Go free... or not?

When experiencing IBS symptoms, or following a low FODMAP diet, it is a common

misconception that you need avoid either gluten or dairy/lactose (or both)… this is

not necessarily the case!! So why do we feel we need to take an all or nothing

approach around gluten and lactose when managing IBS symptoms?

Gluten

Gluten is a protein that is naturally found in wheat, barley and rye. As a protein, it

plays an important structural role in these products. During the elimination phase of the low FODMAP diet, wheat intake is reduced. This is because it contains high levels of fructans (oligosaccharides, a type of FODMAP). It should be noted that gluten free products are not always low FODMAP and that the low FODMAP is NOT exclusively gluten free. Gluten free is only required for people who are gluten intolerant or suffer from Coeliac Disease. If someone with Coeliac Disease consumes gluten, it causes damage to their small intestine as a result, affects nutrient absorption, leading to deficiencies (e.g. iron, calcium and more) and other potential health problems. People who suffer from Coeliac Disease may experience

some symptoms common with IBS. Unlike gluten, FODMAPs do not cause physical

damage to our intestinal lining or long-term health complications. It is recommended

that when following the low FODMAP diet, bread/cereal products be substituted as

these products contain important nutrients like B vitamins and fibre. It is not necessary to completely eliminate gluten.

Dairy

Like gluten, dairy is another thing that is thought needs to be eliminated when

experiencing IBS. This is because dairy contains a natural sugar, called lactose, that

is a type of FODMAP. When on a low FODMAP diet, it is only necessary to limit

dairy/lactose-containing products if you are lactose intolerant. However, this being

said, studies have found that people who are lactose intolerant can tolerate up to

12-15g of lactose (equivalent of one glass of milk) per day! It is also suggested that

by including small amounts of lactose into the diet can improve tolerance. Luckily,

there are so many lactose-free dairy products on the market these days. These

products contain lactose that has already been broken down, so that our body

doesn’t need to (it’s a win win!). There are also lots of dairy alternatives. However, it

is important that when consuming these products that you make sure they contain

calcium, a nutrient found in dairy products that is particularly important for females

due to its role in bone health. Dairy products that are low in lactose include cheddar, parmesan, feta and brie. Moderate lactose containing products include sour cream & ricotta (yum!).

Although it may be required to avoid gluten and lactose-containing products during

the initial phase of the low FODMAP diet, this isn’t forever!! Symptom triggers are

completely individual and dietary management is not a one size fits all approach.

Reference list:

1. Everyday Nutrition Australia. FODMAPs vs Gluten. 2020.

2. Monash University. Gluten and the low FODMAP diet. 2015. Available from:

https://www.monashfodmap.com/blog/gluten-free-or-fodmaps-culprit/

3. Mcnamara, L. Lactose and dairy products on a low FODMAP diet. 2017.

Monash University. Available from:

https://www.monashfodmap.com/blog/lactose-and-dairy-products-on-low/

4. Mcnamara, L. What is lactose intolerance? 2016. Monash University. Available

from: https://www.monashfodmap.com/blog/what-is-lactose-intolerance/

A note on the author

Hey I'm Abby! I’m a third year Dietetics student studying at the University of the Sunshine Coast. You can follow me at my Instagram @nutritionbyabby where I post simple, evidence-based dietary information, tips and tricks.