Intolerance to a Single Food; Don't Overgeneralize.

This question comes up frequently: If you know you react to a food within a group (eg wheat/fructans) can you assume that you will react to all foods within that group.. in other words could you react to some fructans but not others?

Good question. Remember with FODMAPs we are trying to assess tolerance to a type of carb (ex. fructans) in our food rather than out tolerance to individual foods. If you do an organized challenge process, the outcome might be that you learn you do not tolerate fructans in general very well. But you cannot assume that just because you react to a single food in a group that you will react to others.

Here are a few reasons why: You might be allergic to that food; you might have celiac disease or non-celiac gluten intolerance(in the wheat example you gave); other foods in the same group might have much less fructans per serving than the one that bothers you; your portion size of other foods in that group might be much smaller, the specific type of fructans in the food might be more or less rapidly fermentable than others, etc.

It's important not to overgeneralize, because its a nutritional mistake to unecessarily restrict your diet.

Comments

[Joyce]

Nicely stated! Thank you, Patsy.

[Amy]

Hi,
I'm sorry if this is in the wrong section, but can you please give me advice about protein shakes? I've been on the elimination diet for a few days so far and am feeling good, except I've just had a protein shake (mixed with half water, half lactose free milk) and have become immediately bloated. I'm thinking it probably isn't the lactose, because it happened almost straight away...
Is a powder like the following one allowed on the elimination challenge? I can't see any 'not allowed' ingredients, except it says "contains milk proteins" (but the book says WPI is allowed).
Thanks! Amy.

[Patsy Catsos]

A little hard to comment without seeing the complete ingredients. If you could send the name of the product or the list of ingredients or the website of the product I will have a look.

[Amy]

I can't find the ingredients of the one I had yesterday, but here is the one they sell at my gym which I often buy:
http://www.maxs.com.au/index.php?sectionID=1611&pageID=9460

I spoke to a naturopath last night and she mentioned a lot of her clients have problems with protein shakes, although she said something about the 'wheat' content rather than the dairy, which confused me even more! But she also said that just because it was immediately after I drank it, doesn't mean it isn't an intolerance as it is still affecting the stomach...

(By the way, aside from the protein mishap, I'm 3 days into the challenge and feeling good! Your book is a massive help)

[Amy]

Patsy - I also just read that golden syrup has a huge amount of fructose in it (30g per 100g), although I was under the impression that golden syrup, treacle and maple syrup were fine. I've been eating around 15g of golden syrup most days on my elimination phase!!!!

[Patsy Catsos]

Yes, it has 30 grams of fructose, but it has 34 grams of glucose per 100 grams. So it does not have *excess* fructose relative to glucose, and that is the key thing here, since most people absorb fructose better in this circumstance. However, the total amount of sugar could still be too much and overwhelm the absorptive capacity, so small portion sizes are best (less than 40 grams total sugar per serving). Short answer: your 15g of golden syrup is OK for the elimination diet.

[Patsy Catsos]

Glad the book has helped. Usually reactions that occur immediately after ingesting something (if not traced back to what you ate earlier in the day or the night before) are due to sensitivities that involve your immune system. If the bad experience is ever repeated, you should probably avoid the product in the future. The ingredients on the link you sent are technically OK for FODMAPs elimination, however I am not a fan of and would probably not recommend this type of product due to all the artificial ingredients and sweeteners.

[elise]

hi patsy! i just wanted to thank you for this resource. i linked to it in the comments section of this post: http://www.hungryhungryhippie.com/breaking-up-is-hard-to-do/ and have found so many others are interested in what you have to say. please keep up the great work.

[Patsy Catsos]

Elise, thanks for letting my know about your mention! I enjoyed reading your post, and could really relate to it. I hope some of my readers will enjoy visiting you as well.

[Amy]

Thanks Patsy.
I also find that sometimes even after a big cup of tea (even decaf with lactose free milk) I'll become immediately bloated and stay that way for a while - could this be something completely unrelated to FODMAPS? I'm 2 weeks into my elimination phase and although most of my symptoms have eased off, the bloating still remains 100% (reaching from right at the top of my stomach down to the pelvis). I'm bloated nearly 24 hours a day, although it is best in the morning.
I know you aren't a doctor, but could you point me in the direction of someone I could go to for advice? I've seen gastroenterologists, general doctors, nutritionists and naturopaths to no avail so far but I'm not ready to give up.

[Patsy Catsos]

Sure, it could be something else about the tea, such as tannins or oxalates. What happens if you don't drink the tea?