What's wrong with gluten?

Almost everyone should stay away from wheat and other gluten-containing grains. Sound extreme? Unfortunately it’s not. It’s science.

Current research shows that gluten causes intestinal permeability, otherwise known as leaky gut, in ALL people. Leaky gut is bad because it leads to inflammation, which is a key factor in most illnesses, many mental health issues and neurodegenerative diseases like dementia, and can result in auto-immune disease. Humans simply do not have the necessary enzymes to completely break down gluten, allowing it to wreak havoc on our system and potentially cause disease.

You might point out that humans have been eating grains and gluten for over 100,000 years, but grain cropping began only 10,000 years ago. Since then we have hybridised wheat and grains tens of thousands of times. More recently, we have also genetically modified them. In short, the grains we eat today barely resemble their remote ancestors. Many are also laden with pesticides, which can also cause a host of health problems.

I am not Coeliac but I gave up gluten nearly five years ago and within two weeks my life changed. I felt 20 years younger, my zest for life returned, I lost 3kg without trying, my aches and pains disappeared, I could work full time again and many ailments I put down to ageing vanished.

This is part of the reason why I qualified as a Certified Gluten Practitioner under Dr Tom O’Bryan, a world leader in functional medicine and expert in autoimmunity and gluten-related disorders. The statements made in this blog derive from published research provided by him but are not footnoted.

What is gluten?

Gluten is the main structural family of proteins comprising all forms of wheat (durum, emmer, semolina, spelt, farina, faro, graham, kamut, einkorn), barley, rye and triticale.

Gluten is made up of two main groups of proteins: gliadin and glutenin, and people can be sensitive to either. But Gliadins, Hordeins, Secalins and Glutelin found in other gluten-containing grains all atrophy or destroy the villi and cause intestinal inflammation and permeability. The villi are finger-like projections that increase the surface area of the small intestine, absorbing and transporting nutrients into the bloodstream. When they are compromised, so is nutrient absorption.

Research shows that intestinal exposure to gliadin from gluten leads to zonulin upregulation. Zonulin is a protein that modulates the permeability of the tight junctions between cells of the digestive tract wall, immediately opening them up to allow in abnormally large particles of food. This disassembly of intercellular tight junctions increases intestinal permeability, which causes inflammation. Increased intestinal permeability after gliadin exposure occurs in ALL people.

Evidence obtained from human and animal studies provides a unifying paradigm of a vicious cycle

gluten triggers changes in gut flora leading to dysbiosis (gut flora imbalance)
this causes gut inflammation
leading to gut dysfunction
causing intestinal permeability (leaky gut)
leading to systemic inflammation
causing neuroinflammation (of the nervous tissue)
causing pathophysiological alterations, including behavioural changes

If the gut has the capacity to repeatedly heal itself, there is no problem. But with the constant assault of wheat on the gut two to three times a day, oral tolerance is often lost over time leading to health problems. Oral tolerance is the capacity of the immune system to recognise substances taken in through the digestive system and to weaken or suppress the immune response to them. The loss of oral tolerance means the body no longer recognising food and begins reacting to it.

Check out the video below to see what gluten does to EVERYONE. What you will see is the lumen of the small intestine under laser microendoscopy. The patient is given an intervenous fluorescent tracer and scanned pre-antigen (gluten) ingestion to demonstrate an intact mucosa. Following ingestion, you witness a 'bloom' of fluorescence seeping through the tight junctions. This is a gut leaking.

“The matter of fact is that gluten is not digestible by any human kind.
Alessio Fasano, MD , Chair of Harvard’s Mass General Hospital for Children where he heads the Department of Paediatric Gastroenterology”

Modern wheat is very different

The wheat of today is very different to the wheat of 40 years ago. When looking at the proteins in modern wheat hybrids, which number around 900, 5.4% are a new hybrid strain meaning they are not found in either parent. Our bodies are not accustomed or adapted to digesting these and they have been shown to cause different physiological reactions to those previously observed.

According to Dr William Davis, the gluten content of wheat has not increased with breeding. Wheat is not technically genetically modified. Rather it’s the altered structure of the gliadin proteins, change in the structure of wheat germ agglutinin and unique antigens (allergy- and immune-stimulating proteins) posed by new forms of alpha amylase inhibitors and other proteins that is the problem with modern wheat. *

Also, a process called deamidation makes wheat more immune reactive. It uses acids or enzymes to make it more water soluble so that it mixes easily with other foods. A double blind study found that people who did not react to native wheat flour reacted severely to deamidated wheat flour. It is thought this process generates new substances that activate the immune system.

The industrialisation of food over the last 70 years from fresh and toxin free to hybridised, modified, processed and chemical laden has revolutionised our diets, and largely for the worse considering current rates of chronic illness, many of which are based in diet and lifestyle. Another way to look at this is that our way of eating has changed human biology. In Australia, dementia is about to take over heart disease as the number one cause of death. Pretty shocking.

Non-Coeliac Gluten Sensitivity and the brain

It’s not just people diagnosed with Coeliac Disease, an autoimmune condition of extreme gluten sensitivity in people with a genetic predisposition, who are sensitive to gluten.

There is an emerging recognition that some people react to gluten-containing food without being allergic to it in a manner symptomatically indistinguishable from Coeliac Disease, yet without showing up in typical tests. This has been confirmed in many double-blind placebo-controlled studies. Non Coeliac Gluten Sensitivity (NCGS) is common worldwide, but is chronically under-recognised and under-diagnosed. Some people may also have an allergy to wheat rather than or in addition to gluten.

Unfortunately, NCGS patients who generally present with irritable  bowel syndrome (IBS) are treated symptomatically, without the root cause ever being identified or treated and the issue of wheat and gluten being considered. They are told to go on low FODMAP or similar diet for life, which is no long-term solution.

While NCGS and IBS are important chronic functional gut disorders, it’s also important to understand that gluten sensitivity is not just limited to digestive issues. Only one person in every eight with a gluten sensitivity will have digestive symptoms. The rest will suffer from brain symptoms that are more prevalent than in Coeliacs. With NCGS, gluten is considered to cause gastrointestinal, non-neurological and neurological damage via cross-reacting antibodies, immune complexes and direct toxicity.

Similarly, people with Coeliac disease can also present with many symptoms other than digestive ones. These include muscle weakness, ataxia (loss of coordination), diabetes mellitus, pancreatitis, rheumatoid arthritis, psoriasis, diabetes and Sjogren’s syndrome to peripheral neuropathy, Addison’s disease, lupus, osteoporosis, IBS, recurrent miscarriages, mental health issues, autoimmune thyroid disease and much more. The implications are serious for late or non-diagnosed Coeliacs and include cancer and death.

transglutaminase

Gluten can also trigger an autoimmune reaction to transglutaminase, enzymes that help bind proteins together and are involved in the process of digestion. Transglutaminse exists in the human gut (TG2), brain and nervous tissues (TG6), or skin (TG3). In the gut, when inflammation damages the gut lining, the debris includes transglutaminase, which the immune system reacts to and tags with antibodies, potentially leading to autoimmunity. TG2 is thus a marker of Coeliac disease. In the skin, dermatitis herpetiformis is an autoimmune response to TG3.

The food industry in Australia and the US uses transglutaminase the tenderise and ‘glue’ meat, but it can also be found in some vegetarian foods and dairy products, and is used as a pre-treatment for cereals. In Australia, the food industry does not need to declare its use. People with transglutaminase antibodies may react to this food additive.

The government states that while it ‘will not pose a risk to public health or safety’, it also states that ‘Individuals with coeliac disease or gluten intolerance would be advised to avoid gluten-containing foods irrespective of whether they contain protein glutaminase. This would be expected to manage any potential concerns that this enzyme might increase the levels of coeliac disease epitopes in gluten containing foods.’

It would be hard to avoid such foods if they are not fully labelled. In short, avoid processed foods.

Testing for gluten ISSUES

Wheat contains 62 peptides that may trigger an immune response, yet most labs only test for one: alpha gliadin.

Coeliacs are traditionally diagnosed through a biopsy of the small intestine looking for villus atrophy. This is no longer the gold standard for testing as it tests the end state when the disease is full blown. Some top experts describe it as redundant.

Currently there is no single test, not even a biopsy, that can conclusively diagnose or exclude Coeliac Disease, let alone NCGS in every individual. Transglutaminase (tTg) is the prime and unique antibody for screening of the suspected Coeliac population but this testing is not commonplace. Currently, we don’t know which blood markers alone or in combination should be used to diagnose the whole spectrum of gluten-related disorders, and in particular NCGS. However, AGA IgG is a good marker for a gluten-related disorder.

A note on allergy testing. Skin pricking, the gold standard for allergy testing in the 1950s, only tests one kind of immune reaction (IgE) and therefore gives an incomplete picture. Science has moved well beyond this method.

Lectins

As wheat has multiple constituents, discussion of gluten-mediated problems cannot be divorced from considering the role of other components in wheat. Wheat also contains lectins, widely recognised as anti-nutrients because they can bind to virtually all cell types and cause damage to several organs.

gluten and Mental health

Grains can effect mental health. Neuropsychiatric presentations of Coeliac Disease include depression, anxiety, schizophrenia, paraesthesia, cerebrospinal degeneration and peripheral neuropathy.

In all of us, wheat and gluten make the gut more permeable and can thus encourage the migration of food particles to sites where they are not expected, prompting the immune system to attack both these particles and brain-relevant substances that resemble them.

As stated above, a common symptom of non-coeliac gluten sensitivity is brain fog. There are other neurological manifestations too, most commonly cerebellar ataxia, peripheral neuropathy, and encephalopathy (brain disease or disorder). In other words, people with with NCGS develop neurological manifestations similar to what is seen in Coeliacs.

Gluten contains opioids and is addictive

In all of us, bread releases opioid-like compounds, capable of causing mental derangement if they make it to the brain. Gluten can be degraded into several morphine-like peptides named gluten exorphins (which are also found in dairy and spinach). They have been shown to affect hormonal balance, behaviour and learning in animals. They may also mask the negative effects of gluten.

The gluten-free diet

The good news is that studies show that the majority of non-celiac gluten sensitivity patients (93.2%) showed the disappearance of anti-gliadin antibodies after six months on a gluten-free diet. In contrast, 40% of coeliac patients displayed persistent antibodies after gluten withdrawal.

Perhaps the most concerning news for Coeliacs is that there is a 75% increase in mortality after going gluten free. This is because in industrialised countries, wheat often makes an important contribution to the diet supplying fibre (largely prebiotic, which feeds healthy gut bacteria), B vitamins and minerals. In the US, 78% of wheat provides 81% of this resistant starch. This same amount of prebiotic fibre doesn’t usually exist in replacement processed gluten free foods leading to a decline in gut health, increased in inflammation and illness such as heart disease.

The message from this is not that coming off wheat and other gluten-containing grains is dangerous, but that it should be done the right way. Avoid processed, low-fibre and high carbohydrate gluten-free foods and replace wheat with complex carbohydrates like root vegetables (unfortunately white potatoes contain little fibre), other vegetables, whole grains and legumes.

Also ensure that you read every food label and always confirm with the chef when eating out that your order is gluten free. Gluten can be found in everything from Lipton tea, sushi and tabasco sauce to herb mixes and sweeteners.

So often people claim they’re fine with gluten, but they have never been without it. A test of how you really react to gluten is to completely remove it from your diet for 3 weeks. Then reintroduce it and see how you really react.

“There is no such thing as a low-gluten diet – it’s all or nothing.”

Gluten cross-reactivity

Anyone sensitive to gluten will have created antibodies to its protein structure. Other grains such as oats or even quinoa can have similar protein structures and your body may react to those as if they were gluten. If you give up gluten and still don’t feel right, consider cutting out other grains. Also bear in mind that some modern commercial grains like quinoa are cross-bred with other grasses.

Potential cross-reactive foods include

Dairy
Oats
Yeast (brewer’s, baker’s, nutritional)
Instant coffee
Milk chocolate
Millet
Soy
Corn
Rice
Potato

Afterword

You may think what I’ve written here is radical, but at Gutsy by Nutrition we love science and everything in this blog is research based from respected sources.