The Truth About Gluten: Does Gluten Cause Gut Inflammation?

Gluten, a natural grain protein, has a controversial reputation due to its alleged links to gut, health, and weight problems. In this article, we’ll explore what gluten is, its impact on gut and overall health, and the difference between gluten intolerance and sensitivity, helping you decide if going gluten-free is the right choice.

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First things first, what is gluten?

Gluten, found in certain grains like wheat, barley, and rye, comprises gliadin and glutenin, offering elasticity and texture to baked goods. It is present in staples like bread, pasta and cereal, as well as unexpected items such as sauces and processed meats, where it thickens and binds. Despite its culinary importance, some individuals may face digestive discomfort and other health issues with gluten consumption.

Why does gluten have such a bad reputation when it comes to the gut?

In nutrition, gluten is often misunderstood due to negative media and books like "Wheat Belly" and "Grain Brain". These sources imply that gluten causes various health problems, from obesity to neurological disorders. The popularity of gluten-free diets for weight loss and health has furthered this misconception.

In reality, gluten is not inherently detrimental to most individuals, given that humans have consumed it for centuries, primarily through bread-making. Gluten-containing foods have provided protein, soluble fibre, and essential nutrients. A 2017 study of over 100,000 participants without gluten-related sensitivities found no link between long-term dietary gluten intake and heart disease risk. Surprisingly, it even suggested that healthy individuals who avoid gluten may elevate their heart disease risk due to reduced whole grain consumption.

Gluten, especially in whole grains, is not the enemy for healthy individuals with no gluten-related sensitivities. The issue lies in the way grains like wheat are processed into unhealthy snacks like crackers and potato chips, devoid of the nutritional benefits of whole grains. Consequently, many who adopt a gluten-free diet but still indulge in processed foods continue to experience weight gain, blood sugar fluctuations, and other health concerns. The true culprits behind these problems are not gluten-containing foods but rather the excess sodium, sugar, and various additives lurking in processed foods.

Gluten intolerance, gluten sensitivity, or just gluten-haters

Within our bodies, digestive enzymes, including protease, play a vital role in breaking down the foods we consume, notably proteins. However, protease isn't always fully efficient in breaking down gluten, allowing undigested gluten particles to reach the small intestine. While most individuals can tolerate these undigested components without issues, certain cases highlight the potential harm of gluten:

Coeliac Disease: This severe autoimmune disorder is triggered by gluten consumption in genetically predisposed individuals. When people with coeliac disease ingest gluten, their immune system attacks the lining of the small intestine, causing damage and various symptoms. These can range from severe gastrointestinal discomfort to nutrient malabsorption and potential long-term health complications. For those with coeliac disease, strict gluten avoidance is necessary.
Non-Coeliac Gluten Sensitivity (NCGS): Some individuals experience digestive symptoms similar to coeliac disease, such as abdominal pain, bloating, and diarrhoea, after consuming gluten. However, they do not test positive for coeliac disease markers. This condition, known as non-coeliac gluten sensitivity, is less well-defined but raises concerns about gluten in some individuals' diets.
Gluten ataxia: This rare neurological autoimmune disorder causes the body to attack parts of the brain in response to gluten. It’s considered one of the neurological manifestations of gluten sensitivity or gluten-related disorders, distinct from coeliac disease.
Wheat Allergy: In some cases, individuals may have a wheat allergy, which results in allergic reactions when wheat-containing products, including those with gluten, are consumed. Symptoms can range from mild, such as hives and nasal congestion, to severe, including anaphylaxis in rare cases.

Some individuals without coeliac disease or NCGS may experience symptoms of an unhealthy gut like bloating, diarrhoea, headaches or skin rashes after consuming gluten-containing foods. In some cases, this might result from poorly digested carbohydrates known as FODMAPS, which ferment in the gut, causing discomfort in those with sensitive digestive systems. Additionally, some individuals may have impaired small intestines, leading to increased gut lining permeability, allowing undigested substances like gluten and bacteria to enter the bloodstream, causing gut inflammation.

Signs and symptoms of gluten intolerance and gut inflammation

Suspecting gluten intolerance or sensitivity is valid, but it’s crucial to recognise that symptoms can vary widely among individuals and overlap with other conditions. If you suspect gluten intolerance, consult a healthcare professional for a proper evaluation. Here are common gluten sensitivity symptoms:

Digestive Issues: Abdominal discomfort, bloating, gas, diarrhoea, or constipation after consuming gluten-containing foods.
Fatigue: Unexplained fatigue and low energy levels.
Headaches: Recurrent headaches or migraines linked to gluten intake.
Joint Pain: Joint pain or stiffness in some cases.
Skin Problems: Rashes, eczema, or dermatitis herpetiformis (itchy skin rash).
Nausea and Vomiting: Feeling nauseous or vomiting after gluten ingestion.
Brain Fog: Cognitive symptoms like difficulty concentrating, memory problems, and "brain fog".
Mood Changes: Mood swings, anxiety, and depression in some individuals.
Weight Changes: Unexplained weight loss or gain.

Non-coeliac gluten sensitivity (NCGS) is linked to gut inflammation, although the relationship is complex. In NCGS, gluten consumption can trigger localised gut inflammation, leading to symptoms such as abdominal pain, bloating, and changes in bowel habits (diarrhoea or constipation). While NCGS doesn't involve the autoimmune response seen in coeliac disease, it activates the immune system, causing low-grade gastrointestinal inflammation.

Will a gluten-free diet improve gut health and reduce inflammation?

A gluten-free diet is vital for individuals with diagnosed conditions like coeliac disease or confirmed non-celiac gluten sensitivity. However, for those without these conditions, going gluten-free is not necessary to improve gut health or heal inflammation. In fact, this is one of the top gut health myths. Nonetheless, many individuals with inflammatory bowel disease (IBD) opt to avoid gluten because they find it acts as ‘trigger’ food. Here’s why:

Leaky Gut and Gluten’s Impact: Leaky gut syndrome occurs when the small intestine’s lining becomes permeable, allowing substances like toxins, microbes, undigested food particles, and antibodies to enter the bloodstream, potentially causing various symptoms. For gluten-sensitive individuals, consuming gluten-containing foods can irritate the intestinal membranes, contributing to leaky gut. Symptoms may include bloating, gas, cramping, food sensitivities, and various aches and pains. Leaky gut has also been linked to conditions such as eczema, inflammatory arthritis, and chronic fatigue due to the gut-skin-axis.
Modern Wheat Evolution: Modern wheat differs significantly from the wheat consumed by previous generations. Over time, wheat has been selectively bred for robustness and resilience during cultivation. As a result, approximately 5% of the proteins found in contemporary wheat are relatively new, potentially making them less compatible with our digestive systems. This evolutionary shift in wheat composition can lead to digestive issues in some individuals.

Some of the negative side effects of a gluten-free diet

For individuals who are healthy and do not have allergies, intolerances, sensitivities, or medical conditions related to gluten, adopting a gluten-free diet when not medically necessary can have several potential drawbacks, including:

Nutritional Imbalance: Gluten-containing grains like wheat, barley, and rye provide essential nutrients, including fibre, B vitamins, iron, and folate. Removing these grains from the diet can lead to nutritional imbalances if not replaced with suitable alternatives.
Expense: Gluten-free products are often more expensive than their gluten-containing counterparts. This can put a strain on the budget, especially for items like gluten-free bread, pasta, and baked goods.
Limited Food Choices: A gluten-free diet can limit food choices and make dining out and socialising more challenging, potentially affecting one's quality of life.
Increased Processed Foods: Some individuals who go gluten-free without a medical need may rely heavily on processed gluten-free products, which can be low in nutritional value and high in additives.
Reduced Dietary Diversity: Eliminating gluten can reduce dietary diversity, potentially leading to a less varied and balanced diet.

If you choose to remove gluten and/or wheat from your diet, it is advisable to do so with the guidance of a registered dietitian. It's important to commit to a 100% gluten-free diet for a minimum of 30 days. Some individuals who cease gluten consumption may experience a phase known as 'gluten withdrawal,' characterised by temporary symptoms like brain fog, stomach discomfort, headaches, and dizziness. These symptoms typically subside as your body adapts to the dietary change and may suggest that you have a sensitivity to gluten.

Ways to reduce gut inflammation caused by gluten

Reducing gut inflammation caused by gluten primarily involves managing gluten intake and adopting a gut health diet and lifestyle. Here are some steps to consider:

Consult a Healthcare Provider: If you suspect that gluten is causing gut inflammation or have been diagnosed with conditions like coeliac disease or non-coeliac gluten sensitivity (NCGS), it's crucial to work with a healthcare provider or registered dietitian. They can provide personalised guidance and monitor your progress.
Strict Gluten Avoidance: For individuals with coeliac disease or confirmed NCGS, complete and strict avoidance of gluten-containing foods is essential. This includes reading labels carefully, checking ingredient lists, and being aware of hidden sources of gluten.
Choose Gluten-Free Alternatives: Replace gluten-containing grains with gluten-free alternatives such as rice, quinoa, corn, oats (certified gluten-free), and gluten-free flours (e.g., almond flour, coconut flour).
Whole Foods: Emphasise whole, unprocessed foods in your diet, including fruits, vegetables, lean proteins, nuts, and seeds. These foods are naturally gluten-free and promote gut health.
Fibre-Rich Diet: Consume a diet rich in soluble and insoluble fibre, as it can offer benefits of a healthy gut. Foods like fruits, vegetables, legumes, and gluten-free whole grains like brown rice and quinoa are excellent sources of fibre. Supplements like Y GUT sensitive, are a source of prebiotic fibres that further selectively support a healthy gut microbiota.
Probiotics: Consider incorporating probiotic-rich foods like yoghurt (if tolerated) or fermented foods (e.g., kimchi, sauerkraut, kefir) into your diet. Probiotics may help maintain a balanced gut microbiome that produces health promoting metabolites. Alternatively, use postbiotic containing supplements, such as Y SKIN and Y GUT sensitive that support gut barrier function and prevent leaky gut syndrome.
Stay Hydrated: Proper hydration is essential for a healthy gut. Drink plenty of water throughout the day to support digestion and overall well-being.
Manage Stress: Chronic stress impacts gut health. Engage in stress-reduction techniques such as mindfulness, meditation, yoga, or deep breathing exercises.
Regular Exercise: Physical activity can promote gut health and reduce inflammation. Aim for regular, moderate exercise as part of your routine.
Get Adequate Sleep: Prioritise quality sleep, as it plays a vital role in overall health, including gut function and inflammation control.
Monitor Symptoms: Keep a food diary to track your diet and any symptoms you experience. This can help identify specific triggers and patterns.

Key takeaways

The demonisation of gluten isn't justified for most people. Gluten, especially when derived from whole grains, offers valuable nutrients and has been part of our diet for centuries. The real focus should be on making informed dietary choices, avoiding overly processed foods, and understanding one's unique health needs before deciding to go gluten-free. Consulting with a healthcare provider or registered dietitian can help you make informed decisions about your diet and overall health.