'Low-FODMAP' May Be the Next 'Gluten-Free', Except with Better Scientific Support
One week ago, friends and family members gathered around tables strewn with mashed potatoes, greasy gravy, shimmering vegetables, and juicy turkey jam-packed with gluten-free stuffing.
Wait, gluten-free stuffing?
Though it may seem sacrilege to many ardent eaters, gluten-free Thanksgiving options likely made the rounds at many festive dinners around the country. Considering that the gluten-free market has surged 63% in the last two years to around $8.8 billion in sales in 2014, that should really come as no surprise.
Three out of every ten Americans are now trying to eat less gluten, a protein commonly found in wheat, barley, and rye that's been criticized for inciting everything from gastrointestinal discomfort to autism. Three out of ten is far more than the one in 141 people estimated to have celiac disease, an autoimmune disorder triggered by gluten in which the hair-like villi that line the small intestine become damaged, leading to gastrointestinal discomfort and hampered nutrient absorption.
So why are millions of Americans eating less gluten? It may be in an attempt to attain health benefits, though there don't seem to be many, or because they might be "sensitive" to gluten, even though researchers have yet to characterize the biomarkers of non-celiac gluten sensitivity which would conclusively prove that it exists. More often than not, however, they suffer from general stomach problems like cramps, bloating, and pain, and are understandably looking for some way to alleviate their uncomfortable symptoms.
Sadly, however, everyday stomach trouble remains an enigmatic problem for modern medicine. All sorts of things can make a gut unhappy. Stress and anxiety are commonly to blame, but they rarely get much attention in the popular media or in the break room at work. Thus, dietary triggers -- like MSG or gluten -- are most often vilified, since they are "simple" fixes that engender a soothing placebo effect and fit well on a food label.
Out of the medley of marketing, blogs, and dietary advice that pervades modern society, it's difficult to determine which solutions to a sour stomach are backed by good science and which aren't. While the evidence for going gluten-free in the absence of celiac disease is lacking at the moment, another diet seems to be gaining popularity.
It's called Low-FODMAP, which is an acronym for "Fermentable, Oligo-, Di-, Mono-saccharides And Polyols." Basically, FODMAPs are substances that aren't absorbed very well in the small intestine. So when they pass into the large intestine, bacteria ferment them, creating gas that can cause pain, bloating, and flatulence. FODMAPs aren't harmful in any way; they simply make more "noise," so to speak, as they are digested. Dietary sources high in FODMAPs include milk, broccoli, apples, onions, beans, wheat, and -- glaringly -- high-fructose corn syrup, which has become widespread in the last four decades. A Low-FODMAP diet simply recommends that you eat less of these foods and more of foods lower in FODMAPS, like bananas, carrots, corn-based cereals, beef, chicken, lettuce, and rice.
Though gluten is significantly more studied than FODMAPs -- a PubMed search returned nearly 4,000 results on gluten and just 53 on FODMAPs -- scientists have still yet to conclusively determine the mechanism for how gluten could cause stomach issues in people without celiac disease. On the other hand, it's well understood how FODMAPs can trigger gut discomfort. Occam's Razor should be put to use here. FODMAPs may be the stomach irritants we've been looking for, not gluten. In fact, a well-controlled study published last year found that when patients diagnosed with gluten sensitivity went on a Low-FODMAP diet, their symptoms largely disappeared.
As a treatment for many functional gut disorders, the Low-FODMAP diet certainly deserves more attention than it's currently getting. A team of gastroenterologists recently made that clear in a review published to the journal Digestive Diseases and Sciences. Examining the diet's potential to treat irritable bowel syndrome, a gastrointestinal disorder that affects 10-15% of North Americans every year, they concluded:
"The available data are impressive and should prompt healthcare providers to include the FODMAP diet into their repertoire of treatment options."
Eating Low-FODMAP to ease nagging stomach symptoms may not be as trendy as going gluten-free. It is, however, supported by fledgling, but thus far solid science.