Can gluten cause digestive problems and auto-immune diseases?

This article won't discuss coeliac disease or wheat allergy

1. An overview

The word gluten comes from a Latin word meaning “glue”. Gluten’s adhesive and binding properties give bread and cakes their spongy texture. Gluten is a complex protein structure mainly made up of glutenin and gliadin, which in presence of water becomes elastic. 

From an evolutionary point of view, grains were introduced 10.000 years ago, which might not be a sufficient time for humans to have genetically adapted to a high carbohydrates diet, mostly refined, which the “western diet” is very rich of. Moreover, the highly refined wheat flour has only been used for the last 200 years. Previous to this, the flour in use was wholemeal, containing more fiber, and it was also a mix of different grains and legumes flours.

The process of baking and making bread has also dramatically changed within the last century or so. In fact bread dough is no longer left to rise over night, but only for a couple of hours. The super spongy texture is then achieved by adding extra gluten to the dough. All this means that the enzymes present in the yeast, needed to raise the dough, do not have enough time to break down so much gluten in a short period of time, which will result in a more indigestible end product.

2. Non-celiac gluten sensitivity

A growing number of people have recently reported intestinal and extra intestinal symptoms after ingestion of gluten containing cereals like wheat, barley, spelt and rye, even without having a wheat allergy or being gluten intolerance, like celiacs do. Clinical trials have found that these symptoms improve after gluten withdrawal. This new syndrome called “non-celiac gluten sensitivity” (NCGS) was scientifically recognised in 2012.

In the large majority of people, gastro-intestinal symptoms appear from few hours up to one day after ingestion of these grains. Extra-intestinal manifestations may take much longer to appear.

Gastro-intestinal symptoms of NCGS are:

  • Bloating
  • Abdominal pain
  • Diarrhoea
  • Acid reflux
  • Nausea
  • Constipation
  • Flatulence.

Extra-intestinal manifestations of NCGS are:

  • Lack of general well being
  • Headaches
  • Tiredness
  • Anxiety
  • Joint and muscles pain
  • Foggy brain
  • Skin rash
  • Allergies
  • Depression
  • Auto-immune disorders.

3. Not just gluten

There are different types of proteins found in wheat, other than gluten, such as amylase trypsin inhibitors (ATIs), which may also contribute to NCGS by increasing gut inflammation and decreasing digestive enzymes action, which may result in IBS type symptoms. ATIs are present in wheat, rye and barley and serve these plants as pest controller. Moreover, ATIs are highly present in the modern types of wheat, compared to the more ancient varieties.

In addition, recent studies have evidenced the possible role of fermentable oligo, di and monosaccharides and polyols (FODMAPs) in the progress of NCGS. FODMAPs are short chain carbohydrates and sugar alcohols that might be poorly absorbed in the intestine. They are present in milk, legumes, honey, some fruits (cherry, watermelon, pear and mango,) and some vegetables (leek, chicory and fennel). FODMAPs also include wheat and rye, which also contain gluten and ATIs.

5. Hyperpermeability, aka “leaky gut”

Your gut wall has a very complex system of nutrients absorption and border control that only allows entry to minerals, vitamins, water, amino acids, fats, sugar and other nutrients.  

Sustained gut inflammation, over time, can lead to “leaky gut” syndrome, which implies hyperpermeability due to gut lining damage and subsequent entry into the body of harmful agents, like microscopic parasites, bacteria and undigested food particles.  

When “invaders” find a breech into the gut wall and penetrate inside the body they will cause an activation of the immune system defense mechanisms. If leaky gut is sustained for long period of time, the immune system will become over reactive and eventually will miss place attacking and it will start attacking the self, “thinking” it is still attacking the invader. This condition of self harm over time may develop into an auto-immune disease like diabetes 1, Hashimoto’s, Rheumatoid Arthritis, eczema, MS, Ulcerative Colitis etc.

Once ingested, gluten stimulates the release of a protein in the intestine called zonulin. This protein contributes to loosening and breaking the bonds between the gut lining cells, consequently causing or worsening the “leaky gut” syndrome and increasing intestinal inflammation.

6. Few simple ideas:

  • Cut right down your intake of processed meals, which might contain hidden gluten.
  • Avoid gluten containing grains like wheat, spelt, barley, rye and oat, although some oat is free from.
  • Avoid conventional bread, pizza, pasta, cakes and biscuits.
  • Experiment with gluten free products. Please visit the free-from aisle at the grocery store and also look for gluten free dishes at the restaurant.
  • Do not rely on or abuse of gluten free processed foods.
  • Implement a wholesome and varied diet aiming for a total of eight portions of fruits and vegetables per day, two to three fruits and five to six vegetables.
  • Use gluten free grains, to include wholemeal, red and black rice, buckwheat, amaranth, millet, quinoa, corn and gluten free oat.
  • Implement a strict gluten free diet for at least two weeks, but I will recommend extending it to one month. Be mindful of your gastro-intestinal symptoms and extra-intestinal manifestations named above while you do this.                                           
  • I appreciate that it is pretty hard to avoid gluten completely, but do the very best you can. Don’t forget to feed back to me on your findings, as I am always happy to hear about your stories.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119241/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772047/pdf/nutrients-08-00084.pdf

https://www.ncbi.nlm.nih.gov/pubmed/24533607

https://www.ncbi.nlm.nih.gov/pubmed/16635908

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5214347/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4053283/

Nutritionist Resource is not responsible for the articles published by members. The views expressed are those of the member who wrote the article.

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Written by Cristiano Percoco BSc (Hons) Clinical Nutritional Therapist

I am a Clinical Nutritional Therapist, trained using the Functional Medicine model at the University of Westminster in London. I cover all aspects all health with the belief that what we eat, but also don't eat and our life style is all there is between "ease" and "dis-ease". Investing in your health is the best investment you will ever make.… Read more

Written by Cristiano Percoco BSc (Hons) Clinical Nutritional Therapist

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