This Is the Villain, Not Gluten

Low FODMAP vs. Gluten Free Diet

People think going gluten-free makes them leaner, better athletes, and less prone to digestive upset, but they’re blaming the wrong guy.

Do you want to be gluten-free?

I blame that tennis player for most of today’s gluten tomfoolery. Yeah, Novak Djokovic. Here’s the ridiculous way it went down:

In 2010, Djokovic met with Dr. Igor Cetojevic, a Bosnian Serb who theorized that Djokovic’s up-til-then frequent breakdowns on the court were due to a wheat allergy. Djokovic was instructed to hold one hand on Cetojevic’s stomach, the other open with his palm upwards. Djokovic resisted the doctor’s request to push down on his outstretched hand and tell him to resist the pressure.

Cetojevic then told the tennis player to do the same thing while – get this – holding a piece of bread against his stomach. Cetojevic was now able to push the opposite arm down just as easily as if it was a willow leaf. The doctor explained that Djokovic had been transformed by the experiment. “showed that his body was resisting the wheat,” Or, in other words, to resist the gluten found in wheat products

It’s true. Good thing the doc didn’t suspect an allergy to blueberry pie because that would have left a nasty stain on Djokovic’s shirt.

Djokovic was eventually convinced by this medical Svengali. It was an unmatched success story. Djokovic won 21 Grand Slam titles. He also won or did every other thing in the tennis-balling industry.

Many athletes around the world have adopted a gluten free diet to improve their performance. Gluten phobia was also a common problem among non-athletes. They lit their torches, picked up their pitchforks, and stormed the bread castle – not to make toast for their club sandwiches – but to banish it entirely.

Others have also given up wheat due to the “Wheat Belly” This book was published one-year after Djokovic publicly opposed wheat. The book gave a fresh perspective to the debate. The book claimed that modern wheat is high in gliadin, an addictive protein that can turn normal people into bread-seeking zombies that will do anything to get another bagel.

A quarter of Americans have switched to a gluten-free or bread-free diet. Many people feel happier and more productive as a result.

It could be partly due to the “nocebo” Effect is when an inert substance causes harm to be perceived. The nocebo, which is bread in this instance, can be eliminated to make you feel better and perform better.

More likely, though, there is something in bread that’s causing problems, but in the vast majority of cases, it’s not gluten – they’re blaming the wrong guy. This is because about 5% of the population have celiac disease, which is a condition that causes gluten intolerance. Another 5-10% might be affected. “non-celiac gluten sensitivity” (NCGS).

And that stuff about gliadin. Gliadins, which are addictive, can be found in all types of grain. Some ancient seeds even contained more gliadin than modern ones. Besides, the human gut doesn’t appear to even absorb the opioid protein fraction of gliadin.

So, let’s forget about the “Wheat Belly” faction of bread phobics and concentrate on what it is about bread that’s allegedly causing so many people to have digestive problems.

Are there any studies to support the fear of Gluten?

About a year after the ridiculous piece-of-bread-on-Djokovic’s-tummy fiasco, Peter Gibson, a professor of gastroenterology, published a double-blinded, randomized, and placebo-controlled experiment that found gluten to be the cause of gastrointestinal distress in people without celiac disease.

The anti-gluten folks received plenty of doughy ammunition, but Dr. Gibson decided to sit down and enjoy a delicious, gluten-free garbanzo bean biscuit. He felt a strange sensation in his stomach, which was completely unrelated to gluten.

Gibson couldn’t figure out what it was about gluten that could be causing problems in people. Also, there were so many variables in his initial experiment that he worried that there might be something he wasn’t controlling or taking into consideration. He decided to do another experiment but this time he would take extra precautions not usually found in nutritional research.

He discovered 37 subjects. None of them had celiac disease, but all had gastrointestinal problems that had improved upon a gluten-free diet. He then provided all their meals, so there was no chance of subjects making midnight runs to Al’s Donut Emporium or Taco Cabana.

He eliminated any possible dietary triggers for gastrointestinal problems including lactose and certain preservatives.

And, in an effort to leave no stone unturned, he collected everyone’s urine and fecal matter for analysis. He also made them cycle on different diets. In order to establish a baseline, the first two weeks were spent on a low-FODMAPS diet. Then, they were offered either a diet high or low in gluten. One with 2 grams gluten and 14g protein isolate (the lowgluten diet) or one with 16g protein isolate (the placebo).

No one knows which diet he/she is on. He looked over the results and found that all diets had similar effects on gastrointestinal symptoms. He concluded it was psychological and participants were expecting to feel worse.

Gibson was forced into concluding “In contrast to our first study, we could find absolutely no specific response to gluten.” Gibson and Jessica Biesierkierski, Gibson’s co-researcher on anti-gluten, found a culprit. The study found that the FODMAPS were more likely to be the cause of the gastrointestinal problems previously thought to be caused by gluten.

Remember I mentioned that the subjects were first given a low-FODMAP diet as a baseline. According to Biesierkierski “Reduction of FODMAPS in their diets uniformly reduced gastrointestinal symptoms and fatigue in the run-in period, after which they were minimally symptomatic.”

Also, if you decide to stop eating bread products (which is the most popular attribute of the lowgluten diet), you will eliminate some of your largest sources of FODMAPs. Many people claim that they feel more satisfied when they are on a bread-free diet.

FODMAPS are poorly absorbed by pretty much all of us human types, and any that aren’t absorbed by the small intestine pass onto the large intestine where they’re fermented by bacteria.

Some people with overpopulations of certain bacteria or underpopulations of other bacteria may experience symptoms similar to irritable stool syndrome. This could be mistaken for gluten sensitivity.

Is This All You Have, One Measly Study or is That All You Have?

A more recent study (Skodje, et al. The 2018 study had the exact same goal, to discover if gluten is causing people’s gastrointestinal problems. They found 59 people with gluten sensitivity, and gave each one of them a different muesli bars to eat for a week.

• One with 5.7g of gluten
• One without gluten, but with 2.1g of fructans (a type FODMAP).
• One that was a placebo (no gluten or fructans).

Participants were asked to rate how they felt after eating the bars. They were then asked to complete a seven day washout, until the symptoms from their previous challenge had subsided. After that they were allowed to cross over into another group for the second round of the test. They continued this process until they had all consumed each of the three bars for one week.

You should hold onto your toilet seat’s sides because the gluten group was the last to cause problems. They actually found “no significant effect” Gluten. The most severe problems were with the fructans bars.

Don’t We Already Know This Stuff?

I’ll readily admit that some of this isn’t ground-breaking information, as it’s well-known among the scientific community that self-reported gluten sensitivity is largely bogus. However, the information hasn’t yet permeated down to the great unwashed and too many people still peg gluten as the enemy.

You can be sure that the public doesn’t know the truth about gluten by counting how many gluten-sensitive people you know. It’s probably a number that belies the estimate that only 5 to 15% of the population has celiac disease or gluten sensitivity.

Which foods contain FODMAPs?

As implied above, fructans are present in wheat, spelt, rye, and barley, the main components of many breads, so when people with digestive problems eliminate bread from their diet, they’re automatically getting rid of one source of their difficulties.

Fructans are one member of FODMAP, however. FODMAP stands for fermentable oligosaccharides (disaccharides), monosaccharides and polyols. These four small-chain carbohydrates are found naturally in nature and are easily fermented and caused by intestinal bacteria.

The damnable thing is that they’re in a lot of foods. It’d be great if people susceptible to FODMAP problems could eliminate all their problems by just avoiding bread, but unfortunately, it’s not the case. Here are some foods high in FODMAPS that those who are sensitive might want to limit.

Vegetables, Legumes

• Garlic
• Onions
• Asparagus
• Beans, e.g., black, kidney, lima, soya
• Peas
• Mushrooms
• Cabbage (savoy)
• Cauliflower

Fruit

• Apples
• Apricot
• Avocado
• Bananas (ripe)
• Blackberries
• Grapefruit
• Mango
• Peaches
• Pears
• Plums
• Raisins
• Sultanas
• Watermelon

Meat Products

• Sausages (some)
• Some processed meat

Breads, Cereals & Grains. Pastas

• Barley
• Bran
• Cous cous
• Granola
• Muesli
• Muffins
• Rye
• Seminola
• Spelt
• Wheat foods

Nuts & Seeds

• Cashews
• Pistachio

Milks

• Cow’s milk
• Goat’s milk
• Sheep’s milk
• Soy milk

Eggs and dairy

• Buttermilk
• Cream
• Custard
• Greek yogurt
• Ice cream
• Sour cream
• Yogurt

Cheese

• Cream cheese (over 2 tbsp)
• Ricotta

Condiments

• Hummus dip
• Jam (mixed berries)
• Pasta sauce (cream based)
• Relish

Sweeteners

• Agave
• High Fructose Corn Syrup
• Honey
• Inulin
• Isomalt
• Maltitol
• Sorbitol
• Xylitol

Drinks

• Juice of apple
• Pear juice
• Mango juice
• Sodas with HFCS
• Strong herbal tea
• Beer (even though it’s made from barley, wheat, or rye, it still qualifies as a low-FODMAP food)

I know what you’re thinking: “Jeebus! Can’t I eat anything safely?” Sure. It is impossible to list all low-FODMAP food options here. But, suffice it to say that you can still base your meals on these:

• Eggs and meats
• Cheeses such as cottage cheese, Swiss, Mozzarella and feta.
• Almond, rice and coconut are all options.
• Grains like quinoa, oats, popcorn, and rice.
• Peanuts, almonds walnuts sunflower seeds and pecans are all good options for seeds.
• Vegetables such as potatoes, corn and pumpkin, red peppers.
• Fruits such as grapes, oranges (no more that 30), raspberries (no greater than about 30, strawberries, blueberries and pineapple.

How to Use This Information

Here’s what I recommend doing:

1. Take a look at the evidence, and you might be open to the possibility that gluten intolerance may occur in certain cases. “nocebo” effect. It’s not hard to imagine, especially with so many yahoos claiming that eliminating gluten was the athletic game-changer they’d been waiting for.
2. If being gluten-free has allowed you to lose weight, consider that most people start to lose weight whenever they start following any diet where they’re forced to pay attention to what they’re eating. Not only that, but gluten-free diets are restrictive, so you’re bound to lose weight.
3. Consider whether you have legitimate gastrointestinal issues that disappear when you go gluten-free. Remember that low- and no-gluten diets also contain low levels of FODMAPs.
4. FODMAPs could be a problem for some people. There are many resources available on low FODMAP diets. Begin by observing how you feel after eating high-FODMAP or low-gluten foods. If those foods cause gastrointestinal rumbling or worse, it’s a good chance you’re sensitive to FODMAPs. FODMAPs-sensitive people might want to try probiotics. Probiotic foods To see if there are any benefits.
5. If you don’t have celiac disease or NCGS, accept that going on a no or low-gluten diet isn’t going to do squat for your athletic ability.
6. However, if you are one of the few people with celiac disease, or have NGCS, keep going and avoid gluten.

Although I knew there were many questions and controversy about gluten, I could not determine how fraudulent Wheat Belly was. I was diagnosed with celiac disease 10 years ago. This condition put me in hospital multiple times until my gastroenterologist finally figured it all out. This made my life easier as I didn’t have to be involved in the controversy.

How do you cope with it? How can you keep your symptoms under control?

This is muscle testing. Although it sounds crazy, there are actually interesting research findings. You might want to check it out TC.

Hello. Hello. I’d assume they’d both be good to go staples no matter what.

Let’s see…daughter recruited wife who then recruited sister-in-law (her sister) and sister (my sister).

“…it’s well-known among the scientific community that self-reported gluten sensitivity is largely bogus.”

Just not goin’ there. They are too many. Then there’s the restaurant scene:

Waitress: Do You Want Bread?
Wifey: “No, I am gluten-sensitive.”
Me: “Yes, and bring me hers too.”

I am fine as long there is no gluten.
Last year, however, I began to experience episodes of acute Pancreatitis. It seems that this was due to taking too many bodybuilding products and too few vitamins.

Both of these are great because of the many positive aspects they offer, but my stomach aches almost every time I eat one.

Many foods, including sauerkraut and kimchi, are high in mannitol. Mannitol can often cause stomach discomfort. It is worth trying small amounts and seeing how you feel.

I’m a little bit familiar with it, but holding a piece of bread to the stomach? I’m more than a little skeptical.

Yikes! Hope you’ve got that in check.

FODMAP-free milk that is lactose free is available. FODMAPS’ D (Disaccharides), lactose is its component. Many cheeses, whether they are hard or aged, contain very little lactose. This is why they’re safe for low FODMAP diets.

Because it wasn’t mentioned on your “safe” List, but I thought it worth explaining before so many people lose something as nutritious as milk. They are probably fine with lactose-free varieties.

This is a great article.

Thank you, TC. It amazes me that you have not stopped answering me personally after more than 20 years.

Excellent! Thanks!

Gluten causes me to avoid it because it raises my prolactin. Lower testosterone is usually associated with higher levels of prolactin.

Also, gluten tends to be in processed foods, and I usually stick to more whole natural sources of my carbs such as potatoes, rice, quinoa, millet etc, so by extension I don’t eat much gluten.

So instead of eliminating bread, we eliminate or limit some 30 or so other items including cauliflower, plums, sultanas, bananas….onions and Garlic?! I am currently in Paris, better not mention that to my French hosts…who all seem slender and with no gastrointestinal issues to speak of!

I’ll also avoid showing this to my wife, a senior gastroenterologist at one of the world’s top centres, who happens to know a thing or two about FODMAPs.

I’m a huge follower of TC. But this article is so off-track that it is hard to know where to start.

Ask your wife to review the article and then share it with you. Do you want to be an admirer of the problem?

IBS sufferers often have two main culprits: onions and garlic. They are also high in FODMAPs. I’m sure your wife could tell you. I don’t know what you’re dismissing. FODMAPs are literally measurable – it’s not the case of opinion. TC stated only what is generally accepted knowledge.

I’m not getting you. I don’t know what I wrote that was so objectionable. Most of the time when I write an article, I throw in some of my own conjectures, but I don’t think I raised anything here that isn’t widely accepted.

Hi TC

First, let me say that I am a huge fan of Tennessee and have a lot of respect for you. I was so excited to see the article in my email, and have since read it several times.

This was what I did, and it was passed on to my wife and other leading gastroenterologists. They do not debate the matter in a forum.

To sum it all, the real issue is your statement that FODMAP sensitive people might avoid certain foods. Many of these staples are also off limits. It is better to see a specialist than to self-diagnose and avoid foods that may cause sensitivity.

This is an increasingly common trend in the gastro industry. Many is the patient turning up at my wife’s and her colleagues clinics claiming some allergy or intolerance that they’ve read in some Marie Claire article. The trend I see in the lifting community is the same (see comments below!) These are the same guys who will happily pump their bodies full of pre-w/os and protein bars. Although the percentage of people with a true intolerance is very small, their number is steadily increasing. These neuroses are fueled by this type of article. It is a responsible thing to encourage people to seek professional assistance.

Although I don’t often get involved in these discussions, I felt it was important to have a healthy discussion.