A large study by the University of Technology Chalmers and Uppsala University in Sweden suggests that gluten and certain types of carbohydrates called “fodmaps” have less than expected effects on the symptoms of IBS. Gluten had no effect and FODMAPs had little effect. Changes above 50 points show clinically significant effects, according to the metrics used for IBS symptoms (IBS-SSS). The FODMAP and placebo changes were 42, and the gluten and placebo changes were only 10.Credits: Chalmers University of Technology | Elise Nordin and Yen Strandkvist
Many IBS patients often avoid certain types of foods and exclude gluten.But a large new study from Chalmers University of Technology Uppsala University in Sweden has not shown a link between high gluten intake and increased IBS symptoms. Researchers have discovered that certain types of carbohydrates, called “fodmaps,” can exacerbate bowel problems, but the overall result is that they are more influential than previously thought. It shows that there are few.
“IBS is a very complex disease with many factors, but our results show that the effects of a particular diet are not as great as previously thought,” Chalmers Food Science said. Elise Nordin, a PhD student and lead author of scientific papers, explains.In American Journal of Clinical Nutrition.
IBS (Irritable Bowel Syndrome) affects about 3-5% of the world’s population and is accompanied by symptoms such as abdominal pain, diarrhea and constipation. In a new study of 110 people with irritable bowel syndrome, researchers looked at how people are affected by providing rice pudding prepared in different ways. One variety was rich in gluten and the other was high in carbohydrates from the “FODMAP” variety. That is, a fermentable carbohydrate that contains specific chains of fructose and lactose. Many foods, such as dairy products, bread types, and certain fruits and vegetables, are rich in FODMAPs.
In addition to the specially prepared rice pudding, the researchers also provided a neutral rice pudding that acted as a placebo.
Rice pudding double-blind knowledge
Participants in the study ate rice puddings rich in fodmaps, gluten, and placebo in a random order for a week by category. The study was double-blind. In other words, neither the participants nor the researchers knew who ate which rice pudding when.
“Diet studies are often difficult to perform a double-blind study because it is often clear what the participants are eating. Something is added to or removed from the diet. This is a major obstacle, as knowledge of sickness can affect results. The fact that we have succeeded in making a completely blind diet with a large number of participants makes our study unique. It’s a thing, “says Elise Nordin.
Elise Nordin, PhD student, Chalmers University of Technology, Faculty of Biology and Biotechnology, Sweden.Credits: Chalmers University of Technology | Martina Butrac
The subject’s gastrointestinal system was induced by high doses (1.5 times the daily intake in a normal population) of FODMAPs or gluten. FODMAPs exacerbated the symptoms, but not as much as researchers expected based on the results of previous studies. However, gluten was found to have no measurable adverse effect on the subject’s sensory symptoms.
“Our results are important and show that psychological factors are probably very important. IBS has previously been shown to be related to mental health. It has been tested in research. Just knowing that can reduce the burden of symptoms, “said Per Hellström, a professor of gastroenterology at Uppsala University, who was responsible for the research.
Distinguish between gluten and fodmap effects
In previous studies, researchers primarily excluded fodmaps from the subject’s diet, indicating a clear reduction in IBS symptoms. However, due to the small number of participants in these studies and the lack of a double-blind study, it is difficult to objectively evaluate the results.
Professor at Riccard Randberg, Chalmers University of Technology, Biology and Biological Engineering, Food and Nutrition Sciences, Sweden.Credits: Chalmers University of Technology | Anna-Lena Lundokuvist
Many IBS patients exclude gluten from their diet, despite the lack of scientific evidence. The results of previous studies are inconsistent. Gluten-rich foods such as bread are often also rich in FODMAPs. Therefore, there is a theory that it is the fodmaps of these foods that cause IBS symptoms, not gluten. This demonstrates the importance of research to separate the effects of fodmaps and gluten.
Consider ways to adapt your diet individually
New research is part of a larger project looking for biomarkers in the gut flora or blood to help researchers predict health outcomes. Researchers can classify individuals into different groups based on their metabolism, that is, how their metabolism and gut microbiota respond to different diets, and these groups. I would like to investigate if I have various IBS symptoms.
“Finding objective biomarkers that can determine if an individual belongs to a particular metabolic syndrome of IBS symptoms can ease the lives of many individuals with IBS. A more individually tailored diet. There are many indications that it is possible to use objective markers for advice, “says Professor Ricard Landberg, head of the Food and Nutrition Department at Chalmers Institute of Technology.
The new IBS study also clearly shows that individual differences are significant in how different people are affected by a particular diet.
“At the group level, some individuals may react strongly to these foods, even if the FODMAPs show only moderate effects and no gluten-inducing effects, so consider individual differences. That’s important, “says Elise Nordin.
Study and FODMAP details:
- Fodmap is an abbreviation for “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols”. Examples of FODMAPs are fructose, lactose, fructose / galactooligosaccharides, and sugar alcohol polymers, which are found in a variety of food products such as dairy products, cereals, mushrooms, fruits and vegetables. For example, xylitol-sweetened products are also rich in FODMAPs.
- Scientific study “FODMAP induces moderate symptoms of irritable bowel syndrome, but not gluten: double-blind, placebo-controlled, randomized tripartite crossover study” in The American Journal of Clinical Nutrition It was published. The authors of this article are Elise Nordin, Carl Brunius, Rikard Landberg of Chalmers University of Technology, and PerM Hellström of Uppsala University.
- In this study, subjects were given high doses (1.5 times their normal daily intake) of FODMAPs (50 g) and gluten (17.3 g) and the results were compared to placebo. Throughout the study, all subjects ate a diet with minimal FODMAP content and no gluten. Each trial period was one week, followed by a one-week break. Blood and stool samples were provided weekly as subjects also answered a questionnaire about the perceived symptoms.
- This study was funded by Formas and the Swedish Research Council.
Reference: “Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) induce moderate symptoms of irritable bowel syndrome, but gluten does not: double-blind, placebo-controlled, random Tripartite Crossover Study, Elise Nordin, Carl Brunius, Rikard Landberg, PerM Hellström, October 7, 2021 American Journal of Clinical Nutrition..
DOI: 10.1093 / ajcn / nqab337
