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Recent research blames FODMAPs for bloating
Posted 3 years ago by Jo
The Daily Mail has reported on new research indicating that FODMAPs (scroll down for definition), rather than gluten containing foods, are to blame for bloating. Gluten is currently a nutrition buzzword, and many celebrities and natural health professionals advocate a gluten-free diet to help relieve all manner of different symptoms. Professor Gibson of Monash University in Melbourne was in fact one of the initial advocates for removing gluten from the diet to help relieve symptoms of bloating. Following the results of this latest study he reportedly believes that this information may not in fact be accurate, gluten may have been inaccurately blamed, and that it is in fact FODMAP foods that are to blame for bloating.
FODMAP foods contain sugars not absorbed by the body that may cause bloating and gas
The recent study, with 37 people, involved all meals being prepared by researchers; feedback was analysed and stool samples were taken. The meals were swapped between those containing high amounts of gluten, low amounts of gluten and gluten-free meals. Those taking part in the study remained unaware of the type of meals they were consuming and the interesting discovery was that they reported the same symptoms regardless of the amount of gluten they were eating. The conclusion was drawn that it was not gluten causing their symptoms. Dr Peter Gibson furthermore hypothesised that they would be more likely to see benefits from giving up FODMAPs.
Dr Peter Irving, a gastroenterologist at Guy's and St Thomas' Hospital and The London Clinic, supports Dr Gibson's theory and Guy's and St Thomas' Hospital have adapted the FODMAP diet with positive results. Dr Irving says, "a Low FODMAP' diet can be very beneficial for people with IBS". If you would like to read more about IBS and bloating you can do so here.
What are FODMAPs?
FODMAPS are known as Fermentable Oligo- (e.g fructans and galactans), Di- (e.g lactose), Mono-saccharides (e.g fructose) and Polyols (e.g sorbitol, mannitol), which are short chain carbohydrates which cannot be broken down by the body and absorbed by the bowel. As FODMAPs are not absorbed by the body, they cause fermentation in the bowel and are also thought to cause water to be drawn in and gas to be produced, causing bloating and flatulence. FODMAP foods, specifically FOS (Fructooligosaccharides) act as prebiotics, and, especially if taking a poor quality FOS, these are thought to potentially provide a food source for pathogenic bacteria in the gut. This could further exacerbate problems with bloating and gas. In this instance, it is particularly important to focus on increasing levels of beneficial bacteria in the intestine. You may like to read more about probiotics here and their benefits for bloating. At the end of the day, focusing on one's gut health is imperative to solving problems such as bloating in the long term.
A low FODMAP diet
A low FODMAP diet restricts foods containing the poorly absorbed sugars mentioned above. Dr Gibson explains that, "It works on the principle that not all sugars can be absorbed within the small intestine and as a result they are rapidly fermented by bacteria in the bowel which draws in fluid and produces gas. This can cause symptoms including bloating, abdominal pain and diarrhoea".
A low FODMAP diet has previously been shown in clinical trials to be effective in helping to reduce symptoms of IBS. One study at King's College Hospital found that 75% of those following a low FODMAP diet saw their symptoms improve.
A low FODMAP diet excludes many healthy foods such as certain fruits and vegetables
A diet low in FODMAPs is however notoriously tricky to follow due to its restrictive nature and involves cutting out a lot of 'healthy' foods including many fruits and vegetables. FODMAP foods include apples, pears, onions, garlic, honey, peaches, cabbages, beans, lentils and chickpeas. It is worth nothing that the low FODMAP diet does exclude bread, we have previously discussed whether bread acts as a trigger for bloating which you can read about here. The low FODMAP diet also eliminates all dairy foods, often regarded as a primary dietary source of calcium, so it is important that someone following a low FODMAP diet ensures they seek adequate alternatives for the foods that are being reduced or eliminated.
FODMAPs or Gluten to blame?
Whilst this new research into FODMAPs is interesting, and FODMAPs can certainly cause bloating or IBS symptoms in many people, it's worth considering that it isn't necessarily a simple question of 'either/or'. The media have reported this story with a strong play off between gluten and FODMAPs, with the suggestion that gluten is just fine. However, it's worth being aware that this was a small observational study, and that gluten certainly can cause bloating for a number of people! - Especially in those who are intolerant to gluten and do not digest it well (not to mention those who are allergic and have coeliac disease.) A few years ago Sarah wrote a post in response to research at the time which stated bread does not result in bloating... Sarah also points out in her blogpost that the study in question was funded by the National Association of British and Irish Millers, and the Federation of Bakers!
If you believe FODMAPs are to blame for your bloating, I would advise you to seek advice from a qualified nutritionist or naturopath. Although the low FODMAP diet clearly has some benefit, from experience working with clients in my Nutritional Therapy practice, as well as removing potential trigger foods (such as FODMAPs), I would also recommend addressing your overall digestive health. This includes assessing the levels of beneficial bacteria in your gut. You can read more about FODMAPs and probiotics in the relevant FAQ by OptiBac Probiotics - my probiotic supplements of choice.
This research is very interesting, and it seems there is evidence to remove FODMAP foods to help reduce bloating, at least for a period of time. There may of course be other causes of bloating, including gluten, which are causing a problem for you and one of the best ways to help determine if any food is contributing to your symptoms is to follow an elimination diet. You can find out more about potential triggers foods and bloating in an article I wrote recently about the top 6 trigger foods for bloating.
If you have managed to find the trigger for your bloating symptoms, and any effective natural remedies, we would love to hear about it. Please let us know by commenting below.
Susan Shepherd J, Parker F C et al. 2008. Dietary Triggers of Abdominal Symptoms in Patients With Irritable Bowel Syndrome: Randomized Placebo-Controlled Evidence. CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2008;6:765–771
Staudacher, H M, Whelan K et al. 2011. Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPS) versus standard dietary advice in patients with irritable bowel syndrome. JOURNAL OF HUMAN NUTRITION AND DIETETICS. 25 May 2011.
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