(Bloomberg) — Sue Shepherd says she never expected to become famous for taming cantankerous tummies.
The 38-year-old Australian dietician invented a food regimen with a bizarre name in her early 20s to relieve symptoms of bloating and stomach cramps. It’s now being adopted internationally, changing the way doctors manage a set of digestive troubles known as irritable bowel syndrome.
Shepherd initially set out to help the 1% of people with a gluten intolerance causing celiac disease. She found even those without the condition felt better when they avoided the grain-protein and foods containing certain sugars named “Fodmaps,” an acronym for potentially tough-to-absorb molecules. Shepherd’s diets low in gut irritants have spurred an $8.3 billion market, encouraging the likes of Abbott Laboratories to introduce products devoted to food intolerance.
“This approach has really revolutionized the way we treat a common condition,” says Jason Tye-Din, a gastroenterologist at the Royal Melbourne Hospital and celiac researcher at the Walter and Eliza Hall Institute. “The significance has been realized around the world.”
Screening for celiac disease in Australia alone has increased 25% over the past four years, according to Tye-Din, who runs two of Australia’s four celiac disease clinics. That’s bolstered demand for gluten-free foods and other products for so-called functional gastrointestinal disorders.
“Gluten-free food is flourishing,” says Ewa Hudson, head of health and wellness food and beverages research at London-based Euromonitor International Ltd., who predicts retail sales of food intolerance products will reach $10.5 billion worldwide by 2017, especially as more grocery chains carry them.
The market in developed nations “has undergone a revolution,” Hudson says in an email. “Prior to that, gluten-free had been the preserve of pharmacies and specialist health-food stores.”
Shepherd says she’s sold almost 200,000 copies of her eight cookbooks, which include Irresistibles for the Irritable, that help people choose bowel-friendlier foods. The recipes avoid sugars that aren’t well absorbed in some people’s bowels, found in products ranging from onions to yogurts.
These foods can cause bloating, excess gas, abdominal discomfort and diarrhea in some people — hallmarks of irritable bowel syndrome experienced by at least 10% to 15% of adults, according to the International Foundation for Functional Gastrointestinal Disorders, a research and education group in Milwaukee, Wisc.
“I pieced together what was an experimental diet,” says Shepherd, who began teaching the regimen in her private dietetics practice in early 1997. “I wasn’t randomly picking these foods — they all had something in common: they were all potentially not absorbed in the small intestine.”
The diet has gained popularity in the U.S. since Gibson and Shepherd spoke on the topic at the American College of Gastroenterology annual meeting a year ago, says Patsy Catsos, a dietitian and author in Portland, Maine, who keeps a list of more than 90 dietitians who feel comfortable delivering the diet.
Scientists had identified some of Shepherd’s Fodmap culprits at least as early as the 1940s, though no one had put them into a diet plan supported by scientific evidence until Shepherd, according to Muir.
“Doctors would pretty much say you’re crazy, there’s nothing wrong with you, go home,” she says. “People are looking at it, and see there are things that you can do about it. It’s very empowering for both the health professional and the patient to have a solution for a common problem.”
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