
Fructan, not gluten, induces symptoms in patients with gluten sensitivity - kmundnic
http://www.gastrojournal.org/article/S0016-5085(17)36302-3/pdf
======
miek
I 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.

~~~
weddpros
miek, I'd really appreciate if you could contact me with more precise
information (analysis you did, etc...).

I've been struggling with gluten sensitivity for 1.5yrs (been through the
gastroenterologist circuit already, with 0 results) so your comment blew my
mind.

Thank you! My email: chris [à] chris-hartwig.com

~~~
sasas
Hi, I had “gluten sensitivity” for maybe the last decade. Brain fog, fatigue
etc. removing gluten helped but did not fix. Then I tried the ketogenic diet
and all my problems went. Infact I feel better then I have ever in my life
when in a state of ketosis. Not sure of the reason - It could be I’m cutting
out a certain foods.. or it’s the anti inflammatory effects of ketone bodies?
Still searching for answers on why. But for now it feels like I’ve been given
a second chance at life.

I’d be happy to provide more details to you if your interested in trialing
this path.

~~~
scarygliders
Not sure why you're being downvoted.

If there's one thing I've learned, when researching how diet can affect
myself, it's that different humans react to different food types and intake,
in different ways.

If a ketogenic diet works for you, the same diet may not work for others.
Similarly, other types of diet may not work for you.

It's for that reason I decided to vote you up again - there is no reason to
downvote what you posted.

One particularly enlightening book which changed my outlook on diet, raised an
eyebrow, and just clicked with me, was "Eat Fat and Grow Slim", written in
1958 by Richard Mackarness, M.B.,B.S.

~~~
sasas
1958.. The more you dig into th history of nutrition the more you realise
there was two parallel tracts. The one that won public opinion (low fat/high
carb) has pretty much contributed to an epidemic. Recommend the book “the big
fat surprise” by Nina Teicholz on the topic.

------
tunesmith
There 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
My pet theory is that people are sensitive to the glyphosate sprayed on most
wheat, not the actual gluten.

~~~
saalweachter
People spray glyphosate on wheat?

Glyphosate is typically used in conjunction with "Roundup Ready" crops, or
before/during planting in "no-till" crops. While Monsanto developed a Roundup
Ready line of wheat, it never actually made it to market, AFAIK, so why would
you be spraying glyphosate on wheat?

(Serious question; while I have some background in agriculture, I'm not
familiar with all of even the common practices.)

ETA: Reading the Snopes link, looks like it's mainly practiced in North
Dakota, which explains why I've never heard of it.

~~~
seanot
It's not practiced in ND out anywhere else. The export market won't accept it
and it's not deliverable against spring wheat futures so it's not marketable
and never has been.

------
karlkatzke
I'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."

~~~
goialoq
if placebo is a sugar pill, maybe it's a sugar sensitivity...

~~~
brbsix
I assume placebo is the same muesli bar used in the other groups (without the
supplemented fructan or gluten).

~~~
basicplus2
Ah! Excellent point!

------
Arete3141
FWIW, 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.

~~~
taeric
I 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! :)

~~~
asplake
You 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-a...](http://acaai.org/allergies/types/food-
allergies/types-food-allergy/oral-allergy-syndrome)

~~~
taeric
Thanks for the link! That at least makes it look like I didn't imagine the
article. The one I remember was a more direct link between allergies to thing
X, but only in the presence of thing Y. With no reported allergies to thing Y.

------
erichmond
I 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
Looked 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.

~~~
davegardner
Ideally 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.

~~~
ThrustVectoring
I know someone who has, but that was because it helped manage her auto-brewery
syndrome. Pretty much any time she ate off-diet she immediately regretted it
the next day, so that was _very_ effective at keeping her honest.

------
steanne
..oh. elsevier.

[https://www.ncbi.nlm.nih.gov/pubmed/29102613](https://www.ncbi.nlm.nih.gov/pubmed/29102613)

~~~
Bromskloss
What do you mean?

~~~
romwell
The 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
But what does the link help?

~~~
tesin
"The OP provided a link that doesn't go to an Elsevier-affiliated website."

~~~
Bromskloss
Yes, what does that achieve?

~~~
interfixus
Did 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
Hah, 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
Yes, 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.

------
nlfire
I 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.

------
1024core
My 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.

------
bertil
Thank 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
Science 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
There 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.

------
floatingatoll
Fructan 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
This 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
Although 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.

------
belen3
I 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)

------
jostylr
Just 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
59 subject divided into three groups - is that even statistically relevant?

------
rossrubacon
Maybe. U need a Lectin blocker. Have u looked at lectin in foods?

------
rossrubacon
Lectin in foods? Maybe u need a lectinblocker?

