“Good bread is the most fundamentally satisfying of all foods,” said chef and food writer James Beard, “and good bread with fresh butter, the greatest of feasts.”
While many people would still agree with Beard, bread today is under siege (along with the wheat from which it’s made) in sensationalist books like Wheat Belly and Grain Brain. “Wheat is the great disruptor. It’s the ﬂoozy girlfriend of the midlife crisis male, bursting apart the entire happy family,” says the author of Wheat Belly. Really?
Because Oldways always grounds its work in solid science, we talk regularly to scientists, doctors, dietitians and others experts around the world. Today I want to share with you six important things you should know about what’s up with wheat, gluten and human health.
#1. Most of us can eat wheat just ﬁne. I’ll start at the conclusion: the world’s top gluten researchers and celiac doctors agree that there’s no reason that all of us should avoid gluten, the protein found in wheat, barley and rye that gives these grains their stretchy ability to turn into risen loaves. About 0.4-0.8% of us have a wheat allergy, around 1% of people have celiac disease (an auto-immune disorder to gluten that damages the intestinal lining), and another estimated 6% or so of people have something that’s been tentatively termed “non-celiac gluten sensitivity” (more on that later). It’s no small thing that as many as 8-10% of us may need to avoid gluten – but that does mean that 90% or more of us can enjoy a crusty fresh loaf of wheat bread.
#2. Celiac disease doesn’t always show up as digestive symptoms. “Celiac disease can present with many more symptoms than we ever thought possible,” according to Dr. Dan Leﬄer, director of research at Boston’s Celiac Center at BIDMC. Extra-intestinal symptoms like anemia, osteoporosis, and headaches may in fact be more common than gut troubles. Many people have no obvious symptoms and ﬁnd out they have the disease only when they get tested after learning a ﬁrst-degree relative has CD.
#3. Gluten levels in wheat have stayed steady. Wheat Belly’s author claims that modern wheat is toxic, GMO, and higher in gluten than wheat eaten before about 1950. Donald Kasarda, a USDA researcher, surveyed data going back to the beginning of the 20th century, and found that gluten levels in wheat have stayed pretty much the same for more than 100 years. Kasarda does note, however, that the use of vital wheat gluten as a food additive has increased three-fold in the last 15 years. (It’s also useful to note that none of the wheat in our food supply is GMO – something wheat farmers have fought against tooth and nail, as it would aﬀect their export markets.)
#4. Gluten-free diets aren’t much fun. Just because your favorite actress or athlete touts a gluten-free diet for weight loss or performance doesn’t make it so. While it’s possible to eat well on a gluten-free diet, most people who follow a GF diet actually gain weight, and are more apt to have deﬁciencies in nutrients including ﬁber, iron, calcium, and zinc. Recent research backs this up. Dr. Alessio Fasano, of the Center for Celiac Research and Treatment at MassGeneral Hospital for Children, shakes his head when speaking about those who go on a GF diet without proper diagnosis: “If you thought you had diabetes you wouldn’t self-diagnose and shoot yourself full of insulin every day just to see what would happen! Why do people put themselves on a gluten-free diet?”
#5. Maybe the gluten’s not to blame. While gluten is certainly a factor in celiac disease, many scientists presenting in Chicago questioned whether “non-celiac gluten sensitivity” is the right term for the larger group of people who have symptoms that lessen or disappear on a diet without wheat, barley and rye. Gluten may not be troubling these folks at all. A few of the possible culprits: certain enzyme deﬁciencies, other components of wheat (including a pest-resistance factor that has been bred to higher levels, and to which some people are sensitive), or “FODMAPS” an acronym for certain hard-to-digest sugars found in a wide range of foods (including wheat, barley and rye) that can cause gut problems for some people.
A September 2017 meta-analysis, combining data from 11 clinical trials, found that 70% of people thought to have non-celiac gluten sensitivity do not in fact show a relapse of symptoms when they unknowingly consume gluten, though this dropped slightly to 60% when a new broader deﬁnition of symptoms (the Salerno criteria) was applied.
#6. No one is born with celiac disease. As Dr. Fasano says, “People can avoid celiac disease for years. Why does tolerance then get replaced by celiac disease?” Many experts feel that the documented increase in sensitivity to gluten could be due more to changes in our gut than to changes in the wheat itself. It’s a fact that 30-40% of us have the genes that predispose us to celiac disease, but only 1% of the population ﬂips over into celiac disease. So what is causing more of us to lose our inborn tolerance for gluten?
Putting it all together
Gluten is in fact one of the most diﬃcult proteins to digest, but almost all of us have done just ﬁne digesting it for millennia, thank you very much. Now celiac disease and gluten sensitivity are rising, in tandem with the rise in other auto-immune diseases and allergies. Scientists we’ve talked with mentioned several factors that seem to increase our risk for celiac disease: Increased use of antibiotics, which wipe out good bacteria and bad in the gut. The rise in Caesarian deliveries, which bypass the mother’s usual transfer of bacteria to the baby. The hygiene hypothesis, which theorizes that our immune systems don’t develop properly anymore because our super-clean homes don’t give them enough early exercise. (Breastfeeding and time of introduction of gluten were also thought to be possible celiac risk factors for many years, but recent research has failed to show an association.)
All of these factors throw oﬀ the bacteria in our gut. Perhaps hard-to-digest gluten is simply the canary in the coal mine, alerting us that something’s gone seriously wrong in our gut ecology. (If gluten didn’t exist, the next-in-line hard-to-digest protein might be getting all the blame!) Rather than point a ﬁnger at the canary and say, “bad gluten” many scientists are suggesting we should take a hard look at what’s going wrong in the “coal mine” – the human gut.
Want to learn more? Check out Michael Pollan’s classic explanation of how the foods you eat inﬂuence your gut bacteria, and how your gut bacteria may inﬂuence the foods you eat! If we all eat a balanced, traditional diet of whole, minimally-processed foods, maybe we can safeguard our ability to digest gluten and enjoy the “most fundamentally satisfying of all foods” – bread.
Cynthia Harriman, Director of Food and Nutrition Strategies