might actually be reacting to FODMAPs in wheat-containing foods, not gluten. A low FODMAP diet helped reduce fatigue and GI symptoms in these patients regardless of gluten content in the food. Low FODMAP foods include poultry and fish; oats and rice; lactose-free dairy or dairy alternatives; most vegetables; and fruits such as bananas, pineapple, raspberries, and kiwi. Apples, watermelon, mango, and blackberries are high in these sugars and should be avoided on a low FODMAP diet.

So, is a gluten-free diet for you? If you do not experience uncomfortable symptoms after eating foods with gluten, there is no reason to eliminate it from your diet. Whole grains offer a host of healthy nutrients such as fiber and B vitamins, so if you’re living pain-free keep gluten on the menu.

If you do experience discomfort after consuming foods with gluten, speak with your doctor about how to best treat your condition. He or she can work with you to determine what might be triggering symptoms, and help you discover a diet that is best for you.

Published March 1, 2015