Is It Always About Gluten?
If you have celiac disease, the answer is “yes.” But for non-celiac gluten sensitivity (NCGS), it’s not so clear cut. If you think you have NCGS, your healthcare provider may have suggested you have an issue with “FODMAPs” instead. Here, we explain what FODMAPs are, why some people have issues digesting them, and why there can be a link between FODMAPs and gluten sensitivity.
Non-celiac gluten sensitivity [or “gluten sensitivity” (GS) for short] is not well understood or clearly defined. Since it has no specific diagnostic test, gluten sensitivity is generally diagnosed when other conditions that may be causing symptoms are ruled out, and when a gluten-free diet leads to relief of symptoms. One condition that should always be ruled out is celiac disease. It turns out that one of the additional “other conditions” could be sensitivity to FODMAPs.
What are FODMAPs?
FODMAP stands for Fermentable-Oligosaccharides-Disaccharides-Monosaccharides-And-Polyols. To translate this into something a bit more understandable, FODMAPs are essentially certain types of sugars and shorter chain carbohydrates. They are found in a wide range of foods, including some items from each of these categories: fruits, vegetables, nuts, seeds, grains and grain-based products, dairy and dairy alternatives, sugars and sweeteners.
Low digestibility of FODMAPs means they are poorly absorbed in the small intestine and therefore move on to the large intestine, where they are fermented by bacteria. In some people, this leads to IBS (Irritable Bowel Syndrome)-like symptoms including gas, bloating, abdominal discomfort, pain and altered bowel function. All these are symptoms often associated with gluten senstivity, too.
Link between gluten sensitivity and FODMAPs
If you’ve gone on a gluten-free diet and experienced relief of symptoms, or you still don’t feel well, how do FODMAPs fit in to the picture? It turns out that by cutting out gluten, you’ve also been reducing intake of FODMAPs. The gluten containing grains wheat, rye, and barley also happen to be high-FODMAP foods. (It is the type of carbohydrates in these foods, not the gluten protein, which makes them high FODMAP.) So, when these foods are eliminated on a gluten-free diet, FODMAP intake is also reduced. Some research has concluded that gluten may not be a trigger of gastrointestinal symptoms in some individuals once FODMAPs have been reduced.
Low FODMAP diet
Individuals interested in considering a low FODMAP diet should always consult with their personal healthcare provider, and with a dietitian who has specific knowledge of this diet and of food intolerances. In addition, it should be determined in consultation with a healthcare provider whether other testing and/ or treatment is indicated, which may include testing for celiac disease.
Many foods are sources of FODMAPs and if a low FODMAP diet is followed, it is important it be well planned to ensure that it provides sufficient nutrients. Generally, the low FODMAP diet is followed strictly for a period of two to six weeks. This is followed by reintroduction of some foods to determine which specific FODMAP sources are problematic for each particular individual. Again, always consult with your personal healthcare team.
Barrett JS, Gibson PR. Fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) and nonallergic food intolerance: FODMAPs or food chemicals? Therap Adv Gastroenterol. 2012 July; 5(3) 261-268.
Biesiekierski JR, Peters SL, Newnham ED, Rosella O, Muir JG, Gibson PR. No Effects of Gluten in Patients With Self-Reported NonCeliac Gluten Sensitivity After Dietary Reduction of Fermentable, Poorly Absorbed, Short-Chain Carbohydrates. J Gastro. 2013; 145 -2.
Gibson PR, Shepherd SJ. Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach J Gastroenterol Hepatol. 2010 Feb;25(2):252-8. doi: 10.1111/j.1440- 1746.2009.06149.x.
Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. J Gastro. 2014 Jan;146(1):67-75.e5. doi: 10.1053/j.gastro.2013.09.046. Epub 2013 Sep 25.
The Monash University Low FODMAP Diet. Monash University. Published 2010. Updated January 8, 2013. Accessed April 12, 2019. www.med.monash.edu/cecs/gastro/fodmap/description.html
Scarlatta K. For A Digestive Piece of Mind. FODMAPs 101. Accessed April 12, 2019. www.katescarlata.com/fodmaps-101/
Shepherd S. (2014, March 26). Is Gluten Really the Problem? The Role of FODMAPs in Gluten-Related Disorders. Live webinar, hosted by NFCA, now Beyond Celiac. www.beyondceliac.org.
Skodie GI, et al. Fructan, Rather Than Gluten, Induces Symptoms in Patients With Self-Reported Non-Celiac Gluten Sensitivity. Gastroenterology. 2018 Feb;154(3):529-539.e2. doi: 10.1053/j. gastro.2017.10.040. Epub 2017 Nov 2.
Fody’S Easy Weeknight Low FODMAP Teriyaki Chicken
Try this quick, protein-packed dinner with Fody Teriyaki Sauce & Marinade for a delicious meal the whole family can enjoy!
Teriyaki Chicken Ingredients
- 8 chicken thighs, legs or a combo, at room temperature
- Kosher salt
- Freshly ground black pepper
- 2/3 cup (165 ml) Fody Teriyaki Sauce & Marinade, divided
Teriyaki Chicken Cooking Directions
Preheat oven to 375F/190C. Place chicken skin side up in roasting pan and season with salt and pepper on all sides. Drizzle with about two-thirds of the Fody Teriyaki Sauce & Marinade and roast in oven for about 20 minutes or until skin begins to crisp. Brush with remaining sauce and continue roasting until chicken is cooked through, skin is glazed, browned and crisp and juices run clear. Allow to sit for 5 minutes to allow juices to redistribute, then serve hot. Serve with your favorite side of vegetables or gluten-free grains.
Fody’s Potato, Red Pepper & Spinach Low FODMAP Frittata
Frittatas are so versatile – you can eat them for any meal of the day, use up random vegetables from your fridge, prepare ahead of time, and still serve an impressive meal! Try this delicious low FODMAP-friendly recipe using Fody Shallot-Infused Oil, Steak Seasoning, and Teriyaki Sauce & Marinade.
Fody’s Potato, Red Pepper & Spinach Low FODMAP Frittata Ingredients
- 1 pound (455 g) small waxy potatoes, red or yellow skinned
- ¼ cup (60 ml) Fody Shallot-Infused Olive Oil
- 1 medium red bell pepper, cored and thinly sliced
- 2 tablespoons chopped scallion greens
- 2 packed cups (2-ounces/55 g) baby spinach
- 4-ounces (115 g) mild goat cheese, crumbled
- 3/4 teaspoon Fody Steak Seasoning, or more to taste
- 8 large eggs, well beaten
Directions for Low FODMAP Frittata
Bring a large pot of salted water to a boil. Add potatoes and adjust heat to a simmer until potatoes are tender when pierced with a knife, about 15 minutes. Drain and cool, then slice crosswise into ½-inch (12 mm) discs.
Set broiler to high and adjust rack about 4-inches (10 cm) from broiler.
Heat a large, 12-inch (30.5 cm) oven-safe nonstick skillet or a cast-iron skillet over medium heat. Add oil, and when it is shimmering, add the scallions and red pepper strips and sauté for a minute or two until softened. Add the spinach and sauté until wilted, stirring everything together well. Stir in the sliced potatoes and goat cheese and stir around gently until combined and butter is melted and cheese is incorporated. Season to taste with Fody Steak Seasoning. Add the well-beaten eggs and stir until everything is evenly combined.
Cook over low-medium heat for about 6 to 8 minutes or until the bottom is golden, then transfer to broiler for a minute or two until all of the egg is set and the top is browned as well. Serve immediately cut into wedges.