In the past decade nutrition has become a bun fight. Every day there is a new battle to be fought, and you need to pick a side. Is fat good or bad? Is cholesterol dangerous, or not? Paleo or vegan? Yet few battles compare to the war over wheat. Sufferers of a panoply of complaints, ranging from depression to thyroiditis, pin their symptoms on wheat despite their doctors' doubts. Their claims have spawned a multi-million dollar ‘gluten-free’ industry, but they hold no water with the public-opinion mob. Time and time again it is argued that the science shows that unless you have celiac disease or an allergy, gluten is a good nutritious food and a gluten-free diet will do you more harm than good. Science, however, is always evolving. Every day we add to the knowledge that came before, and its quite possible for the public opinion mob to fall behind. What does the most recent science really say about wheat and our health?
The Seeds of Civilisation
Let’s start by giving wheat it’s due. I wouldn’t be sitting writing this article on my laptop if wheat were not part of the human diet. 10 000 years BC, the future of humankind was decided when an innovative Mesopotamian decided to not just harvest and eat the seeds of the indigenous grains, but to plant them too. In the ‘Fertile Crescent’ of present day Iran, Emmer and Einkorn wheat grasses were among the first cultivated human crops. The grains they produced could be stored and stockpiled, and were nutritious enough to sustain a population for a long time, even when other foods ran short. For the first time in human history, we could plan for a future without fear of starvation. Soon, other crops and animals were domesticated, and humans were liberated from the evolutionary constraints that hold other species forever enslaved to the availability of resources. Wheat began the cascade of events that allowed humans to settle, civilize and innovate.
We owe wheat and those first farmers an enormous debt of gratitude, but that doesn’t mean that the transition to a wheat-heavy diet was benign. Anthropological evidence suggests that the transition from a paleolithic diet to one dominated by grains significantly weakened human bone structure, leading to an abrupt increase in bone and dental pathologies in the archaeological record. In fact, it's hypothesized that you can blame your kid’s orthodontic bill on that ambitious Mesopotamian and his seeds.
None-the-less, there is no doubt that the domestication of wheat provided the foundation for human progress and culture. It was certainly tolerated well enough through history not to diminish our ability to survive and thrive. So why does it stand accused of doing us harm today?
Modern Wheat
We can thank Gregor Mendel for the fast-growing, high-yield, extra-white wheat crops we produce today. The discovery of selective breeding and genetic modification in the 1860’s revolutionized agriculture, and allowed us to produce ultra-efficient crops that are very different from the ancient grains they descend from. Strains were carefully selected for ease of cultivation and harvest, but not necessarily for nutritional value. Several studies have suggested that our modern wheat has lost some of its goodness and gained unwanted qualities through centuries of selection, but others argue that these changes are inconsistent and of relatively minor consequence to health. It remains unclear whether ancient grains cause fewer adverse health effects than modern variants.
Perhaps more important was the transformation of how we process wheat. Ancient grains were stone ground, leaving much of the nutritional structures intact and tempering wheat's more reactive elements with roughage. Today’s wheat is mechanically ground in industrial mills to a far finer powder that is 70-80% poorer in vitamins than the original kernel. What we lost in vitamins, minerals and fibre, milling made up for in starch. Finely milled flour is considerably more starchy than stone ground flour, meaning that modern wheat flour contributes more calories to our diet and affects our blood sugar more than the bread our great grandparents ate. Research suggests that milling may also concentrate immunoreactive elements in the wheat, including proteins like gluten. Many commercial bakers actually add supplemental gluten , known as Vital Gluten, to their flours to enhance its elastic properties for better baking.
Its not just the gluten content in modern flours that has changed. Several frequently used additives to commercial flour have been found to cause or aggravate intestinal damage and wheat allergenicity. Sugar, salt, emulsifiers, surfactants, organic solvents, microbial enzymes and nanoparticles are all found in ever-increasing amounts in commercial wheat products. This means that the bread you eat today is nothing like the bread your grandfather ate every day until he died at 90. We have no idea what the long term health consequences of the plethora of additives will be on long term health. We have, however, gained several insights into the effects of one of wheat's most demonized ingredients: gluten.
What’s so bad about gluten?
Gluten is the miracle protein that makes dough elastic and gives baked wheat products their light, fluffy and delicious properties, but it has become a curse word in health conscious circles. The scientific community has long criticized the gluten-free movement of being no more than an unscientific health fad, but an increasing amount of literature is stacking up on the side of gluten-skeptics.
Zonulin
Your gut lining is like a border post. It has the difficult job of transporting the nutrients it wants from your food into your bloodstream, whilst keeping the bacteria, viruses, toxins and other undesirables out. Some nutrients are escorted directly through the cells of the gut lining by highly specific membrane receptors and transport proteins, but larger molecules must pass between the cells. To do this, the Tight Junctions (TJs) that keep cells firmly locked together must be loosened through a process regulated by a recently discovered protein called zonulin. Zonulin allows the membrane to become momentarily permeable, so that important macromolecules can pass through. In some genetically predisposed individuals, dietary triggers can cause more zonulin than usual to be produced, prompting too many TJs to open up. Like a hosepipe full of holes, the gut lining becomes 'leaky', and allows unwanted molecules to enter the blood. Recent research has discovered that gliadin, a constituent of gluten, activates zonulin and promotes intestinal permeability in all individuals. For most of us, the effect is mild and fleeting, but for the genetically unlucky, including those with celiac disease, it can be dramatic.
New studies show that wheat may further compromise gut barrier integrity by diminishing the microbial populations that promote and protect its mucous lining, such as Akkermansia muciniphila. With the tight junctions compromised and the mucous lining eroded, there’s little to prevent unwanted particles from the gut contents entering the bloodstream. Immune cells recognize these fragments as foreign and trigger inflammation and the formation of antibodies. Antibodies act like flags that tell the immune system what to attack. If a foreign protein that looks similar to a human protein sneaks across the gut barrier, those antibodies may accidentally bind to human tissues that contain that protein. The immune system attacks the antibody-marked tissues, and autoimmunity ensues. Certain wheat proteins contain regions that closely resemble proteins found in human tissues. If they get across the gut barrier, these molecular mimics may be key players in the development of autoimmune conditions such as Hashimoto's thyroiditis.
A 2013 review concluded that wheat could cause an elevated immune response and inflammation even in non-celiac patients, so why don't all wheat-lovers have autoimmune conditions? In a Q&A for the medical journal Integrative Medicine, World renowned autoimmunity expert Allessio Fasano suggested that for an autoimmune syndrome to manifest, five factors play a role: genetic susceptibility, immune triggers, gut permeability, microbiome composition and the health of the immune system. Dozens of factors may interact to create the perfect storm of autoimmunity, but we can no longer deny that wheat-associated gut permeability can be one of them. Increasing numbers of experts are proposing gluten-free diets as part of the treatment protocol for Hashimoto’s thyroiditis, Type 1 Diabetes and multiple sclerosis, among other autoimmune conditions.
What about the rest of us?
We have established that those with autoimmune symptoms have a case against wheat, but what about the claims that wheat may be the villain behind depression, mood disorders, ADHD, autism, diarrhea, constipation, bloating, gut pain, headaches, chronic fatigue, joint pain, allergies and brain fog. It seems an unlikely rap sheet for a single food, yet remarkably studies have revealed that there is a sub-population of patients across this spectrum of symptoms for whom wheat does seem to be a culprit. These individuals vastly improve when they drop wheat from their diet, despite being negative for celiac and allergy. They have termed the condition Non-Celiac Wheat Sensitvity (NCWS), but the definition is fuzzy, and there is no official way to test for it other than observing improvement on a gluten-free diet. A raft of wheat components have been implicated in NCWS.
FODMAP is an acronym that describes fermentable carbohydrates that are indigestible by humans, but fermented enthusiastically by our gut microbes, causing symptoms of gas, bloating, gut pain and constipation or diarrhea. The fructans in wheat act as FODMAPs, and they have been blamed for wheat's association with the symptoms of IBS. Amylase trypsin inhibitors (ATIs), a group of defensive enzymes found in wheat kernels that naturally defend them against parasites, have been found to ramp up inflammation in the gut. Wheat Germ Agglutinin (WGA), also a defensive molecule from a group known as lectins, is an ‘anti-nutrient’ that binds other metabolically active proteins and disables them. These compounds, in combination with zonulin-promoting gluten, act together to compromise the gut lining and increase intestinal inflammation. There is evidence that like the autoimmune patients, NCWS patients experience elevated gut permeability when they eat wheat, though to a less extreme extent than their celiac or autoimmune counterparts. While the subject remains much debated, it is hypothesised that increased intestinal permeability may underlie many of the diverse symptoms associated with wheat consumption.
What does this mean for croissants?
For many people, the dose may make the poison with wheat. If you don't suffer from chronic illness, simply reducing wheat intake would be a safe strategy to protect your gut health and blood sugar balance. Bear in mind that as you age, your intestinal lining ages too, and your susceptibility to intestinal permeability may not be the same at 50 as it was at 20. There are safer wheat options to choose from: stone-ground artisanal flours appear to be less reactive than industrially-milled additive-laden flours, and sprouted or fermented wheat products seem to cause fewer symptoms.
For those that do suffer from chronic conditions, remember that almost all ailments are multifactorial, and each person has their own unique health picture. There is no one size fits all solution, but reducing or eliminating wheat may certainly be part of the solution for many. It's worth knowing if it's part of the answer for you, and the only way to know that is to remove it from your diet and see if your health picture changes.
If you do go gluten-free, do so carefully. Removing a staple food from your diet comes with the risk of introducing micronutrient deficiencies. There are dozens of gluten free alternative flours to try, and a booming industry of gluten-free baked goods. Gluten-free does not mean problem-free however, and its worth doing your research on the pro's and con's of the many gluten-free options. If you are not confident that you can cover your nutritional bases, enlist the help of an expert nutritionist or health coach. In the end, its your health journey, and you get to choose where it goes.
