The Great Gluten Myth VS The Phantom Fructan?

fructanIn case you haven’t heard, gluten is kind of a big deal. You can learn this from just about anyone that visits a grocery store or health food store. Wait staff and check-out clerks are being trained on how to answer about which of their offerings contain the terrible substance. There is no denying that gluten is at the center of a formidable economic movement. Fortune reports that “sales of products with a gluten-free label have doubled in the past four years, rising from $11.5 billion to more than $23 billion.” The irony being that the main suffers of gluten intolerance (people with Celiac disease) are in fact a tiny fraction of the population.

The science regarding non-celiac intolerance is present, albeit sparse. A trial performed in 2011 titled “Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial” indicated gluten may play a large role in gastrointestinal symptoms. There was a huge public reaction to this trial. This study is often referred to by gluten free product manufactures. So large was the reaction that the original research team set out to reproduce the study with a larger trial group (37 people vs 34 in the original).

The result was shockingly different from the first. The title of the study says it all:

“No Effects of Gluten in Patients With Self-Reported Non-Celiac Gluten Sensitivity After Dietary Reduction of Fermentable, Poorly Absorbed, Short-Chain Carbohydrates”

Note the drastic change in tone from the title of the first trial to the second. In an NPR interview the head researcher, Jessica Biesiekierski stated, “We believe non-celiac gluten sensitivity probably does exist, but it’s not very common and we have a lot more to do until we fully understand [gluten].”

Now hold on! Anyone that has ever taken themselves off of products containing gluten can tell you that they notice an improvement in their health. So what’s going on?

There is no denying that multitudes of people are seeming to benefit from low gluten or gluten free diets. But is one connected to the other? The answer may not be as obvious as you think. For anyone entering statistical sciences, there is a mantra that is virtually beat into new student’s heads:  “Correlation is not causation”.  Simply because a factor is present in a consistent result, does not mean it is CAUSING the outcome. But we live in a 24 hour news cycle world eager to jump to snap causation. It sells a lot of ad space if you can say THIS thing causes THAT aliment, even if you state the exact opposite in next week’s report. An example of the folly of correlative assumptions is a pretty hilarious website that draws correlation between all types of data. My personal favorite is this one:  the years where a movie starring Nicolas Cage is released have higher rates of pool drownings. While stranger things have happened, it is not too likely that people are killing themselves because of Mr. Cage’s poor career choices (In my book, it’s all downhill after Moonstruck and Raising Arizona).

So what “might” be at play when a person feels better after removing gluten from their diet? While statistically unlikely, it is possible that the person is an undiagnosed celiac sufferer. Another, more likely explanation, could be that the person is in fact cutting something else out of their diet at the same time.

Enter the The Phantom Fructan

Dr. William Chey a gastroenterologist at the University of Michigan, believes that we should be looking at the carbs. Many gastroenterologists are focusing their microscopes on a group of carbs they say is irritating the guts of a lot of people, causing gas, diarrhea, distention and other uncomfortable symptoms. Altogether these carbs are called fermentable oligo-di-monosaccharides and polyols, or the cumbersome acronym FODMAPs. The specific culprit is believed to be a carb named fructan.

The fructan in wheat is more likely triggering IBS in most patients rather than the gluten. “But we still need to understand which symptoms are related to gluten, and [which ones are] related to fructans,” stated Dr. Chey in the NPR piece.  Whatever that actual answer, it seems clear that we need to reduce high carbohydrate foods because they contain both gluten and the FODMAP fructan. Essentially, cutting out gluten is ALSO cutting out FODMAPs. This seems to ring true for many other people trying to improve their health by cutting carbs from their diet. They regain their energy while reducing inflammation and bloating. They also experience healthy weight loss almost effortlessly.

So whether it is the gluten, the fructan or Nicolas Cage – a reduction of carbohydrates is inextricably linked to healthy weight loss and improved health for millions of people.  As a newly diagnosed diabetic, removing carbs from my diet transformed my life. In my case, the need for medication was reduced and eventually eliminated as a result of my low carb diet. It was this revelation that motivated me to write the documentary film Carb-Loaded: A Culture Dying to Eat. Which I might add is safe for people with pools since Nicholas Cage DOES NOT appear anywhere in the film!

So whether it is the gluten, the fructan or Nicolas Cage – a reduction of carbohydrates is inextricably linked to healthy weightloss and improved health for millions of people.

Lathe Poland is one of the creators of the documentary film Carb-Loaded: A Culture Dying To Eat. Watch it now on iTunes, Amazon, Roku and many other platforms


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