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    At the American Dietetic Association’s 2004 Food & Nutrition Conference & Expo in Anaheim, Calif., Dr. Barbara Levine, a registered dietician and professor of nutrition at Cornell University, discussed the recommended treatment for Complex Carbohydrate Intolerance (CCI), a condition she recently identified in a paper published in the latest edition of “Nutrition In Clinical Care.” 

    The very foods nutritionists recomm/files/storyimages/for good health – vegetables, whole-grain breads and cereals, legumes, nuts, seeds – are the ones that cause symptoms of CCI.  CCI is caused by a deficiency of the intestinal enzyme, alpha-galactosidase, which results in the incomplete digestion of complex carbohydrates.  Symptoms of CCI include flatulence, abdominal pain, bloating, cramping, diarrhea and constipation. 

    Dr. Levine, lead author of the professional paper and director of the Nutrition Information Center at Weill College of Medicine of Cornell University in New York, cites in the paper that enzyme replacement therapy is the only method that targets the root of the CCI problem, an enzyme deficiency.  Enzyme replacement therapy requires that alpha-galactosidase preparations be taken at the same time as ingestion of each half-cup serving of complex carbohydrate foods.  The enzyme alpha-galactosidase, currently only found in Beano®, is the one option that prevents formation of CCI symptoms.

    “Everyone should feel right when they eat right.  Now that Beano has been identified as the preventative treatment for CCI, Americans can go back to the garden and eat the healthy foods they need and want without embarrassing digestive episodes,” said Dr. Levine. 


    Who is at Risk?

    The United States Department of Agriculture recommends that between 40 and 60 percent of Americans’ total calories come from carbohydrates, preferably from complex carbohydrates (starches) and naturally occurring sugars.  According to Dr. Levein,  nearly 79 million Americans avoid eating these healthy foods because they can lead to uncomfortable and embarrassing digestive distress.

    “I hear it in my practice everyday.  CCI sufferers are most fearful about exhibiting the embarrassing symptoms of the condition, often to the extent of putting their favorite activities and social lives on hold.  More importantly, those with CCI frequently avoid eating the nutritious foods they need, despite their protective health benefits,” Dr. Levine said.  “Identifying CCI is important in helping patients to more easily discuss their symptoms with healthcare professionals and to tolerate healthy diets that aid in warding off serious conditions, such as heart disease, some cancers and type-2 diabetes.”


    Managing CCI

    CCI sufferers should be aware that gastrointestinal discomfort following meals containing complex carbohydrates is common and can be alleviated through a variety of over-the-counter treatments.  However, unlike treatment options that may only relieve symptoms, enzyme replacement with alpha-galactosidase (found only in Beano) is the most effective option because it treats the cause of CCI and thereby prevents the symptoms.

    “Symptoms of CCI are similar to those of more serious conditions like cardiac events, and individuals with CCI may seek medical attention for presumed more serious conditions,” Dr. Levine said.  “This mistaken symptom association can lead to costly medical procedures, and misdiagnosis may result in patients taking drugs that are not treating the underlying cause of the condition.  Increased awareness of CCI, its symptoms and enzyme replacement therapy is paramount to avoiding unnecessary treatment measures.”

    Other treatment options are available, including diet and lifestyle changes, prescription and over-the-counter drugs, and dietary supplements.  Diet and lifestyle changes may help some people manage CCI, but others may continue to suffer, requiring additional treatment.  Prescription and over-the-counter drugs may target specific symptoms associated with CCI, but do not allow the body to more easily digest complex carbohydrates, thus preventing the occurrence of CCI symptoms.  Dietary supplements, such as peppermint, help soothe the digestive tract and may also be beneficial in preventing belching and in decreasing bloating after large meals.  However, despite its efficacy, peppermint and other herbs do not target the enzyme deficiency responsible for CCI discomfort.


    What is Beano®?

    Beano is the only over-the-counter solution that prevents CCI symptoms before they start if taken right before the first bite of most gas-causing foods.  Beano contains a natural food enzyme called alpha-galactosidase, which works with the body’s digestive system to break down complex sugars in gas-causing foods, making them more digestible.  Beano is not just for beans.  Vegetables, legumes, grains, cereals, seeds, nuts, pasta, soy products (e.g. tofu) and bagels are some examples of everyday foods that cause unwanted CCI symptoms that can be prevented by Beano.  Beano is available in the antacid section of supermarkets, pharmacies, mass-merchandising outlets and health food stores across the country.  For more information, visit



    Online CCI Resource

    In an effort to educate consumers and health professionals about CCI, a free, interactive online information center,, is available.  The site features in-depth, valuable information, including how to diagnose and manage CCI, animation of the digestive process, common questions, a listing of problem foods and links to additional resources.  User-friendly drop-down menus provide content in an “at-a-glance” format for easy navigation of the site.  Visitors to the site also can get the latest news about CCI, submit questions, share their personal success stories and sign-up for e-mail updates. 

    “Serving as a resource for CCI sufferers, is a unique hub that combines medical and nutritional information from several sources and brings it all together in a clear, understandable way.  With a few clicks of the mouse, users can obtain information to better understand the needs of those suffering from CCI,” Dr. Levine said.


    Barbara Day, M.S., R.D., C.N., is the publisher and nutrition editor of KHF.  She is the former sports nutrition consultant to the University of Louisville Athletic Department and the United States Navy SEALs.   Barbara is also the author of Fast Facts on Fast Food For Fast People (ISBN 0-9631538-6-2) and High Energy Eating Sports Nutrition Workbook for Active People (ISBN 0-9631538-5-4).  In addition, Barbara has a private practice specializing in sports nutrition, has a weekly health & fitness radio show on WKJK 1080 AM and is the nutrition/recovery editor for Performance Volleyball Conditioning. Barbara serves on the Board of The Mint Jubilee, Special Olympics Kentucky, the Louisville Youth Training Center and Fit Louisville and is a member of Greater Louisville, Inc. and NAWBO.



    Foods That Can Cause CCI

    Many foods that are part of a healthy diet can cause complex carbohydrate intolerance. This includes many prepared foods as well, such as chili and lentil soup.





    Brussel sprouts
    Peppers, sweet

    Black-eyed peas
    Bog beans
    Broad beans
    Field beans
    Lima beans
    Mung beans
    Pinto beans
    Red kidney beans



    Breakfast cereals
    Oat bran
    Oat flour
    Rice bran
    Sesame flour
    Sorghum, grain
    Sunflower flour
    Wheat bran
    Whole-wheat flour

    Baked beans
    Bean salads
    Lentil soup
    Peanut butter
    Soy milk
    Split-pea soup
    Stir-fried vegetables
    Stuffed cabbage
    Whole-grain breads



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