Are you one of the gluten-intolerant people who have cut out gluten because it hurts to eat breads, pasta, and baked goods? Do gluten foods give you fatigue, brain fog, and bloating? Gluten sensitivity has been reported by 10 to 15% of the population. That’s a huge number of people. And yet most of this gluten sensitivity is not diagnosed with gluten-specific factors but by challenge studies and personal experience of avoiding gluten-containing foods.
But it’s quite likely that it’s not the gluten in the foods that you’re reacting to, and all of the efforts to avoid gluten are misguided. And, to top it off, you still don’t feel great, either.
What you and many others have experienced is formally explained in a new major review. It was published in The Lancet on October 22, 2025. This review assembled evidence from decades of research and dozens of double-blind trials examining non-celiac gluten sensitivity (NCGS). And this is what lead researcher Associate Professor Jessica Biesiekierski had to say about the findings:
“Contrary to popular belief, most people with NCGS aren’t reacting to gluten. Our findings show that symptoms are more often triggered by fermentable carbohydrates, commonly known as FODMAPs, by other wheat components, or by people’s expectations and prior experiences with food.”
Let’s break this down a bit more thoroughly and give you some suggestions about what this means for your “gluten sensitivity,” and what you can do about it today.
Most “gluten sensitivity” reactions disappear in properly blinded studies
In a properly blinded trial, the foods look identical, one with gluten and one without, but the patients don’t know which one is which, and the doctors and researchers who work with them don’t know which one is which either. They only break the randomization code after all of the lab work and testing are done, and the results have all been compiled. Then they sort out the groups and see if the test substance made any difference.
When gluten is put to the test in this kind of double-blinded controlled trial, something surprising happens.
- Most people can’t tell the difference between the gluten and the placebo. They feel equally good or bad on both treatments.
- Only a few of the participants (between 0 and 30%, but closer to 0% in tightly controlled studies) show a reproducible reaction that is truly due to gluten.
In plain English: If you feel terrible when you eat bread, but you feel fine when you eat a placebo that you think is bread, the problem probably isn’t the gluten protein itself.
Here are the components that really cause symptoms
The Lancet authors and many gastroenterologists now point to these much more common culprits:
- FODMAPs (fermentable carbohydrates in wheat, other grains, legumes, onions, garlic, etc.). These are classic IBS triggers.
- Amylase-trypsin inhibitors (ATIs) and other non-gluten proteins in wheat.
- Fructans (a specific type of FODMAP that is very high in modern wheat).
- Expectation/nocebo effect (your brain anticipates trouble, and your gut delivers trouble).
- Additives, ultra-processing, and fast-rise commercial yeast doughs (especially common in U.S. breads). See my previous article on the contrast between bread from Europe and the USA.
What Should You Actually Do About It?
- Don’t assume your symptoms are due to gluten. Test them properly. The gold standard way is to work with a dietitian or gastroenterologist with a double blind gluten challenge, but you can do a simple home version instead.
- Follow a strict gluten-free diet for two to four weeks. This removes gluten but also removes some FODMAPs at the same time, which is fine for the first step.
- Break your gluten-free diet with real sourdough bread. Make sure it’s not fake sourdough-flavored bread from the supermarket, but it’s fermented for at least 24 to 48 hours.
- If the sourdough bread is fine for you, but regular bread still gives you GI symptoms, then you almost certainly have a FODMAP/IBS issue, not a gluten issue.
- If you really want to deal with the FODMAP IBS issue, you should check out the low FODMAP protocol at Monash University. They have a three-step FODMAP program to go from restriction to discovery to freedom. It’s evidence-based, there’s research behind it, and that’s what they do. So they’re really good at that one thing.
- The goal with dealing with FODMAPs is not to stay there, but to retrain your gut and brain to deal with some of these fructans and oligosaccharides in a healthy way. So you don’t want to get stuck on a low FODMAP diet; it’s too restrictive and it’s not safe for the long term.
Here is an overview of what dealing with FODMAPs could look like:
Step 1 – Low FODMAP Elimination (2–6 weeks)
Swap high-FODMAP foods for low-FODMAP alternatives until symptoms are under control. See the table below for an idea of what that looks like. The official up-to-date list is on the Monash University app if you want to know more.
Once you regain control over your gastrointestinal symptoms and feel better, you can move on. The duration of this process varies from person to person.
Step 2 – Systematic Reintroduction (8–12 weeks)
Stay on the low FODMAP program overall. Then add in one higher FODMAP group at a time (fructans, galactooligosaccharides, polyols, mannitol, etc.) for three days at a time to see which ones actually trigger your symptoms. Use a food diary to keep track of foods, symptoms, and stress levels. The gut-brain connection is involved here, so what and how you think and respond to stress impact your symptoms, too.
Step 3 – Personalisation (your long-term diet)
Once you figure out which things you can tolerate, you just restrict the specific FODMAPs or amounts of FODMAPs that cause you trouble. Most people who do this protocol end up with a diet that’s far less restrictive than eliminating every high FODMAP food out there.
You can use the table below for an example to start with, but the full list is on the Monash University FODMAP app. The app does have a diary function that helps you record the foods you’ve eaten, GI symptoms, and stress levels. It will also guide you through step two of the diet, which is reintroducing FODMAPs.
A Comparison of High vs Low FODMAP Foods
Category
High FODMAP (limit/avoid in Step 1)
Low FODMAP Alternatives (safe in Step 1)
Vegetables
Artichoke, asparagus, cauliflower, garlic, green peas, mushrooms, onion, sugar snap peas
Eggplant, green beans, bok choy, green bell pepper, carrot, cucumber, lettuce, potato, zucchini
Fruits
Apple, pear, mango, watermelon, peach, cherry, dried fruit
Cantaloupe, kiwi fruit, mandarin, orange, pineapple
Dairy
Cow’s milk, yogurt, soft cheeses, ice cream, soy milk made with whole beans
Almond milk, brie/camembert cheese, feta cheese, hard cheeses, lactose-free milk, soy milk (made from soy protein)
Protein
Most legumes/pulses, some marinated meats/poultry/seafood, some processed meats
Eggs, firm tofu, plain cooked meats/poultry/seafood, tempeh
Breads & Cereals
Wheat/rye/barley-based breads, breakfast cereals, biscuits, and snack products
Corn flakes, oats, quinoa flakes, quinoa/rice/corn pasta, rice cakes (plain), sourdough spelt bread, wheat/rye/barley free breads
Sweeteners
High fructose corn syrup, honey, sugar-free confectionery
Dark chocolate, maple syrup, rice malt syrup, table sugar
(The full up-to-date list is in the Monash app — this is just from their website. Also, this list is not endorsed by Hallelujah Diet, nor 100% vegan, but an example of categorizing foods according to FODMAPs.)
The Real Goal: A Healthy You
The goal of going through this program is to end up with a diet that is personalized and sustainable, and has a wide variety of foods in it. A gluten-free diet can actually have a lot of FODMAPs in it, as you can tell from the table above.
Ideally, you’ll end up with a diet that includes some prebiotic foods. Things like a little bit of garlic, a bit of onion, a few beans, berries, and certain sweet fruits. You will likely be able to eat sourdough wheat products, which makes sandwiches a possibility again. You still need fiber in your diet, so finding acceptable plant foods is an important discovery in this process.
The gluten-free diet may not have helped you feel that much better. But when you focus on the right thing, FODMAPs, you can actually feel better with your GI symptoms being close to normal.
In summary, if you’ve been using a gluten-free diet to try to control GI symptoms, the problem is likely FODMAPs, not gluten. Here are the three steps:
- Adopt a low FODMAP diet long enough for your symptoms to go away.
- Introduce high FODMAP foods one kind at a time to figure out which foods you can tolerate.
- Transition to a diet that only eliminates those foods that you really react to.
You’ll end up with a diet that is as broad as possible, and that makes you feel good inside. Since you’re working with a more accurate diagnosis, you get better results. And that’s the real goal.
