I ran into something interesting this morning. As it turns out the Australian gastroenterology prof who did the 2011 study that kicked the interest in gluten-free diets into high gear has produced another much more rigorous study that contradicts his previous findings:
Analyzing the data, Gibson found that each treatment diet, whether it included gluten or not, prompted subjects’ to report a worsening of gastrointestinal symptoms to similar degrees. Reported pain, bloating, nausea, and gas all increased over the baseline low-FODMAP diet. Even in the second experiment, when the placebo diet was identical to the baseline diet, subjects reported a worsening of symptoms! The data clearly indicated that a nocebo effect was at work here — patients reported gastrointestinal distress without any apparent physical cause. Gluten wasn’t the culprit.
The present working hypothesis is that people are reacting to the FODMAPs. “FODMAPs” are short chain carbohydrates and everybody has difficulty in handling them. They’re the cause of the frequently, er, observed problems in digesting beans. Just about everything contains FODMAPs so avoiding them altogether isn’t a particularly good option. There are several different classes of FODMAPs (fructans, galactans, polyols), some people have more problems with one or another of these than the others, and the sensitivity to them appears to vary based on genetic background. Some people can’t eat beans. Others can’t eat crucifers (members of the cabbage family). Some can’t handle artificial sweeteners (many are FODMAPs). And so on.
It seems to me that if you suspect that you might have a particular sensitivity to one class or another of FODMAPs the best thing to do might be to approach the matter systematically. Don’t try to eliminate everything at once. Research what’s in what, pick one particular class of FODMAP, and experiment with reducing that in your diet. Some people might need to eliminate one class entirely from their diet. Others might find that just reducing the load being placed on their digestive systems is enough. One size may not fit all.