Do you experience occasional or regular digestive issues? If so, you're not alone; most people do.
The descriptor "digestive issues" covers all manner of things, doesn't it? So much can go amiss in that part of our bodies given it's the processing center for food and emotions––the two things that basically run our lives!
Gas, bloating, stomach pain, diarrhea, and constipation are just a few of the unpleasant and disruptive symptoms that many people regularly experience because of what they eat. But wait a minute--if your diet is primarily fresh, nutritious food, why do you have to snap open the button on your trousers after you eat a light meal or exit the room to avoid gassing your dinner guests? It's not only unpleasant, it's alarming.
Unless you overeat at meal times, a properly functioning digestive system should not produce any abdominal discomfort, diarrhea, gas, constipation, or otherwise. So what's going on and what can you do about it?
FODMAPs: The simple explanation
What are FODMAPs? FODMAP stands for "fermentable oligo-, di-, mono-saccharides and polyols," which is a bit of a jawbreaker to say and a whole lot of mumbo-jumbo if you're not deep into the science of nutrition. So, we'll break it down:
Monosaccharides are the most basic form of sugar and carbohydrates. They're also called simple sugars. Examples are glucose, fructose, and galactose.
Polysaccharides are monosaccharides joined together, and the most abundant carbohydrate in our food. Examples are cellulose, chitin, glycogen, starch, and hyaluronic acid.
Oligosaccharides are two or more monosaccharides joined together. Examples are sucrose, lactose, and maltose.
Polyols are naturally-occurring short-chain carbohydrates found in some fruits and vegetables and additives in packaged foods.
These four carbohydrates don't make it into your bloodstream because they are resistant to digestion. They pass through the digestive tract and arrive at the most bacteria-dense part of the journey: the far end of the large intestine. Bacteria use the carbs as energy, and for those who are sensitive to these sugars, produce gas and other unpleasant symptoms.
Putting the science aside now, let's look at what actually happens to those sugars in your system that makes some people suffer so much.
(Interested in learning about the impact of these carbohydrates on the brain? See our article Grain Brain & The Interaction Between Diet and Genes).
FODMAPs are considered a dietary fiber. Fiber passes through the digestive tract without breaking down, and it does us a favor by sweeping out the colon, promoting regularity, and keeping blood sugar balanced. (To learn more about the importance of fiber, see our Ultimate Guide To Grain Nutrition).
Some carbohydrates, such as lactose and fructose, don't adversely affect everyone. In some people, FODMAPs are poorly digested, and the combination of gases produced by the different bacteria in the gut can create abdominal distension and gas. FODMAPs also draw water into the intestine, leading to diarrhea.
A low-FODMAP diet can help prevent and alleviate these uncomfortable symptoms. The different sugars noted earlier are FODMAPS, and you can reduce intake or avoid them altogether. If you're eating packaged food, check the label to determine the presence of those sugars.
Let's take a look at what foods contain FODMAPS to get a better idea.
High FODMAP foods include apples, garlic, onions, sauerkraut, mung beans, cauliflower, falafel, fresh beetroot, dates, avocados, bananas, wheat products, cheese, and milk.
Low FODMAP foods include carrots, broccoli, lettuce, papaya, pumpkin, kale, most meats, most fish, and most wheat alternatives. For a more comprehensive list of high and low FODMAP foods, see this FODMAP dieting guide.
Gluten Intolerance & Sensitivity
Gluten-related disorders seem to be on the rise. Gluten has been a big, bad, buzz word for several years as many people discover that they just don't feel great after consuming certain gluten-containing foods, like bread, some grains, and other wheat products. But there's a broad spectrum of gluten-related conditions, from mildly adverse post-digestive reactions to nausea and vomiting.
Gluten-related issues are categorized as either gluten intolerance or gluten sensitivity. The most serious form of gluten intolerance, celiac disease, is an autoimmune condition that affects a very small portion of the population. When gluten is consumed, the immune system identifies it as dangerous, and its response damages the lining of the small intestine and severely impairs digestion. The impact on the rest of the body can be significant because of immunological scarring which may cause chronic inflammation (1).
While celiac disease is in a class of its own, milder forms of gluten intolerance are also immune system disorders, but their symptoms are much less severe.
Although it's often used interchangeably with gluten intolerance under the spectrum of gluten-related disorders, gluten sensitivity is different. The symptoms can mimic gluten intolerance but its etiology is still unclear.
What about gluten makes some people sensitive to it? There are two main proteins in gluten––gliadin and glutenin. When water is added to wheat flour, which contains gluten, these proteins bind together into an elastic type substance that's a bit like glue. In some cases, that substance is difficult for the digestive system to break down and causes a range of uncomfortable gastrointestinal discomforts, similar to those caused by FODMAPs.
It's important to note that grains are not the only derivatives of gluten. Cakes, cereals, crackers, certain condiments, energy bars, even malt vinegar, prepared lunch meats, canned soups, processed cheese, and fried foods are a few (the list goes on). If you suspect you're gluten intolerant or sensitive, look beyond bread and take stock of all the ways gluten may be sneaking into your daily diet.
Conversely, not every grain contains gluten, and some grains contain much less gluten than others. (Read why bulgur is better for your belly than other grains).
Is There A Link Between Gluten and FODMAPs?
Suspected gluten sensitivity may actually be a sensitivity to FODMAP foods because the gastrointestinal symptoms are so similar. But there may be more to it than that. Recent evidence suggests a link between gluten sensitivity and FODMAPs, such that gluten-containing grains like wheat, barley, and rye are also high in FODMAPs (2).
With that understanding, someone may only be sensitive to gluten when it's present in foods that are also high FODMAP foods, like certain grains. The reason for it? That's currently under speculation. FODMAP sensitivity has to do with the fermentation process in the colon, and gluten sensitivity primarily affects the small intestine. If someone is sensitive to both nutrients, the double hit may be too overwhelming to their digestive system. This is surface speculation because the research is minimal, but it's a plausible explanation.
The Good Grains
If you suspect you may be sensitive to either FODMAPs or gluten or both, grains may not be the best food to include in your diet. But, don't rule them out altogether. Go digging, test foods out, and monitor your body's response. Or see your doctor to get tested. Check out our grains guide, or for a quick read, read our blog on the 5 Most Nutritious Grains.
From our kitchen to yours, we wish you a happy belly and better (read: comfortable) times in the bathroom!