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Is Your Gluten Intolerance Really FODMAP Sensitivity?

By Lea Basch, M.S., RD ; Updated June 23, 2016

Does this sound familiar? You started experiencing bloating, gas, lethargy and other digestive symptoms a few years ago and discovered after some trial and error that you felt better after cutting gluten from your diet.

But after sticking to a pretty strict gluten-free diet, your symptoms still haven't completely gone away, even when you know you haven't had any gluten. These lingering issues can cause of a lot of stress and frustration, which often exacerbate your symptoms.

Enter FODMAPs. Many researchers and health professionals attribute these ongoing symptoms not only to gluten intolerance, but to a wider intolerance to certain poorly digested carbohydrates (sugars) called FODMAPS.

FODMAP is an acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. FODMAP foods are composed of short-chain carbohydrates that some people can't digest.

First brought to light by an Australian research team, FODMAPS can be problematic in people with IBS or who have existing digestive issues. FODMAPS are poorly absorbed in the small intestine and rapidly fermented by bacteria in the large intestine, causing symptoms such as diarrhea, constipation, bloating, abdominal pain and gas.

Wheat and dairy are FODMAPs, which explains why many people with gluten or dairy/lactose intolerances feel better on a low-FODMAP diet.

The list of high-FODMAP foods to stay away from is pretty long and not logical or familiar to most people, but here are some general guidelines and some examples of foods to avoid or reduce:

Fermentable Oligosaccharides (fructans and/or galactans): wheat, barley, rye, beans, lentils, soybeans, peas, onions, garlic, asparagus, pistachios, miso.

Disaccharides are found in lactose, the natural carbohydrate of milk, soft cheeses (ricotta, cottage cheese), yogurt, custard, kefir, sour cream, buttermilk and ice cream.

Monosaccharides are found in fruits in the form of fructose in apples, dates, figs, grapefruit, honey and high-fructose corn syrups.

Polyols are found naturally in some fruits such as peaches, plums, avocados, apricots and cherries, but they also come in processed form as sugar alcohols, which are added to foods that are labeled “sugar-free.” On food labels, look for these types of sugar alcohols: xylitol, maltitol, sorbitol and erythritol.

The general approach taken by dietitians to figure out if you are FODMAP intolerant is to prescribe an elimination diet. This typically means following a strict low-FODMAP diet for at least six weeks. Then, if symptoms have improved, you add back foods from each category one by one to see what you are really not tolerating.

It’s important to note that a low-FODMAP diet is not for everyone. Foods that contain FODMAPs are generally healthy foods, so there's no benefit to cutting them out unless you are intolerant. It's also not an easy diet to follow, especially if you eat out a lot, and since this is a relatively new and growing field of research, the list of high- and low-FODMAP foods may continue to evolve.

If you think you could benefit from following a low-FODMAP diet, be sure to visit a health professional for a confirmed diagnosis before embarking on this complex way of eating. To help you remember which are high- and low-FODMAP foods, keep a photo of a list handy in your kitchen and on your mobile device so you can refer back to it when you eat.

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