12 January - 20 June 2016

Fructans rather than gluten are more likely to induce symptoms in those sensitive to wheat, rye and barley

Researchers from the University of Oslo, Norway and Monash University Australia, are reporting that fructan, not gluten, may induce gastrointestinal symptoms in people with non-celiac gluten sensitivity (NCGS). Fructan is a type of carbohydrate found in wheat, as well as onions, garlic and some vegetables. The study published in Gastroenterology investigates the effect of gluten and fluctans separately in individuals with self-reported gluten sensitivity using a double-blinded crossover challenge.

Researchers from the University of Oslo, Norway and Monash University Australia, are reporting that fructan, not gluten, may induce gastrointestinal symptoms in people with non-celiac gluten sensitivity (NCGS). Fructan is a type of carbohydrate found in wheat, as well as onions, garlic and some vegetables. The study published in Gastroenterology investigates the effect of gluten and fructans separately in individuals with self-reported gluten sensitivity using a double-blinded crossover challenge.

Skodje et al. recruited 59 participants aged 18-80 years who had followed a gluten free diet (assessed at baseline by trained dieticians) for at least six months.  Celiac disease for all participants had been excluded. The recruits were randomly assigned to one of three seven day challenges, with a wash out period of at least 7 days, or until symptoms had resolved before starting the next challenge. They were instructed to consume once daily a 50 g, 220 Kcal gluten free museli bar of which either 5.7 g gluten, or 2.1 g of fucto-oligosaccharides (fructan bar) were added.  They recipients also consumed a placebo for 7 days.  All bars had a similar appearance so that the participants were unable to differentiate between them.

Using Gastrointestinal Symptoms Rating Scale, Irritable Bowel Syndrome-version (GSRS-IBS) a self-administered 13 item questionnaire, the participants reported their symptoms over the 7 days, rating pain, bloating, constipation, diarrhoea, and satiety.  They also report secondary outcomes such as depression, anxiety and fatigue. 

kodje et al carried out numerous statistical analysis and report “no significant effect of gluten was found as compared to placebo and fructan.  In contrast, a small daily dose of 2.1 g of fructan induced greater symptoms on multiple criteria including the overall GSRS-IBS, after a seven-day challenge.”   They continue by stating “On group level, the difference from placebo was significantly higher after fructan challenge, than after gluten challenge.”  The study reports that GSRS score for bloating was significantly higher than for gluten. The scientists report that of the participants, “thirteen participants had the highest overall GSRS-IBS score after consuming gluten, 24 had the highest score after consuming fructan and 22 had the highest score after consuming the placebo.” 

Skodje et al report that previous research has also found a possible link between fructan and irritable bowel syndrome.  In discussion, the authors state that it is possible that some fructans may behave differently.  The fructan used in their challenge was from chicory roots and may have a different affect to that of fructan found in wheat.  The authors question the use of the term NCGS and its distinction from IBS.  They state that some IBS patients do benefit from a gluten free diet but even if they eliminate wheat from their diet, they may still have issues from high fructan food such as onions and garlic.  In conclusion, they state “the findings weaken the use of the term NCGS and raises doubt about the need for a gluten-free diet in such patients.”

Using the latest analytical techniques RSSL can test for all 14 allergens subjected to mandatory labelling under the EU Food Information for Consumers Regulation including gluten. To find out more please contact Customer Services telephone 0118 918 4076 or e-mail enquiries@rssl.com

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