Most people who avoid gluten because of pain and bloating do not actually have a true gluten intolerance, according to a large analysis published in The Lancet, cited by the Daily Mail.
Scientists have found that the culprit of unpleasant symptoms in most cases is not gluten, but FODMAP carbohydrates - a group of complex compounds that are not broken down in the small intestine and cause fermentation in the large intestine.
Gluten is not the main enemy
Despite the popularity of gluten-free diets, scientists remind us that true celiac disease — an autoimmune disease that requires complete avoidance of gluten — occurs in only about 1% of the population. The rest, who complain of pain, cramps, or bloating after eating bread or pasta, often react to other components of the products.
The researchers note that when participants in the experiments switched to a low-FODMAP diet — limiting their intake of onions, garlic, apples, nectarines, and certain grains — symptoms disappeared even after gluten was reintroduced.
The influence of the psychological factor
In many cases, negative feelings after eating are related to the expectation of pain, rather than to actual changes in the body. In experiments where people did not know whether they were getting gluten, the difference in symptoms was minimal. Some even felt worse after a placebo - gluten-free products.
" Activity in the gastrointestinal tract can affect brain function, and anxiety can increase sensitivity to normal digestive processes ," the study authors note.
Gluten-free diet can be harmful
Experts warn that avoiding gluten without medical advice is not only unnecessary, but potentially harmful. Gluten-free products often contain more fat, sugar and salt, but less fiber, protein and nutrients, which can negatively affect the gut microbiota.
In addition, psychologists warn: compulsive avoidance of certain foods increases anxiety and can exacerbate irritable bowel syndrome (IBS).
Researchers from the University of Leeds analyzed 67 clinical trials involving more than 7,000 people and found that cognitive behavioral therapy (CBT) is more effective than medication in reducing pain and fear of food.
" It is time to move from the reductionist approach of 'gluten is evil' to personalized therapies that will help people safely reintroduce gluten into their diet ," the scientists conclude.
Thus, the new study suggests reconsidering the popular belief that gluten is the main cause of discomfort after eating. In most cases, the problems are caused by individual reactions to carbohydrates, peculiarities of the intestinal microflora and psychological factors.
