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Fructan, not gluten, induces symptoms in patients with gluten sensitivity
- steanne 9y ago..oh. elsevier. https://www.ncbi.nlm.nih.gov/pubmed/29102613 https://www.ncbi.nlm.nih.gov/pubmed/29102613
- Bromskloss 9y agoWhat do you mean?
- romwell 9y agoThe OP means that the publication appears in one of the Elsevier journals, and the link goes to an Elsevier-affiliated website. The OP provided a link that doesn't go to an Elsevier-affiliated website. Elsevier is an academic publisher that is a relic of a pre-digital world. Essentially, it leeches on universities, charging money for access created by academics,funded by the state, and peer-reviewed by volunteers for free. They justify their need to charge money by reasons such as hosting costs, but whenever someone tries to host their articles for free, they pull out the big guns. Such actions, in particular, led to death Aaron Schwartz (see https://en.wikipedia.org/wiki/Aaron_Swartz https://en.wikipedia.org/wiki/Aaron_Swartz ). Elsevier is not liked around here. Speaking of resources that anger Elsevier by hosting articles for free, Sci-Hub is one. In particular, you can read the full text of the article by going to https://sci-hub.cc/ https://sci-hub.cc/ and looking up the paper's DOI (10.1053/j.gastro.2017.10.040). This full text is not available for free on the original publication link (nor on the NIH website). The study was funded by: the Extra Foundation Health and Rehabilitation, the Norwegian Celiac Association, the Throne Holst Foundation for Nutrition Research and the Wedel Jarlsberg Foundation - neither entity being Elsevier. (You can find this in the paper once you pay Elsevier to access it). So yes. Oh, Elsevier.
- Bromskloss 9y agoBut what does the link help?
- tesin 9y ago"The OP provided a link that doesn't go to an Elsevier-affiliated website."
- Bromskloss 9y agoYes, what does that achieve?
- interfixus 9y agoDid you apply your moniker to yourself? [For the rest of the world: Bromskloss is Swedish for brakepad]. The link achieves access to the article without driving traffic to the parasites at Elsevier.
- romwell 9y agoHah, interesting. Brake pad is a mild insult in Russian, used in the same way slowpoke is used in English online these days. I've always wondered which languages use brake pad (or any part of the braking mechanism) in the same way.
- interfixus 9y agoYes, interesting, thank you. I've never heard bromskloss used that way in Swedish, but then, I'm Danish, and don't really know this neighbouring language from the inside.
- pizza 9y agoSo that elsevier doesn't study user interactions, or that new users don't rely upon their services
- erichmond 9y agoI can confirm this was the case for me. After months of testing I was considered “not gluten sensitive”, while experiencing bad IBS when consuming gluten. Once I tried the FODMAP diet I found that the food should high in fructans were my trigger.
- tyingq 9y agoLooked that up, sounds perhaps like a harder diet than gluten free. Giving up onions and garlic, plus pasta, bread, etc...ouch. You have my sympathy.
- sushid 9y agoIt certainly does but you CAN eat things like pickled onions, various grains like corn, oat, quinoa, etc. I'm sure it makes going out a huge hassle.
- cjcampbell 9y agoHad to do it for two months while recovering from severe gut issues. It's no walk in the park. There were very few meals that I was able to enjoy, and I found it difficult to really meet my nutritional needs.
- dimal 9y agoI had to give up all of that stuff initially, but after symptoms recede (a few days) I was able to selectively reintroduce foods until I found the much smaller subset of foods that caused symptoms.
- davegardner 9y agoIdeally you should use FODMAP as an elimination diet to determine what food's you react to. I went though it a couple of years ago and discovered that onions (and large amounts of garlic) will give me IBS symptoms. I'm fine with everything else on the FODMAP list. I know others that have discovered they are sensitive to fruits such as apples, pears, etc. I don't know anyone who has stuck to a strict FODMAP diet long-term.
- karlkatzke 9y agoI'm not a statistician, but the results section is worth reading -- the fructan results are not much higher than placebo but both placebo and fructan are more affective than gluten. "Overall GSRS-IBS scores differed significantly during gluten, fructan, and placebo challenges; mean values were 33.1±13.3, 38.6±12.3, and 34.3±13.9, respectively (P = .04). Mean scores for GSRS bloating were 9.3±3.5, 11.6±3.5, and 10.1±3.7, respectively, during the gluten, fructan, and placebo challenges (P = .004). The overall GSRS-IBS score for participants consuming fructans was significantly higher than for participants consuming gluten (P = .049), as was the GSRS bloating score (P = .003). Thirteen participants had the highest overall GSRS-IBS score after consuming gluten, 24 had the highest score after consuming fructan, and 22 had the highest score after consuming placebo. There was no difference in GSRS-IBS scores between gluten and placebo groups."
- ezzaf 9y agoThis was my thoughts too. The values appear to be fairly similar for all three, especially given the large variations. Not to mention that they're explicitly trialling this with people "for whom celiac disease had been excluded". So an alternate conclusion could be "people without celiac disease but with self reported gut issues don't respond significantly differently to fructan, gluten, and placebo". Which is... not surprising?
- ameister14 9y agoThey don't appear that similar to me - if you plot them graphically you'll see a significant difference, particularly at the lower end.
- karlkatzke 9y agoP values of less than .005 generally mean that you accept the null hypothesis. The authors did otherwise for one hypothesis, which I find interesting.
- alexandercrohde 9y ago
- tunesmith 9y agoThere are a ton of theories out there that the gluten sensitivity is something other than for gluten, but just a big correlation. I'm pretty convinced by the literature that gluten sensitivity isn't really a "thing" outside of celiac disease, but even with me, I have problems with painful acne breakouts when I eat gluten, that don't happen when I don't have gluten. And from doing some googling and informal surveying of friends, it seems I'm far from alone on that. Now is that because of gluten itself? Who knows. Maybe it has to do with how wheat is processed these days, or something else. It's really frustrating that something so basic and common doesn't seem to have any scientific answers, though.
- Danihan 9y agoMy pet theory is that people are sensitive to the glyphosate sprayed on most wheat, not the actual gluten.
- kevin_thibedeau 9y agoBS. Glyphosate doesn't last long enough to persist in plants and nobody is spraying wheat right before harvest.
- DowsingSpoon 9y ago>nobody is spraying wheat right before harvest Glyphosate is sometimes used as a desiccant to alter the timing of wheat harvests, ensure even ripening, and to make harvesting easier. While it's not a widespread practice, it does happen in the US.
- forgotmypw 9y agoThe typical Glyphosate mix includes many other chemicals that do persist.
- msandford 9y ago> Glyphosate doesn't last long enough to persist in plants and nobody is spraying wheat right before harvest. Citation needed! Snopes says that the underlying practice is real despite a lack of evidence that the glyphosate causes the ailments: https://www.snopes.com/food/tainted/roundupwheat.asp https://www.snopes.com/food/tainted/roundupwheat.asp This paper attempts to draw some kind of causual biochemical link between glyphosate and celiac through metabolic processes: https://www.ncbi.nlm.nih.gov/pubmed/24678255 https://www.ncbi.nlm.nih.gov/pubmed/24678255
- nlfire 9y agoI could never pinpoint what foods caused trouble for me until I was an adult. Turns out I have (what I call) an intolerance to canola oil. No allergic reaction, but serious digestive trouble / etc. And it can be in anything. Different production runs of the same brand of crackers can use different oils so it is nearly impossible to identify unless you stumble upon it by accidentally fasting due to flight problems and just making hashbrowns (potatoes and canola) at your destination as a snack. I had accepted it as a fact of life until eliminating it from my diet, and lo and behold, food is always awesome.
- bertil 9y agoThank you for sharing the link to the actual summary. N=59 which is enough to justify for a larger survey but probably not to garner the attention this piece is receiving. This will trigger massive swings in how certain food groups are perceived, affect farmers, etc. Caution is required.
- weddpros 9y agoScience is science, not politics, and it must stay that way. A french wheat producers syndicate has published web pages to say even coeliacs should eat gluten, just less of it... That's even the first article my mom found about gluten intolerance and she called me to tell me gluten intolerance isn't really a thing according to the internet. My guts and my gastroenterologist both disagree. That's what happens when you listen to politics and silence scientists.
- ropable 9y agoThere is an app which might be useful for anyone undertaking or starting a FODMAP elimination diet called Monash Uni Low FODMAP Diet. No affiliation; we just found it very helpful to classify ingredients and for recipe ideas while we were new to the process.
- Arete3141 9y agoFWIW, I've been sensitive to gluten for years, but when I traveled in Spain -- I was fine. Then I came back to the US, and tried wheat again. Nope. I would not be surprised if the way we're processing / spraying our wheat here is giving some folks problems.
- lactinfo 9y agoWhat does gluten sensitivity symptomize as (assuming you do not have celiac’s disease)?
- taeric 9y agoI would similarly be unsurprised if there is just some other factor. I saw an article onetime that showed a link between alergies to apples and the range of an unrelated tree. That is, there was some other type of tree that, if present, increased the occurrence of reported allergies to the apple. Whereas the same apple in a location without this tree had fewer allergies reported. Sadly... my inability to refind this article makes me suspect that, though I may be unsurprised by this idea, I have no evidence for it. So, if anyone can help refute the idea, that would be great! :)
- jon_richards 9y agoHoly shit. I've always been allergic to random things like cherries, apples, tomatoes, melon, peaches, etc., but only some of the time and never when it's cooked. It could definitely be some other tree or something that's doing it. Edit: Just read the other reply. I'm definitely allergic to birch and grass pollen and I've always had hay fever. That solves that mystery.
- taeric 9y agoDefinitely seek out more information on this. I'm still halfway convinced I imagined the article I am referring to. :(
- asplake 9y agoYou may be thinking birch trees. I’m allergic to certain raw fruits (cooked or canned ok), beans, and tree nuts (peanuts and cashews ok). I’m told this weird combination is a thing. I found “Oral allergy syndrome” http://acaai.org/allergies/types/food-allergies/types-food-allergy/oral-allergy-syndrome http://acaai.org/allergies/types/food-allergies/types-food-a...
- 1024core 9y agoMy theory is that we have hybridized and bred strains of wheat in the West which have caused these problems. An interesting study would be take some "old world" wheat (that has not been impacted by the industrial-scale farming practices of the West), and see if the gluten-sensitive people still have the same reaction to that.
- floatingatoll 9y agoFructan is, if I trust internet definitions, a fructose polymer. Perhaps fructan sensitivity is an immune/whatever reaction to high fructose corn syrup, mis-directed at fructan due to its similar composite materials.
- tom_mellior 9y agoThis study was done in Norway. HFCS is pretty rare in Europe compared to the US. It's possible that it was present in the "fructan" treatment here, but if I had to bet, I'd bet it was unlikely.
- chrismanning 9y agoAlthough the study isn't about the FODMAPs generally, note that fructose itself is also a FODMAP (when present in larger quantities than glucose), and so could also cause similar symptoms.
- jostylr 9y agoJust looking at the abstract, does anyone know what the typical values for that questionnaire of GSRS-IBS would be? Is it a mean of near 0? I would want to see a control group, different notion than a placebo, which has no self-reported problems and see what kind of variety there is in the scoring.
- dandare 9y ago59 subject divided into three groups - is that even statistically relevant?
- miek 9y agoI had a 3-year span where I could not eat gluten, and for 1 year of that I could not eat corn. My level of sensitivity was such that I could not eat gluten-free meals at any restaurant due to cross contamination nor drink instant coffee because the conveyors are sprayed with a corn-based anti-clumping solution. I saw 3 different digestive specialists (I believe all gastrointestinologists, it's been a few years). Their approaches did nothing. Then I searched for digestive disease research centers, went to one, and was "cured" after two visits. The doctor said that my situation is becoming more prevalant, and that the issue is typically one or more of the following: A hostile bacteria in the digestive tract, overgrowth of one or more bacteria in the digestive tract, or a parasite. A round of the following two drugs fixed me within a few days: Alinia and Neomycin. I was drinking beer and eating noodles again without any problems. Now I have to take an antibiotic that targets the digestive tract every 1 - 1.5 years as symptoms return. This indicates that my problem is bacterial rather than parasitic, although the exact cause of my problem hasn't been identified. An interesting side note: I traveled to Japan while affected by gluten (but before corn became problematic), and I ate in restaurants the whole trip with only one problem. I am certain that I was consuming small amounts of gluten with each meal. I learned that Japan and other countries have rejected US wheat shipments over certian GMOs, but I couldn't reliably explain why I was largely unaffected in Japan.
- sasas 9y agoThis is incredible. Could you explain what your symptoms were? Thanks for sharing your story.
- miek 9y agoOf course. Symptoms: gas, bloating, diarrhea, constipation, mental slowness/fuzziness (I was always saying "sorry, I'm really out of it today"). Symptoms could last anywhere from 12-48 hours, and usually the onset of the symptoms was around 4-8 hours.
- sasas 9y agoDid they do an actual test/sample before prescribing th medication or just take a guess? Congratulations on escaping all those terrible symptoms!
- rossrubacon 9y agoLectin in foods? Maybe u need a lectinblocker?
- rossrubacon 9y agoMaybe. U need a Lectin blocker. Have u looked at lectin in foods?
- belen3 9y agoI think the paper focuses only in gastrointestinal symptoms. NCGS actually causes more extra-digestive problems than the classic Celiac disease ones. Before I started my very strict gluten free diet I had migraines, fatigue, joint pain brain fog... I continued eating lots of fructans, especially garlic an onion, but I still improved dramatically. My thyroid, inflamation and cholesterol markers went back to normal. My rheumatologist Carlos Isasi has done extensive work about it and even published a study about a big % of fibromyalgia patients improving a lot by avoiding gluten. So, I don't believe it is all about fructans. I think it is related, though. My theory involves archaea overgrowth, pyrrolisine use for methane production (here comes the gas and IBS symptoms) and leaky gut as a result letting gluten into the bloodstream (which causes the toxic immune response)