Gluten-free foods are everywhere now- whether its supermarket aisles labeled “Gluten-Free” or restaurants offering gluten-free options. Contrary to before, people aren’t just avoiding gluten because of a disorder, like celiac disease (CD). Lately, people have been adopting a gluten-free diet to lose weight, boost energy, treat autism, and generally feel healthier. Is it just the hip new diet or is there evidence behind this trend? Interestingly, a large culprit for gluten’s negative health effects is the inflammation it causes when consumed. We know inflammation is the predecessor of damage, so let’s see how gluten may cause inflammation.
What is Gluten?
Gluten is a family of proteins found in many grains including rye, spelt, barley, and, the most commonly consumed, wheat. The primary proteins found in gluten are glutenin and gliadin. Most of the negative effects that are associated with gluten are caused by gliadin [R].
Gluten, Inflammation, and Disease
Celiac disease is a condition in which the immune system is highly sensitive to gluten. When these individuals consume gluten, the immune system instigates an inappropriate inflammatory response against gliadin (a component of gluten), which causes wide-spread inflammation, increased intestinal permeability, and intestinal damage [R]. CD occurs in about 0.7-1% of the population. Yet, gluten-free diets are increasingly popular and definitely attract more than 1% of the population. That’s because studies have shown that gluten may be causing inflammation even in non-celiac individuals [R].
For example, irritable bowel syndrome (IBS), which is a disease that involves intestinal inflammation, can be adequately controlled with a gluten-free diet alone in some cases, implying gluten’s role in IBS’s symptoms [R].
Non-celiac gluten sensitivity (NCGS) is another condition that is characterized by intestinal symptoms following the consumption of gluten in individuals that don’t have celiac disease nor a wheat allergy. Symptoms are similar to those in CD and include bloating, abdominal discomfort, diarrhea, and flatulence [R]. This condition was first described in the 1980s but was overlooked because of its ambiguity and lack of biomarkers. Recently, however, it has been rediscovered as more individuals self-diagnose themselves with gluten sensitivity.
Unlike CD, gliadin does not cause an inflammatory response in NCGS patients [R, R]. Studies suggest, however, that another component of wheat, called amylase trypsin inhibitors (ATIs), could be the trigger for an immune response following wheat consumption. Wheat ATI’s are a family of proteins that are very resistant to intestinal digestion and are known to activate a pro-inflammatory response in cells of both celiac and non-celiac patients [R].
Besides gliadin and wheat ATI’s, low-fermentable, poorly absorbed, short-chain carbohydrates (fermentable, oligo-di-monosaccharides, and polyols [FODMAPs]) found in wheat can also contribute to NCGS symptoms [R].
These findings on NCGS, however, need validation and additional studies with a larger number of subjects. If these findings are confirmed, the name NCGS will likely be altered to indicate wheat sensitivity rather than just a gluten sensitivity since other components of wheat are responsible for the inflammation and symptoms.
Conclusion
So why is this important to be aware of? Wheat-induced inflammation raises concerns not only for intestinal damage, but for other conditions as well, such as obesity, metabolic syndrome, neuropsychiatric symptoms, and cardiovascular disease [R]. Following diets that reduce the consumption of components that may induce an inflammatory response will, therefore, be beneficial. The tricky bit is that a lot of “gluten free” products contain something called mTg (microbial transglutaminase) which can be almost MORE damaging than gluten itself and can actually cause both leaky gut and celiac disease. This is why it is so important to seek high quality, minimally processed, whole foods – especially when they are labeled “gluten free”. So what is the solution? Do you have to avoid carbohydrates all together? Definitely not! Eat whole foods like potatoes and squash and the most ancient of all the grains like teff, buckwheat and basmati rice. If you think you may have leaky gut or gut inflammation from a history with gluten or mTg (which is also found in meats and cold cuts), add gut healing supplements like L-Glutamine and Probiotics.