Grains make up a large portion of the North American diet but they have been linked to many inflammatory health conditions including obesity, Type 2 diabetes, metabolic syndrome, autoimmune conditions, dementia, cancer and arthritis.
Wheat has been consumed for thousands of years, but industrialized farming has changed its properties and how it works in our bodies. Processing has allowed grains to be used in many different forms and store easily for long periods. This is why modern grains have become staples in our diets. Manufacturing also removes many of the vitamins, minerals and nutrients that wheat and other grains are thought to contain. Ancient grains don’t seem to cause inflammation in the same way as modern wheat and other processed grains do. This is likely because modern grains are recognized as very different than the grains our bodies processed thousands of years ago.
Modern grains are also exposed to many fertilizers, pesticides and chemicals. When you eat grains, these toxins are consumed and can have a detrimental effect on the body. The agriculture industry has also manipulated the genetics of grains to yield larger crops that are resistant to drought, pests and disease. These genetic advances are too fast for our bodies to keep up with and although the body is usually able to break them down, it doesn’t mean it should have to. Modern grain processing techniques also raise the gluten content in many grains, especially wheat.
What’s the deal with gluten?
There has been a lot of controversy surrounding gluten in recent years and gluten-free diets have become very popular among health-conscious individuals. Gluten is a group of proteins found in grains such as wheat, rye, barley and spelt. Gluten is actually made up of 2 proteins; gliadin and glutenin. Gliadin is thought to be the more inflammatory component (1).
Gluten is responsible for the stickiness of dough and the consistency of many grain products. When flour is mixed with water, the gluten proteins give the dough elasticity. It also allows bread to rise when baked and gives it its fluffy texture (2).
What is Celiac Disease?
Many people can tolerate gluten very well while other people have various degrees of sensitivity to gluten. Celiac disease is a severe form of gluten intolerance and is actually an autoimmune reaction to the gluten proteins. When the body views gluten as an invader, the immune system attacks it as well as the lining of the intestines (3). This damage to the intestinal cells can cause nutrient deficiencies and many digestive issues (4) such as abdominal pain, bloating, diarrhea, weight loss and foul-smelling stools (5). Symptoms can also occur outside the digestive system including fatigue, skin conditions, mood disturbances or anemia (5). Celiac disease can be difficult to diagnose due to the variety of symptoms it can present with. Rates of diagnosis have been increasing in the past decade but it has been estimated that up to 80% of people with Celiac disease remain undiagnosed (5).
Not everyone with a gluten sensitivity will test positive for Celiac disease. Many people have non-celiac gluten sensitivity. The symptoms are similar to Celiac disease but are typically less severe. This diagnosis is controversial since it relies on a patient’s report of their symptoms. It is difficult to determine if they are reacting to gluten or other molecules. We also know the digestive system can be affected by emotions and conscious thought so it is possible a person’s symptoms are psychologically created. Some people just feel better when they are eating a gluten-free diet. This is difficult to quantify or prove but we cannot discount a patient’s individual experience.
How are gluten intolerances diagnosed?
Celiac disease is typically diagnosed through laboratory tests. Blood tests that screen for the Tissue Transglutaminase (tTG) Antibody determine if antibodies to the gluten molecules exist in the body. If positive, this is usually followed by analyzing a biopsied sample of the small intestine. This looks for damage to the intestinal cells and can only be done if the patient is currently eating gluten. For those who think they may be sensitive to gluten but not have Celiac disease, The Elimination Diet can be helpful. Eliminating gluten from your diet will remove the inflammation gluten may be causing and your symptoms should improve. If your symptoms return after reintroducing gluten, you may have a gluten sensitivity. If your symptoms don’t change after removing gluten or putting it back in, you are likely reacting to something else.
What can I eat if I have a gluten intolerance?
A common misconception is that gluten-free food is always healthy. Gluten-free alternatives have become readily available as the popularity of gluten-free diets has grown. Many products replace gluten with corn, binders, fillers, sugars and artificial flavours to mimic the taste and texture of gluten-containing grains such as wheat. These products are often highly processed!
Eating foods that are naturally gluten-free is generally a better option. This includes fruits and vegetables, meats and animal products, nuts, seeds, oils and gluten-free grains including quinoa, rice, flax, millet, buckwheat, arrowroot, amaranth and oats.
Gluten-containing grains are often hidden ingredients in many commercial products. Depending on the level of your sensitivity, even traces of wheat, gluten and corn can cause inflammatory symptoms. These foods can be found in packaged, canned and bottled products that you wouldn’t think are grain-based. It is important to read ingredients labels carefully on all foods to determine which ones contain wheat and corn. Certain brands may be okay while other are not!
1. Wieser H. (2007). Chemistry of gluten proteins. Food Microbiology, 24(2):115-9.
2. Shewry PR, Halford NG, Belton PS, Tatham AS. (2002). Philosophical transactions of the Royal Society of London, 357(1418):133-42.
3. Castillo NE, Theethira TG, Leffler DA. (2015) The present and the future in the diagnosis and management of celiac disease. Gastroenterology Report (Oxford), 3(1):3-11.
4. Nadhem ON, Azeez G, Smalligan RD, Urban S. (2015) Review and practice guidelines for celiac disease in 2014. Postgraduate Medicine, 127(3):259-65.
5. Rubio-Tapia A, Hill ID, Kelly Cp, Calderwood AH, Murray JA. (2013). ACG clinical guidelines: diagnosis and management of celiac disease. American Journal of Gastroenterology, 108(5):656-76.
