FODMAPs the next gluten free?

The gluten free diet has surged in popularity in recent years, and none more so than among people without conditions for which the diet is clinically indicated. Despite the many and varied motivations for gluten avoidance, most remain scientifically unfounded and the phenomenon of non-coeliac gluten sensitivity (NCGS) remains shrouded in controversy. Instead, mounting evidence suggests that in the majority of cases, symptomatic responses to gluten ingestion and/or gluten removal are attributable to the presence of undiagnosed coeliac disease; strong nocebo responses; and/or the incidental removal of a group of fermentable carbohydrates (known as FODMAPs) in people with co-existing (possibly undiagnosed) functional gastrointestinal disorders (FGIDs). This evidence is gaining traction in the scientific literature and lay press, leading to growing awareness of-and interest in the low FODMAP diet. As awareness of the low FODMAP diet grows, it will be responsibility of scientists, clinicians and food industry professionals to translate the science of FODMAPs in a responsible way; to balance commercial interests with clinical best practice. Widespread uptake of the low FODMAP diet and availability of low FODMAP food products will only be seen as a win if this is coupled with appropriate diagnosis and management of conditions for which the diet is clinically indicated. The challenge will be to ensure that the low FODMAP diet does not suffer the same fate as the gluten free diet; that the diet is used, but not abused.