More Important Than Gluten?




Essential Guide to Managing Celiac Disease and Related Conditions

Joseph A. Murray, M.D.

(Also mentioned: article in 11/3/2014 issue of The New Yorker magazine.)


Mayo Clinic keeps publishing books that are helpful without either dumbing down or getting too technical. I confess I bought this one out of curiosity, wondering whether the low-FODMAP diet is getting well enough known to appear in new books on related topics.


Sure enough, FODMAPs are listed in the index and discussed under a heading “Is It Something Else?” This book really is about coping with Celiac Disease more than the “related conditions” mentioned in the subtitle—naturally! Dr. Murray is president of the North American Society for the Study of Celiac Disease and has studied wheat genetics, so he definitely knows the topic.


We FODMAPers really are going mainstream, though. That article in The New Yorker (“A Reporter at Large: Against the Grain: Should you go gluten-free?” by Michael Specter) spends a full page on the topic, describing the 2011 Monash University research that turned up the FODMAP complication, describing it as a spinoff from research into the gluten/celiac connection. Dr. Murray’s research is mentioned here too, and he too seems convinced that FODMAPs are important—as important as gluten, or rather, more important. Specter’s conclusion, after interviewing Dr. Murray: “In fact, FODMAPs seem more likely than gluten to cause widespread intestinal distress, since bacteria regularly ferment carbohydrates but ferment protein less regularly….”


If you’re a new FODMAPer, I hope that’s encouraging. A lot of people who give up wheat are feeling better these days.

“Patient Attitudes” toward diet can make a difference

doctorHere’s another “translation for the rest of us” of a FODMAP-relevant science article: Sunanda Kane of the Mayo Clinic, “What physicians don’t know about patient dietary beliefs and behavior can make a difference,” published in 2012 on It’s an evaluation of an article published in the journal Inflamm. Bowel Dis. also in 2012, by Zallot C, Quilliot D, Chevaux JB, et al. That makes this blog report third-hand.

It’s frustrating when our doctors don’t seem to care what we eat. This study presents that problem from a different point of view. It was a wake-up call to physicians, telling them it DOES matter how their patients feel about what they’re eating. According to the article, more than 50% of IBD sufferers in one study felt sure that food “could” play a role in relapses. Quoting Dr. Kane: “Interestingly, nearly half of the patients in each disease group believed that raw vegetables could improve their symptoms…[but] Only 36% believed that their dietary behavior could lead to … nutritional deficiencies.”

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