Do you have issues with gluten? Many people do. In the US alone, it’s estimated that 2 million people have celiac disease. Celiac disease is an autoimmune condition where your body creates antibodies in response to gluten that then go and attack the small intestine.
But celiac disease isn’t the only negative reaction to gluten. If you notice you don’t feel well after eating things like bread, pasta, and processed foods, you may have a gluten intolerance — or even a wheat allergy.
If you’d like to learn more about the different potential reactions to gluten, check out this article.
Gluten and FODMAPs
Sometimes people with gluten sensitivities and intolerances also have issues with FODMAPs. This is one of those tricky areas because sometimes it’s hard to tell. That’s why I’m such a believer in using lab testing in my practice.
You never eat just one thing at a time. Even if you’re just eating bread, you’re eating all the ingredients in the bread. So it can be hard to figure out what you’re reacting to. Plus, food sensitivity reactions can take up to 72 hours to show up.
So if you’re trying to nail down your food sensitivities and intolerances just by journaling your foods and symptoms, you may or may not come to the right conclusions. If you’d like to read more about the food sensitivity testing I use in my practice, read this article.
What’s the difference between gluten and FODMAPs?
Gluten
Gluten is a protein found in grains like wheat, rye, and barley. And for some people, it’s hard to digest. You can learn more about the different types of gluten sensitivities here.
For people who are sensitive to this protein, eating it can cause a variety of symptoms including digestive issues, skin problems, joint pain, and mental health problems like anxiety and depression.
If you’re avoiding gluten, you’ll want to avoid anything made with wheat, barley, or rye. But be careful — gluten can hide in a variety of places. Wheat flour is often used as a thickener in soups, sauces, and dressings. You can even find gluten in beauty products and Play Doh.
For more information about how to avoid gluten, read this article.
FODMAPs
While gluten is a protein, FODMAPs are carbohydrates. FODMAP stands for fermentable oligo-, di-, and mono-saccharides and polyols. These carbohydrates can be difficult to digest, especially for people with conditions like IBS. You can read more about FODMAPs here.
If you are intolerant to FODMAPs, you may experience symptoms like gas, bloating, diarrhea, constipation, and other digestive issues. And you may need to spend some time on the therapeutic low FODMAP diet.
The low FODMAP diet is a complicated one. FODMAPs show up in a lot of different foods. So they can be hard to avoid. And the low FODMAP diet carries some risk. This isn’t a diet to do indefinitely or on your own.
If you think the low FODMAP diet might benefit you, make sure to work with a knowledgeable practitioner who can take you through the three distinct phases of this therapeutic diet. You can learn more about how the low FODMAP diet works here.
And while gluten is not a FODMAP, you can find gluten in some high FODMAP foods. Wheat, rye, and barley contain fructan, which is a FODMAP.
Should I avoid both gluten and FODMAPs?
That’s a question to ask your practitioner. We are all different. And even people with similar symptoms may be reacting to completely different foods.
That being said, there is evidence that people who have a sensitivity to gluten may also be sensitive to FODMAPs. If you have celiac disease and your stomach issues aren’t fully eliminated by giving up gluten, you might benefit from trying the low FODMAP diet. Many people with celiac also have some lactose intolerance. And lactose, a disaccharide, is a FODMAP.
Sometimes when someone feels better giving up gluten, it’s really because eliminating gluten foods like wheat has also cut down on their FODMAP intake. A recent study from Monash University in Australia suggests that it may be FODMAPs that are triggering symptoms in some people who believe they have a gluten sensitivity.
The good news is that the gluten free diet and the low FODMAP diet work well together. And if you’re doing both, you’ll skip adding back gluten foods during the third phase (reintroduction) of the low FODMAP diet.
What can I eat if I’m on a gluten-free diet and a low FODMAP diet?
Avoiding gluten is easier than eating low FODMAP. With the gluten-free diet you are going, well… gluten-free. So you avoid all sources of gluten. And with all the certified gluten-free products, labeling, and resources available, it’s not too hard to navigate. That doesn’t mean it’s easy to give up these foods. But figuring out what to eat and what to avoid isn’t too complicated. You can find some tips on how to do that here.
The low FODMAP diet is a different story though. First of all, it’s low FODMAP — not no FODMAP. So it’s trickier to figure out not just what to eat, but how much of it to eat. Plus, FODMAPs are everywhere. And they don’t have the labeling guidelines that gluten does. So the low FODMAP diet has a pretty significant learning curve.
For the patients in my practice who are going low FODMAP, I have several resources I recommend to help them manage this complicated diet. You can find my favorite IBS resources (including those for the low FODMAP diet) here.
Going on two restrictive, therapeutic diets is a challenge. I don’t recommend that you try to do it all at once. Your chances of sticking with it long enough to reap the benefits are much lower if you get overwhelmed or discouraged. This is a good time to lean on your practitioner. They can help you figure out how to pace yourself and make the most effective changes first.
If you’re combining these two diets, I generally recommend eliminating gluten foods and then choosing low FODMAP foods from what’s left. But don’t worry, there are loads of foods that fit well into both diets.
For a low FODMAP and gluten-free diet, you’ll focus your diet on foods like:
Proteins
✅ chicken and turkey
✅ Beef
✅ Seafood like lobster, salmon, tuna, and shrimp
✅ Eggs
Certain dairy products that are low in FODMAPs
✅ Sour cream
✅ Cheeses like brie, cheddar, and feta
✅ Non-dairy milks like almond milk and coconut milk
Gluten-free grains
✅ Rice
✅ Quinoa
✅ Popcorn
✅ Oats — make sure your package has the gluten free label as not all oats are gluten free
Low FODMAP vegetables
✅ Lettuces
✅ Carrots
✅ Green beans
✅ Potatoes
✅ Tomatoes
✅ Cucumbers
Low FODMAP Fruits
✅ Strawberries and blueberries
✅ Pineapple
✅ Grapes
✅ Oranges
✅ Kiwi
Nut butters and seeds
✅ Pumpkin seeds
✅ Sunflower seeds
✅ Chia and flax seeds
✅ Peanuts
✅ Walnuts
✅ Almonds
✅ Pecans
There are more foods than I could list here that fit into both the low FODMAP diet and the gluten-free diet. Both diets take some adjustment, but it’s totally possible to manage them together.
But remember — it’s important to make sure you are on the therapeutic diet that is right for you.
Make sure you work with your practitioner to determine:
- Which of these diets is appropriate for you.
- How to incorporate them into your life. Everything all at once isn’t usually a great strategy.
- How to work through the phases of the low FODMAP diet safely so you don’t end up with nutritional deficiencies.
You need a practitioner who has the knowledge and experience to work with both the low FODMAP diet and gluten sensitive patients. And that’s what I do! If you have stomach issues — whether you have a diagnosis or not — I can help. My specialty is helping patients with stomach issues, digestive disorders, and illnesses like IBS and celiac. If you’re ready to get some help, click below to book a consultation.