Is Gluten Always Bad?
Gluten has become a dirty word in the diet and health culture industry.
There’s reason for this.
I’ve written previously on how this protein found in wheat, barley, rye, and other related grains may indeed trigger a negative response in certain individuals. (1, 2, 3, 4, 5) Under specific health contexts, accompanied by proper testing and/or clinical observations to warrant its association to discomfort, it is probably wise to remove it…at least until the underlying cause is addressed and health is restored.
In other cases, as with those with celiac disease, gluten may be the known perpetrator, contributor, and trigger of unwanted systemic effects and gastrointestinal harm. Therefore, individuals with this diagnosis, which has a genetic component, would be wise to avoid its ingestion… throughout the rest of their life. This “extreme” measure is to decrease the possibility of causing harm to their bellies’ lining and bodies, as celiac disease is a disorder of malabsorption as well as an abnormal immune reaction to gluten.
Lately, numerous experts in health have deemed gluten as a major cause and contributor to a wide range of chronic health diseases. In fact, many have proclaimed that the grain, regardless of quality and food prep, should never be eaten… ever again…by anyone. (Hmmm…shades of butter bashing?)
I admit, I previously had a bit of bias against gluten. In the past, I was quick to point out that it had no place on anyone’s plate. I even explored in several blogs the ways it negatively impacted the body.
It is true that science does support that cessation of gluten in the diet has been helpful in mitigating symptoms of various disease processes…but why?
A Deeper Dive into Why Someone May React to Gluten
Recently, I updated my viewpoint on gluten. I wrote a two-part series that explored gluten’s association to conditions other than celiac disease.
In Part I, I explored:
- The definition of gluten.
- Why it caused so much raucous: celiac disease and beyond.
- Why sensitivity to this peptide has been controversial.
- How gluten-sensitivity is now recognized as a distinct phenomenon.
- How viewing gluten as the “food scapegoat” may be too simplistic.
In Part II, I discussed other reasons that gluten may be more of a witness at the crime scene rather than the criminal. These included:
- The microbiome (more on that below)
- Food processing and results from its commercialization (1,2,3)
- The hybridization of wheat
As you know, I love the topic of belly bugs. As I was exploring more about the microbiome and its interaction with essential oils for my rally presentation (you can get a preview of that here), I also dove into its role in gluten responses.
Here’s what I found.
Gluten and the Microbiome
Some studies have suggested that the differences in our microbiome, and these responses of the critters that line our insides, may be the key factor in if one has negative responses to gluten consumption. Below are a few articles I found on this topic. You can probably get a gist of what the bottom line was by the titles. For some, I included an excerpt:
- Microbiome and Gluten.
- “Epidemiological studies indicate that common perinatal and early postnatal factors influence both CD risk and intestinal microbiota structure. Prospective studies in healthy infants at risk of developing CD also reveal that the HLA-DQ genotype, in conjunction with other environmental factors, influences the microbiota composition. Furthermore, CD patients have imbalances in the intestinal microbiota (dysbiosis), which are not fully normalized despite their adherence to a gluten-free diet.”
- Effects of a gluten-free diet on gut microbiota and immune function in healthy adult humans.
- Intestinal microbiota modulates gluten-induced immunopathology in humanized mice.
- The Cultivable Human Oral Gluten-Degrading Microbiome and its Potential Implications in Celiac Disease and Gluten Sensitivity
This article, Intestinal Microbiota and Celiac Disease: Cause, Consequence or Co-Evolution?, was particularly intriguing. The authors detail how the microbiome and host genetics interact. Importantly, they point out all the factors that influence the microbiome makeup to begin with that would be the basis of a response! (This is similar to the first article on celiac disease):
It is widely recognized that the intestinal microbiota plays a role in the initiation and perpetuation of intestinal inflammation in numerous chronic conditions. Most studies report intestinal dysbiosis in celiac disease (CD) patients, untreated and treated with a gluten-free diet (GFD), compared to healthy controls. CD patients with gastrointestinal symptoms are also known to have a different microbiota compared to patients with dermatitis herpetiformis and controls, suggesting that the microbiota is involved in disease manifestation. Furthermore, a dysbiotic microbiota seems to be associated with persistent gastrointestinal symptoms in treated CD patients, suggesting its pathogenic implication in these particular cases. GFD per se influences gut microbiota composition, and thus constitutes an inevitable confounding factor in studies conducted in CD patients. To improve our understanding of whether intestinal dysbiosis is the cause or consequence of disease, prospective studies in healthy infants at family risk of CD are underway. These studies have revealed that the CD host genotype selects for the early colonizers of the infant’s gut, which together with environmental factors (e.g., breast-feeding, antibiotics, etc.) could influence the development of oral tolerance to gluten. Indeed, some CD genes and/or their altered expression play a role in bacterial colonization and sensing. In turn, intestinal dysbiosis could promote an abnormal response to gluten or other environmental CD-promoting factors (e.g., infections) in predisposed individuals. Here, we review the current knowledge of host-microbe interactions and how host genetics/epigenetics and environmental factors shape gut microbiota and may influence disease risk. We also summarize the current knowledge about the potential mechanisms of action of the intestinal microbiota and specific components that affect CD pathogenesis.
Processing of grains is also a consideration. This is not just in relation to the decrease in its quality and resultant inflammation or nutrient deficiencies that can result. More importantly, it may be its connection to how it modulates the microbiome. Here is a summary of 2015 article in Medical Hypotheses:
While gluten and wheat must be absolutely avoided in coeliac disease and allergy, respectively, nutritional recommendations are largely more confused about non-coeliac wheat/gluten sensitivity (NCWGS). Today, some even recommend avoiding all cereal-based foods. In this paper, the increased NCWGS prevalence is hypothesized to parallel the use of more and more drastic processes applied to the original wheat grain. First, a parallel between gluten-related disorders and wheat processing and consumption evolution is briefly proposed. Notably, increased use of exogenous vital gluten is considered. Drastic processing in wheat technology are mainly grain fractionation and refining followed by recombination and salt, sugars and fats addition, being able to render ultra-processed cereal-based foods more prone to trigger chronic low-grade inflammation. Concerning bread, intensive kneading and the choice of wheat varieties with high baking quality may have rendered gluten less digestible, moving digestion from pancreatic to intestinal proteases. The hypothesis of a gluten resistant fraction reaching colon and interacting with microflora is also considered in relation with increased inflammation. Besides, wheat flour refining removes fiber co-passenger which have potential anti-inflammatory property able to protect digestive epithelium. Finally, some research tracks are proposed, notably the comparison of NCWGS prevalence in populations consuming ultra-versus minimally-processed cereal-based food. (Med Hypotheses. 2015 Dec;85(6):934-9. doi: 10.1016/j.mehy.2015.09.007.)
If you are known to be gluten-sensitive and/or have celiac disease, it would be wise to stay away from gluten until otherwise informed by your trusted health care provider.
However, I believe the world is confusing a trigger with a cause. Even those with celiac are born with the predisposition, not the actual disease.
Will we one-day have a probiotic for celiac disease or a pill to alleviate its exposure?
We may not be there yet, but you never know what can happen in the money of healing!
For now, let’s keep an open mind, continue to focus on what individuals need vs. dietary theories and books to sell, and address the underlying cause of dis-ease. By all means, if that means avoiding gluten, do it. However, if it means avoiding gluten and fixing the gut, then enjoying “real toast” again, do that. I wish I could! (I have celiac disease.)
Maybe then one day, people will be able to eat food without fear and find the joy in life again, without many well-intended individuals scaring the health out of people!