Gluten free. Lactose intolerant. Sensitivities to wheat. What happened to the days when the only issues we had with food were nut allergies? Now we have the Paleo diet, the rise of veganism and everything in between. Has the nation gone crazy over a food intolerance ‘fad’?
From the outside looking in, I used to look on bemused at those in supermarket aisles, boycotting the bread and dairy sections because a diet on a ‘wellness’ website told them milk was bad for them.
Having never worried too much about my own personal diet, whilst still trying to remain healthy, the sudden rise of intolerances and dietary requirements seemed odd, but then it happened to me.
Bloating. Sharp pains. Cramps. Every time I ate a meal no matter how big or small, the problems were the same. It played on my mind, affected my relationships and affected my work. Food is the most crucial fuel we can put into our bodies and all it was doing was causing me great pain.
For too long I pushed it aside. I was a ‘google doctor’ just like those people in the supermarket aisles and thought I knew better. Then the penny dropped. I finally went and got professional help.
“I think you should try a low FODMAP diet to see if you’re intolerant to something”.
The words were uttered from the dietician’s mouth. What the hell was a low FODMAP diet? All of a sudden my life had been turned upside down. There were restrictions on everything I could eat and even my coffee intake was cut down from five coffees a day to a measly one.
The results? The sharp pains were gone, my energy levels were back up and I had the desire to see my friends again. My life had been flipped 180 after the adjustments to my diet and I now had the confidence to be myself again.
But how does it work? Well it turns out gluten isn’t the devil it’s made out to be if consumed in moderation.
According to Dr. Jane Muir, Head of Translational Nutrition Science at Monash University, this is because “a gluten-free diet is only necessary for people who have been diagnosed with coeliac disease – an autoimmune disease that results in inflammation of the small intestine when any gluten is ingested.”
While coeliac disease affects approximately one in 70 Australians on average according to the Coeliac Organisation of Australia, a research study conducted by CSIRO found seven per cent of Australians were avoiding wheat containing foods to manage symptoms they were attributing to these products.
World-leading research conducted by Monash University has cast doubt on whether gluten is the real cause of the problem. According to Dr. Muir, the culprit may be a group of short-chain carbohydrates (or sugars) called FODMAPS, which stands for Fermentable Oligo-, Di- and Mono-saccharides And Polyols.
“The sugars include fructose (in pears and apples), lactose (in milk), sugar polyols (sorbitol and mannitol in stone fruits and artificial sweeteners), fructans, fructo-oligosaccharides (in rye, artichoke, garlic, onions and wheat) and galacto-oligosaccharides (in legumes and nuts),” she says.
“Because these sugars can be poorly absorbed in the small intestine, they reach the large intestine where they are fermented by bacteria to produce gas, leading to abdominal discomfort.”
Researchers from the Department of Gastroenterology at Monash University have been conducting research for over 10 years to develop the low FODMAP diet to help patients with irritable bowel syndrome (IBS).
IBS affects one in seven Australian adults, and is characterized by the discomforts such as lower abdominal pain and discomfort, bloating, wind, abdominal distension and altered bowel habit such as constipation and diarrhoea.
While people can be tested for coeliac disease, the low FODMAP diet is the only scientifically proven way in determining if someone has food intolerances or IBS.
Dr. Muir says the research team at Monash has “good scientific evidence that the majority (75-89 per cent) of patients with IBS will benefit from a diet that restricts their intake of FODMAP sugars.”
It sounds crazy, right? A diet that restricts your intake of all the good stuff: certain fruits and vegetables, milk and yoghurt, cheese, breads, cereals, nuts and seeds. Why can’t you just eliminate gluten and dairy?
Dr. Muir says by ignoring the symptoms associated with IBS and consuming foods high in FODMAPs you could be doing your body more harm than good.
“There are serious gut diseases such as coeliac disease, inflammatory bowel disease and bowel cancer that have similar symptoms so need to be checked out immediately by a GP.”
By self-diagnosing food intolerances and eliminating whole food groups you may also be missing out on important nutrients such as dietary fibre, says Dr. Muir.
“While eliminating gluten is not dangerous if done in conjunction with a dietician who will ensure the diet is adequate and nutritionally balanced, people shouldn’t do it on their own.”
Accredited practicing dietitian Chloe McLeod says it is important to work with a dietician to determine your approach to the low FODMAP diet.
“When I work with patients, most likely high FODMAP foods will be removed from their diet, and I will then set a series of food challenges to determine their sensitivities,” she says.
“Once this is finished we ‘liberalise’ the diet, meaning high FODMAP foods are slowly and gradually added back in, below levels where the symptoms of IBS occur.”
According to McLeod, research indicates that most people don’t react to all of the high FODMAP groups. Identifying these groups means foods the person didn’t react to can be re-introduced, and it can be determined how much of a certain food they can tolerate.
According to Dr. Muir and McLeod, the low FODMAP diet is not a long-term diet, therefore the re-introduction stage of certain FODMAPS is extremely important.
But while it isn’t long term, McLeod says long term a low FODMAP diet will make life easier for people suffering from IBS for the following reasons:
- Most people with IBS are able to re-introduce FODMAPS and maintain good symptom control, making it easier to make informed choices and better manage symptoms
- Many FODMAP foods are high in prebiotics – compounds which provide food for the healthy bacteria that are found in the gut, so it is essential they be added back in at manageable levels
- Avoidance of unnecessary restrictions will help ensure their diet meets their nutritional needs
While the low FODMAP diet eliminates pages of grains, fruits and vegetables, the good news is there are low FODMAP foods to replace them.
So if a low-FODMAP diet that restricts parts of certain food groups isn’t a long-term diet, how healthy can a diet that eliminates whole food groups be?
Diets such as the Paleo diet omit grains, cereals and legumes altogether, which are important sources of dietary fibre. A ‘gluten free’ diet may seem healthy in theory, but many of the replacement foods are high in sugar, salt, fat and low in fibre, meaning by taking this approach you may be doing your body more harm than good.
While many people are intolerant to gluten, it is not the devil and for most people does not need to be eliminated completely. Instead of becoming ‘google doctors’ and cutting out whole food groups, if people notice symptoms associated with IBS after eating, they should seek medical advice.
The low-FODMAP diet has helped me regain control of all aspects of my life, and left me feeling healthy and happy again. I was once bemused at the people boycotting the bread and dairy sections of the supermarket, but now find myself doing the same.
Food is one of life’s greatest pleasures; let’s spend more time understanding how our bodies process it and less time listening to blogs that claim ‘fad’ diets are the golden key to our health.