Getting to Grips with Grains and Gluten
The potential for grains, particularly those containing gluten (i.e. a protein component of wheat, barley, rye), to promote inflammation is a hot topic in the health and wellness world. Yet it is also controversial among nutrition scientists and dietitians. My opinion, as always, is that there is no “one-size-fits-all” approach to this matter.
An individual’s risk of suffering a pro-inflammatory response to eating certain grains is difficult to objectively measure, especially if results of lab tests do not meet the criteria for a clinical diagnosis of established inflammatory conditions of the gut such as celiac disease, Crohn’s disease or ulcerative colitis. However, non-celiac gluten sensitivity is becoming increasingly recognized as a significant cause of not only irritable bowel syndrome (IBS), but also a whole host of other common inflammatory symptoms that manifest outside of the gut (as described in my previous article on inflammation).
In sensitive individuals, gluten and other components of grains such as wheat, are not easily or completely digested. The large particles that remain undigested wear down the lining of the intestine, leading to a condition commonly called “leaky gut”. When these undigested particles escape through the gut wall into the bloodstream, they are recognized as foreign bodies by our immune system, provoking an immune response and an inflammatory cascade ensues.
Who is sensitive to gluten and other grains?
It is important to note that not everybody is sensitive to this inflammatory response to grains, but susceptibility likely depends on a multitude of factors. These include our genetic profile, whether we were breastfed as a baby, exposure to antibiotics and infections throughout our lifetime which alter the gut microbiome, chronic exposure to environmental toxins that increase the stress on our gut wall integrity, the quality of the grain and the soil in which it was grown, and the degree of processing of the grain to form a final food product, such as bread.
This variation in susceptibility to tolerance of certain grains (and gluten) explains why you probably have friends who follow a healthy diet but one that contains large amounts of grains such as wheat, yet maintain a good health status and not develop inflammatory-associated chronic diseases. In contrast, populations with a different genetic pool, higher rate of antibiotic prescriptions, lower breastfeeding rates, greater exposure to environmental toxins and a higher consumption of heavily processed, commercial grain products tend to experience higher rates of gluten intolerance and food sensitivities across the board (e.g. US, Ireland, UK).
My personal gluten conflict
Unfortunately for me, I seem to fall into every category that increases my susceptibility to leaky gut and gluten intolerance, although I do not have Celiac disease, according to clinical lab tests. After following a strict elimination diet five years ago (low FODMAP diet), I could objectively detect my extreme sensitivity to wheat and other gluten-containing foods. As a clinically-trained dietitian who initially believed that only those with Celiac disease reacted to gluten, this was a big surprise to me. Admitting to myself that nutritional science is constantly evolving, and there is probably a lot that we still don’t understand about food tolerances and the microbiome interaction, was extremely liberating for me.
I have followed a gluten-free diet ever since, which rapidly transformed my life from suffering daily inflammatory symptoms and discomfort to one of vitality, mental clarity and improved digestion. I no longer suffer with IBS, acid reflux, frequent headaches, extreme bouts of fatigue and brain fog. Another hugely welcoming benefit I discovered after about a year of following a low grain/gluten free diet was that I could begin to digest other foods again in small quantities, which I was previously sensitive to (e.g. onion, mushrooms, avocados, various fruits).
In my case, and probably true for many others, I believe that a dysfunctional gut microbiome is the root cause of my food intolerances and related symptoms. I can’t undo exposures that led to this through my childhood and early adult life, but I have made the conscious choice to adapt certain behaviors and conditions in my lifestyle to minimize the negative effects and improve my gut microbiome going forward.
Of course, this is my personal experience and I do not advocate that everyone jumps on the gluten-free bandwagon. If you eat grains and gluten as part of a healthy balanced diet and generally feel well, energized without digestive discomfort or other adverse symptoms, you are probably tolerating these foods just fine. On the other hand, if you suspect you have food intolerances, I would advise seeking help from a qualified nutritionist or dietitian to discuss different approaches and dietary elimination plans to help detect the food sensitivities while maintaining good nutritional status.
It can be a long, complex and continuously evolving journey to identify the root cause of digestive discomforts and related inflammatory symptoms. But discovering and understanding the root cause allows you to equip yourself with a toolkit to manage symptoms.
Investigate your body and health, ask questions and seek help from a qualified doctor, nutritionist or dietitian with expertise in this field. It is only through trying out various strategies that you can discover the approach that works best for you to improve your wellbeing and quality of life!
Photo credit: Vincent Botta
