IBS--Free at Last!

Vital Wheat Gluten

Gluten is one of the proteins found in wheat, rye, and barley. In some cuisines (especially Asian, macrobiotic or vegetarian) it is processed and used as a protein source. It is also used in bread baking, to improve the texture, elasticity and rise of the bread.

There are several brands of vital wheat gluten on the market, and I've been asked whether gluten is an allowed ingredient on the FODMAPS elimination diet. Great question! I had a look at the Nutrition Facts for three major brands of vital wheat gluten on Zeer, one of my favorite web sites.

I see that two of the brands, Bob's Red Mill and Arrowhead Mills, have zero grams of fiber per serving, and zero grams of sugar per serving. Therefore, they don't contain any FODMAPS, and are likely to be well tolerated on the FODMAPS elimination diet. Obviously, these products would never be appropriate for anyone with celiac disease, gluten intolerance, or a wheat allergy.

Starting with a gluten-free (non-wheat flour) recipe and adding some vital wheat gluten to help improve the texture and rise of the products could be really interesting! Please comment here if you would like to share the results of your experiments with other readers.

Update to What about Vinegar?

Sprinkling your own oil and vinegar on salad is the FODMAPS-friendly way to dress it, since most commercial salad dressings have one or more ingredients that are not allowed during the elimination phase of the diet. I am often asked which vinegars are OK to use? The answer is that any filtered vinegar will do, in a 1 tablespoon portion. Filtered vinegars include white vinegar, white or red wine vinegar, champagne vinegar, rice or rice wine vinegar, and most flavored vinegars.

Unfiltered cider vinegar does retain some sugar in it, and it has an excess of fructose, so it is probably not appropriate during the elimination phase unless it is a minuscule portion. You can recognize unfiltered cider vinegar because it is cloudy in appearance, not transparent, like filtered or distilled vinegars are.

Balsamic vinegar has a 2 grams of sugar in a 1 Tb. portion, but luckily for us balsamic lovers, there is more glucose than fructose in it, so it is allowed on the elimination phase. For more information about the role of the fructose to glucose ratio, click here.

Update on 1/20/2010: Remember, even if a person has a verified problem with FODMAPS, other kinds of adverse food reactions can occur. Please read my post entitled: One of My Problem Foods is Allowed on the Elimination Diet. Vinegar is complicated. A person could be sensitive to the food the vinegar was made from. Vinegars vary in their degree of acidity. Aged vinegars like balsamic may contain phenylethylamine. Flavored vinegars may have additives; for example some commercially seasoned sushi vinegars contain high fructose corn syrup. Some stray yeasts can be present in raw vinegars. Malt vinegar contains gluten. And so on. All of these factors might influence a body's experience with consuming vinegar.

Sucrose, By Any Other Name...

Sucrose--good old table sugar--is one of the few allowed sweeteners on the elimination phase of the FODMAPS diet. In an effort to be more specific, more exotic or healthier-sounding, manufacturers use a great many different words on the food label that all mean essentially the same thing: sucrose. Here is a list of allowed sugar names you might see in recipes or the ingredients section of a food label:

• sugar
• cane sugar
• confectioner's sugar
• granulated sugar
• superfine sugar
• naturally milled organic sugar
• sugar syrup
• cane syrup
• evaporated milled cane juice
• organic cane syrup
• organic sugar
• beet sugar
• bar sugar
• berry sugar
• castor sugar
• icing sugar
• refined sugar
• cane juice crystals
• invert sugar

Raw, unmilled, unrefined or darker colors of sugar have not had the molasses removed, and have an excess of fructose, so should be avoided on the elimination phase of the diet.

Remember, even if sweetened with sucrose, your treat shouldn't have more than 40 grams of sugar per serving during the elimination phase of the diet.

To learn more about the sweeteners named above, start with one of my favorite sites, Cook's Thesaurus.

Polyols 101

Many of my clients tell me that even a few small pieces of sugar-free candy or gum cause diarrhea. Ditto for the well-know effect of prunes or cherries. What do these foods have in common? They contain polyols, also known as "sugar alcohols".

Technically, they are FODMAPS carbohydrates, and they are sweet! Most polyols are poorly absorbed, and wind up in the large intestine when they are consumed. In the large intestine, polyols are fermented by gut bacteria. They are also capable of drawing water into the large intestine. Together, the excess gas and excess fluid can cause distension of the colon, which cause bloating, flatulence and looser stools for the IBS sufferer. In a double whammy, eating or drinking sugar alcohols worsens fructose intolerance!

Some sugar alcohols, such as sorbitol, occur naturally in fruits such as apples, pears, and the "stone fruits," which include plums, prunes, apricots, peaches, cherries and so on. Sugar alcohols are often used to sweeten "sugar-free" foods (such as candy, gum, low-carb items, and bubbly water) and liquid medications. They can be recognized on the food label's list of ingredients by the ending "-ol". Examples are xylitol and maltitol.

Note that erythritol seems to be an exception. Studies have shown it is well absorbed and unlikely to cause GI symptoms.