Many believe diets free of gluten — the protein found in grains which gives shape to food — eases rheumatoid arthritis symptoms, but experts say there’s no evidence of that. “There aren’t a lot of relationships between diet and rheumatoid arthritis that withstand the test of time,” rheumatologist Susan Goodman told Everyday Health.
A new Gastroenterology study by Norwegian researchers reveals that patients with self-reported gluten sensitivities, which aren’t diagnosed as Celiac disease, might actually be plagued by a carb called fructan, which is often present in foods with gluten and which the human body can have difficulty digesting. The presence of both gluten and fructan in many foods has made it hard to pin down which trigger is to blame, which sows abundant confusion.
“Fructans are polymers of fructose,” a gluten researcher told CBC Radio. “Our body can’t digest them, so we don’t have the enzymes to digest them.” Bacteria ferment the fructans in the large bowel, which produces gases. “That, of course, can distend the bowel and make people feel quite uncomfortable, bloated, it can cause wind, but can actually cause a lot of discomfort for some people,” she said.
As Vox reports, celiac disease, in which gluten consumption causes the immune system to attack the small intestine, is “vanishingly rare.”
When those who swear by gluten-free diets report improvements, an Italian gluten researcher told the publication, it’s generally “a result of a placebo effect unavoidably related to the elimination diet.”
The 59 patients in the study, all of whom chose gluten-free diets, were assigned to three groups: one which consumed bars with gluten, a second with fructan bars, and a third placebo bars.
They found that those eating gluten bars fared better than did those consuming the fructan ones, but that the placebo group also had difficulty, “due perhaps, the researchers said, to the nocebo effect of anticipating negative outcomes after any intervention, which has been as high as 40 percent in other research,” MedPage reports.
A doctor at Spain’s Hospital San Pedro de Alcantara told MedPage that the term “non-celiac related gluten sensitivity” might be better rendered as “wheat and/or cereal sensitivity.”
The research, wrote Kristin Verbeke, of the University of Leuven in Brussels, in an accompanying Gastroenterology editorial, could inspire the food industry to develop new kinds of foods and eliminate the needs of many patients to eat gluten-free. “Adoption of a gluten-free diet might reduce the consumption of cereal fiber or whole grains, affecting cardiovascular risk, and should therefore not be encouraged in subjects without celiac disease,” she writes.
An article in Newsweek notes that more research is necessary, and patients should consult with their physicians before self-diagnosing stomach pains. But the findings “suggest that fructan, not gluten, may be at the root of your unexplained stomach woes,” it adds.
We asked our community about gluten free diets for arthritis and, unsurprisingly, the results were mixed:
“ I found that gluten free helped my tummy and overall swelling but not the arthritis.“
“Gluten free helped pain levels, but no change in inflammation.“
“Gluten free made zero difference for me.”
“[Being gluten free] helps me for sure!“
Editor’s Note: The original version of this article stated that gluten is a carb. Gluten is a protein.