Gut health: When should you go gluten-free?

What is gluten, and why might it affect my gut?

Gluten is one of the proteins found in cereal grains such as wheat, barley, and rye. It's a sticky protein, helping to give bread that stretchy and deliciously bouncy texture. Historically, gluten has formed a large part of the Western diet, in bread, pasta, cakes, and biscuits. However, growing research is showing that gluten can negatively affect the gut and the health of not just people with coeliac disease. This research alludes to a rise in the condition we now know as non-coeliac gluten intolerance.¹

Coeliac disease is a lifelong autoimmune condition where the small intestine becomes inflamed and unable to absorb nutrients, triggered by a reaction to gluten. The condition suggests that gluten needs to be 100% avoided for life. However, the strength of reaction to gluten can vary hugely in different people with the disease. Whilst some may not notice an immediate reaction to being 'gluten-ised', there are other coeliacs who know about it immediately. Symptoms can range from instant vomiting and gut pain to diarrhoea and extreme tiredness. In this instance, it's commonly considered that going gluten-free is the first step in managing this condition.²

What about those who are not coeliac?

In those with non-coeliac gluten intolerance, symptoms similar to coeliac disease are extremely common with altered bowel movement, bloating, wind, discomfort, and malabsorption often experienced.³ Some people may also suffer symptoms outside of the gut, including skin problems, behavioural difficulties, fatigue, headaches, and migraines.

But, why is it that gluten is causing a reaction in these people? Well, we do know that this little protein can increase intestinal permeability. This means that the tight junctions in between the gut cells that line the digestive tract can become looser, allowing large particles such as toxins, undigested food, and pathogenic organisms to cross the gut barrier and enter into circulation. Research has shown gluten can increase zonulin release, which is a substance that can activate gut permeability; loosening the tight junctions in the gut wall.⁴

Usually, these tight junctions only allow specific substances to pass through, such as properly broken down macro and micronutrients from our diet. However, when the gut becomes more permeable, larger particles may cross through the gut wall - potentially causing a variety of symptoms and health problems, including food intolerances.

Given that so many of us eat a lot of gluten, the leaky gut connection could help to explain why so many of us are becoming intolerant to it. If you do have increased gut permeability, this can also trigger an increase in inflammation in the gut wall, which may cause symptoms outside of the gut as well as within the digestive system.

For example, research has suggested that there are many different health problems associated with increased intestinal permeability, including poor skin health, thyroid conditions, IBS and altered bowel movements, joint aches and pains, headaches, and neurological symptoms such as depression and anxiety.⁵

Research is also linking gut permeability to an increased risk of autoimmune diseases, whereby the body starts reacting to its own cells and sees them as an immunological threat.⁶ Autoimmune diseases can affect every part of the body, including the thyroid (Hashimoto's and Graves disease), joints (rheumatoid arthritis) and the skin, in conditions such as psoriasis and eczema.

There is even a strong body of evidence pointing to leaky gut syndrome as a major underlying cause of Type 1 Diabetes. These are chronic autoimmune conditions, which can have a major impact on a person's life both psychologically and physiologically. As such, we should be understanding all we can about gut health and its role in prevention and overall health and wellbeing. Doing so begins with understanding exactly what it is our bodies are reacting to; should you be feeling unwell.

Is it just the gluten I'm reacting to?

Whilst leaky gut is commonly exacerbated by gluten, it's important to remember that, for some people, they may not be reacting to just the gluten in cereal products. For example, bread contains high levels of wheat, and whilst wheat is high in gluten, there are also those who may have a wheat allergy or be reacting to other proteins in the grain, aside from just the gluten.

Bread absorbs a lot of water, and whilst you may not be having an immune reaction to the gluten or even be experiencing problems with leaky gut, it may simply be that having too much bread in your diet leaves you feeling bloated, uncomfortable, and potentially constipated. In this case, it may be worth experimenting with simply reducing the amount of bread you consume. Testing and learning is a path we must all go down when it comes to optimising gut health: you just need to find what works best for you.

How do I go on a gluten-free diet?

If you love your bread, pasta, cakes, and pastries, then the thought of going on a gluten-free diet might seem scary. However, it's much easier these days to achieve given the huge variety of alternative grains and gluten-free products on offer. Just remember that simply because something is gluten-free doesn't mean it's healthy! A gluten-free cake is still full of sugar and often very refined white carbs, which aren't good for your gut health either if eaten regularly and in large quantities.

It's possible to eat a healthy gluten-free diet in a way that won't break the bank or mean you're feeling super stressed trying to cook alternatives. If you want to experiment with going completely gluten-free, then here are some first steps to consider.

1. Choose naturally unrefined gluten-free grains and carbohydrates such as quinoa, brown rice, potatoes and sweet potatoes, nut flour products, and brown rice pasta.
2. Avoid very refined and processed gluten-free products -look for foods which contain just a few natural ingredients. Also avoid products high in corn or maize starch, as these are fast-releasing and may also negatively affect your gut health and microflora balance. Good products to look out for include:
3. If you're diagnosed as coeliac then you should avoid gluten for life. If you aren't coeliac and want to trial going gluten-free, then choose a period of at least 2 to 3 weeks to exclude gluten completely. This is usually enough time to establish whether it makes any difference to any symptoms you're experiencing. However, if you have an autoimmune condition, then it's generally advised by functional practitioners to support the health of your gut as a priority. In certain cases, this can mean avoiding gluten for life, but at the end of the day, you need to work out what works best for you and what makes you feel good.

If you'd like to read more about the benefits of keeping a healthy gut, as well as find more information on how you can promote good gut health, select Digestion from the Your health menu above.