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by Robert Keith Wallace, PhD, and Samantha Wallace

Modern medicine has verified that the following inflammatory diseases are linked to wheat (1-7):

  • Celiac disease (1% of US population)
  • Wheat allergies (0.4%)
  • Non-celiac gluten sensitivity or NCGS (6%).

Many gut health experts advocate a wheat free diet and the number of people who avoid wheat and other grains containing gluten is continually rising. The Gallup Poll estimates that as many as one in five Americans are experimenting with gluten-free products (8).

Not long ago, medical experts maintained that no clear evidence existed of wheat causing inflammation in anyone but celiac patients. Now the situation has changed, and an entire new disease category has been created to include a condition called “non-celiac gluten sensitivity.”

A great deal of what we now understand about the way wheat and gluten disrupt the digestive system is from the work of Dr. Alisso Fasano, one of world’s leading experts on celiac disease (9). Normally, the cells that line our small intestine are held together by tight junctions, which consist of specialized proteins that bind the cells as a rope might bind two pieces of wood. In their healthy state, the tight junctions only allow water and small particles to go from the gut into the body and bloodstream. Fasano showed that the gluten in wheat contains a short protein called gliadin, which is generally considered indigestible. In celiac patients, even a tiny amount of gliadin can trigger the condition known as “leaky gut.” How does this happen?

The gliadin fits into receptors on the surface of the intestinal cells and releases a chemical known as zonulin. Zonulin has the effect of dismantling the proteins that bind the tight junction, creating space between the cells. The barrier between the inside of the gut and the body is now breached, and larger molecules and even bacteria can enter the bloodstream (10). In celiac patients, the situation is greatly magnified, causing the tight junctions to remain open. This results in a chronic inflammatory response from the body. If a celiac patient continues to consume foods that contain gluten, the result will be a full blown autoimmune response, in which the immune system is so aggravated that it begins to attack normal tissues in the body. The only real solution is to stop eating wheat, barley, rye, and other grains containing gluten.

Celiac disease can have over 300 different symptoms, from mild to extreme. You could also have this disease, and be completely asymptomatic. The diagnostic testing is complicated. There are genetic and blood tests, but the definitive test is a biopsy of the small intestine (no small procedure). A simpler way to test it is to go off gluten for some time and then reintroduce it. In a person with full blown celiac disease, even the smallest amount of gluten triggers an immune response that damages the lining of the small intestine, resulting in symptoms from abdominal discomfort to seizures.

You can also be gluten sensitive and have many of the symptoms of celiac disease without having the disease itself. To make matters more complex, some studies show that people who are gluten sensitive, cross-react to other grains that contain gluten-like substances.

Gluten is not the only culprit in wheat that can cause inflammation. Wheat contains a family of proteins called amylase-trypsin inhibitors (ATIs). In plants, ATIs are useful proteins, which help in the development of seeds, and which protect the plant against certain parasites. When we consume ATIs in wheat, they can trigger chronic inflammation and worsen symptoms of rheumatoid arthritis, multiple sclerosis, asthma, lupus, and non-alcoholic fatty liver disease, as well as inflammatory bowel disease (11-15).

Civilization has thrived on wheat for a long time. So, why is the consumption of modern wheat now causing health problems? We know that the wheat we eat today is very different from that our ancestors: The creation of wheat flour involves extensive process before it reaches our grocery store shelf as bread. Modern wheat has been hybridized and is significantly altered, both physically and chemically. And there is also the issue of wheat being sprayed with glyphosate, the main ingredient in the herbicide Roundup. Glyphosate is primarily used on genetically modified glyphosate-resistant crops but may also be used as a desiccant to help dry wheat crops before they are harvested.

We must also consider the role of the microbiome. Recent studies indicate that many diseases are caused or exacerbated by a disruption of the gut bacteria, resulting in damage and inflammation within the intestinal cell lining. It is also known that undigested gliadin fragments can affect these intestinal cells, as well as alter the composition of bacteria in the gut. Studies suggest that gliadin can be broken down by bacteria in the gut, specifically by certain types of bifidobacterium, and some have even proposed that enzymes and probiotics might help in the digestion of gluten and gliadin. With each new finding, we become more aware of the complexity of the ecology of our gut and how important a full understanding of the microbiome is in our understanding of how wheat can cause inflammation (16-18).

A fascinating YouTube debate between Dr. David Perlmutter and Dr. John Douillard makes it clear why modern wheat is different and why it has the ability to disrupt our digestion. I found it especially interesting that both experts use scientific studies to back up their point of view. Dr. Douillard’s claim is that it is our digestion and the toxins we take in, which is the problem. He admits that most people can’t digest wheat very well, but he is against telling everyone to switch to a gluten-free diet. Dr. Perlmutter agrees that improving digestion and getting rid of toxins is good for everyone, but he advocates going on a gluten-free diet, for the simple reason that most people have a problem digesting it (19-20).

https://www.youtube.com/watch?v=97QtIsMTmW0

America is in the middle of the Diet Wars, and there are many hotly debated issues. Do we choose a Mediterranean diet as many nutritionists recommend, or should we switch to a Paleo, Vegan, or Ketogenic diet?

In our personal journey of self-discovery, it is up to each of us to learn what is best for our own digestive system. Certainly, it is our extremely good fortunate to have the time-tested wisdom of Ayurveda to help guide us on this journey.

 

References

  1. Leonard MM et al., Celiac Disease and Nonceliac Gluten Sensitivity: A Review. JAMA. 2017 Aug 15;318(7):647-656
  2. Fasano A et al. Nonceliac gluten and wheat sensitivity. Gastroenterology 2015;148(6):1195-204.
  3. Catassi C, et al. Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts’ Criteria. Nutrients. 2015;7(6):4966-4977.
  4. Catassi C et al., The Overlapping Area of Non-Celiac Gluten Sensitivity (NCGS) and Wheat-Sensitive Irritable Bowel Syndrome (IBS): An Update. Nutrients. 2017 Nov; 9(11): 1268.
  5. Dalla Pellegrina C et al., Effects of wheat germ agglutinin on human gastrointestinal epithelium:  insights  experimental model of immune/epithelial cell interaction. Toxicol Appl Pharmacol. 2009 Jun 1;237(2):146-53.
  6. Rubio-Tapia A et al., Increased prevalence and mortality in undiagnosed celiac disease. Gastroenterology. 2009 Jul;137(1):88-93.
  7. Ludvigsson JF et al., Small-intestinal histopathology and mortality risk in celiac disease. JAMA. 2009 Sep 16;302(11):1171-8.
  8. http://news.gallup.com/poll/184307/one-five-americans-include-gluten-free-foods-diet.aspx
  9. Fasano A. Physiological, pathological, and therapeutic implications of zonulin-mediated intestinal barrier modulation: living life on the edge of the wall. Am J Pathol. 2008 Nov;173(5):1243-52.
  10. Hollon J et al., Effect of gliadin on permeability of intestinal biopsy explants from celiac disease patients and patients with non-celiac gluten sensitivity. Nutrients. 2015 Feb 27;7(3):1565-76.
  11. Zevallos VF et al., Nutritional Wheat Amylase-Trypsin Inhibitors Promote Intestinal Inflammation via Activation of Myeloid Cells. Gastroenterology. 2017 Apr;152(5):1100-1113.e12.
  12. Schuppan D and Zevallos V, Wheat amylase trypsin inhibitors as nutritional activators of innate immunity. Dig Dis. 2015;33(2):260-3.
  13. Schuppan D et al. Non-celiac wheat sensitivity: Differential diagnosis, triggers and implications. Best Pract Res Clin Gastroenterol 2015;29(3):469-76.
  14. Junker Y et al. Wheat amylase trypsin inhibitors drive intestinal inflammation via activation of toll-like receptor 4. J Exp Med 2012;209(13):2395-408.
  15. Saja K et al., Activation dependent expression of MMPs in peripheral blood mononuclear cells involves protein kinase A. Mol Cell Biochem. 2007 Feb;296(1-2):185-92.
  16. Cinova J, et al. Role of Intestinal Bacteria in Gliadin-Induced Changes in Intestinal Mucosa: Study in Germ-Free Rats. Leulier F, ed. PLoS ONE. 2011;6(1):e16169. doi:10.1371/journal.pone.0016169.
  17. Laparra JM & Sanz Y (2010) Bifidobacteria inhibit the inflammatory response induced by gliadins in intestinal epithelial cells via modifications of toxic peptide generation during digestion. J Cell Biochem 109: 801–7
  18. Martin Fernandez-Feo, Guoxian Wei, Gabriel Blumenkranz, Floyd E. Dewhirst, Detlef Schuppan, Frank G. Oppenheim and Eva J. Helmerhorst. The Cultivable Human Oral Gluten-Degrading Microbiome and its Potential Implications in Celiac Disease and Gluten Sensitivity. Clin Microbiol Infect. 2013 Sep; 19(9): E386–E394.
  19. Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar–Your Brain’s Silent Killers by Dr. David Perlmutter, Little, Brown and Company; 1 edition (September 17, 2013)
  20. Eat Wheat: A Scientific and Clinically-Proven Approach to Safely Bringing Wheat and Dairy Back Into Your Diet by Dr. John Douillard, Morgan James Publishing (January 10, 2017)

ROBERT KEITH WALLACE is a pioneering researcher on the physiology of consciousness. His work has inspired hundreds of studies on the benefits of meditation and other mind-body techniques, and his findings have been published in Science, American Journal of Physiology, and Scientific American. After receiving his BS in physics and his PhD in physiology from UCLA, he conducted postgraduate research at Harvard University.

Dr. Wallace serves as Professor and Chairman of the Department of Physiology and Health, Director of Research, and Trustee of Maharishi University of Management (MUM) in Fairfield, Iowa. He helped create the first fully accredited Masters of Science degree in Maharishi AyurVeda and Integrative Medicine in the US.

Dr. Wallace is the author of several books, including Gut Crisis: How Diet, Probiotics, and Friendly Bacteria Help You Lose Weight and Heal Your Body and Mind with his wife Samantha Wallace.

SAMANTHA JONES WALLACE is a former model, featured in Vogue, Cosmopolitan, and Look Magazine. A lifelong practitioner of Transcendental Meditation, she has a deep understanding of Ayurveda and its relationship to health and wellbeing.

The coauthor of Quantum Golf, Samantha is an editor of Dharma Parenting, and coauthor of Gut Crisis. She is finishing a book called Real Deep True Beauty, which emphasizes Essential Oil Skincare, and Ayurveda.