Is gluten bad? | Is going "gluten free" a fad?

gluten is the new dietary enemy more and more people are swearing off wheat and grains in pursuit of better health there's a lot of information on the Internet lots of books lots of media out there saying how good and free diet can make you healthy what we've really seen in the last few years is the rise of celebrity endorsements of the gluten-free diet some experts say humans didn't evolve to digest gluten or the 2.5 million years of evolution 99.9% our species being gluten free there are claims the gluten-free diet here was a wide range of conditions like depression arthritis even autism but this has some dieticians concerned people are going on gluten-free diets to lose weight or to increase their health when in actual fact they're doing the opposite in this special investigation I cut through the hype of the gluten-free diet should we all get on board or is it just another fad this is Australia's wheat belt the food bowl of our nation and the heartland of a multi-billion dollar industry Craig Neal has been farming wheat in Narrabri for decades he says it's now the most widely grown crop in the Western world wheat is one of the staple foods that is incorporated into so many of the varieties of foods that we eat today it's also the main source of gluten in our diet bread pasta cereal and pastries these products of wheat make up 20% of the calories we eat my whole life I've been involved in the grain industry and I've seen a dramatic transition in the eating style and eating habits of a consumer over that period around 10% of Ozzie's are now steering clear of gluten cafes and restaurants have moved swiftly to cater for the new clientele and it's here at Melbourne's gluten-free Expo that you get a real sense of just how popular the gluten-free diet has become this is our ninth year at the gluten-free Expo we supply gluten-free pizza bases throughout Australia today we bought a range of our gluten-free breads our buckwheat Machir our quinoa and soya Brad's or baked fresh sweet right 9b is it so instead of you eating wheat barley we use sorghum we've grown year-on-year every year 20 to 30 percent so with all the hype around gluten what actually is it this is pure gluten it doesn't have much flavor and in fact it has very little nutritional value but you add water and its unique properties come to light gluten is a protein made up of two molecules glutenin and gliadin which form an elastic bond in the presence of water now gluten is what makes dough sticky and flexible and while it's found naturally in wheat and other grains Baker's often add extra gluten to bread to give it that spongy texture essentially gluten is a very important protein for food texture and taste it traps carbon dioxide so makes bread fluffy it allows pizza dough to be 12 around and gives it that kind of elasticity it just so happens though that parts of gluten may be toxic to the immune system in people with celiac disease gastroenterologist dr. Jason tied-in says even the tiniest amount of gluten can be toxic to someone with celiac disease it triggers an abnormal immune response that leads to damage to a variety of organs this includes the bowel this also includes the skin the joints the bones the nervous system the liver it's a very systemic condition about 1 in 70 Australians like Kirsty have celiac disease my first symptoms of celiac disease probably began about 5 years ago I had a lot of symptoms like bloating the diarrhea joint pain fatigue dermatitis but I didn't actually realize it wasn't normal until my doctor four years later sent me for a blood test to check for celiac disease which came back positive Kirsty is now meticulous about removing gluten from her diet I find at home it's easy because I have all my safe food it's more expensive but I don't have to stress I find eating out at restaurants and cafes or at family or friends houses is quite difficult because I have to worry about not only did they use gluten-free flour but did they use a separate chopping board did they use a separate toaster did they wash the utensils do they use a separate deep-fryer that can be really stressful can make a hard eating out Kirsti says that people who needlessly request gluten-free meals and restaurants might diminish the seriousness of celiac disease people may order a gluten free lunch them out of gluten-free salads and then they order the normal cake or they order a beer with it and so are the restaurant staff think we can do that too and they don't understand that we can't have any gluten at all even just one or two crumbs or obviously leave me sick with all my symptoms gluten unleashes its damaging effects in the small intestine so these actually sections of the small intestine under the microscope on the left here you can see a normal healthy small bowel what you can appreciate our finger-like projections which we call villi now the villi are really important in increasing the surface area of the bow and allowing nutrients to be absorbed properly on the right here's a slide from somebody with celiac disease and what happens is that you get a lot of immune cells causing inflammation to the area and this expands the tissue up and effectively obliterates the villi so this lack of surface area obviously results in some kind of malabsorption of nutrients exactly so this can lead to iron and other vitamin deficiencies is this damage reversible yes it is so for persons diagnosed and treated with the gluten-free diet this villous atrophy or the damage here can completely return to normal so is it just people with celiac disease who should be avoiding gluten one of the world's leaders in the field of gluten research is italian-born professor Alessio Fasano he's a pediatric gastroenterologist at Massachusetts General Hospital in the u.s. we as a species we are not engineered to eat wheat because for the 2.5 million years of evolution 99.9 percent our species been gluten free good and came into the picture only 10,000 years ago with the event of Agriculture as a result the human gut reacts to gluten as if it's a foreign invader and mounts an immune response against it we didn't know the details of why gluttonous toxin until the recent past when scientists world war starts really look at this undigestible fragment of gluten and to our major surprise gluten is perceived by our immune system as a component of a bacterium or a virus and unleash the same weaponry that we use when we're under attack by an infection as gluten enters the small intestine it's recognized as foreign and an immune reaction causes local inflammation in the gut this occurs because humans haven't evolved with the right machinery to digest it properly luden cannot be completely dismantled because we don't have the scissors ie the enzymes to cut in pieces and that peel off the single amino acids so if humans can't digest gluten properly does that mean we should all give it up not so fast says professor Fasano the vast majority of people can deal with that and clean this problem we down any clinical consequences but in some people gluten may actually play a role in the development of autoimmune diseases like arthritis lupus and she Moto's disease in 2000 professor for Sano's team made a remarkable discovery his lab showed that gluten could stimulate a molecule in the gut called Sonia llem zhanlin is a protein that has the capability to modulate the permeability of the guts regardless of whether or not someone has celiac disease when they ingest wheat the gliadin portion of gluten stimulates the release of zhanlin which in turn opens the junctions between cells in the gut lining this theoretically makes the intestine leaky intestine has the important task to create a barrier to be extremely discriminatory who comes in and who stays out the leaky gut syndrome or the leaky gut situation is a situation which you lost this capability of control this is purported to allow macromolecules to leak from the bow and increase inflammation and the risk of autoimmune diseases this is a controversial area of science because the evidence is scant while some predict this discovery will earn Fasano a Nobel Prize others in the medical fraternity remain skeptical because there's no medical pest to validate leaky gut syndrome still today classical immunologists we'll have our time to accept the concept that is only by modifying antigen trafficking can have such a role in a variety of diseases that span again from cancer to autoimmune diseases so the burning question at the moment is why do so many people who don't have celiac disease whose the benefits of a gluten free diet is it real or is it imagined in the past we and I put myself in there made the rule that if you have a problem with gluten there must be senior disease and this CD disease was ruled out you had no business whatsoever to be gluten-free over the years particularly that past four or five years we learn that actually that's not the case there are many people they feel miserable when they eat good of containing food without being celiac it's now being referred to as non-celiac gluten sensitivity so non-celiac gluten sensitivity is the term used to describe people who believe that gluten makes them unwell makes them sick but that they've had celiac disease appropriately excluded while it's still controversial dr. tied-in says it's gaining acceptance among medical researchers this is an area where personal experience and anecdote really Trump's the medical evidence that's emerged and when people feel better going gluten-free it's a very compelling argument that it's actually helping them many people when they go gluten-free report that their tummy upset has settled down they have better energy levels mouth ulcers disappear their aches and pains have gone and often that they've lost some weight sometimes parents of children with autism will find that the gluten-free diet may help their behavior or patients who have other autoimmune disease might find it helps with their joints but when you look at actual controlled studies of which they're being very few that kind of benefit hasn't been borne out so I don't want to say that there's no benefit we just haven't yet been able to conduct the studies to show that with good scientific proof that it's happening dr. tied-in says research into other components of wheat may provide the answers what we see here is the structure of a wheat kernel and you can see the major protein is obviously gluten and this is responsible for celiac disease in some cases of wheat allergy but what's striking is that there's a whole range of other proteins as well as carbohydrates so for instance albumins and globulin zhh have been causes of wheat allergy and these amylase trypsin inhibitors are now being implicated in causing inflammation in the intestine and might be potentially our basis for some wheat sensitivity and some certainly studies are underway so it's quite likely that someone who thinks they're gluten intolerant might not be there actually intolerant to other things in wheat exactly right so what we're seeing is that there's not just gluten there's a lot of these other proteins and also the carbohydrate components particularly the Frog downs and when people go wheat free that's very possible that much of the gluten sensitivity problem is related to these other non gluten components the Frog hands are part of a group of carbohydrates called FODMAPs professor peter Gibson from Monash University is the world leader in fodmap research FODMAPs is an acronym which stands for fermentable oligo dye and monosaccharides and polyols and what it does is describes a group of largely sugars which are poorly absorbed from our small intestine or they're totally under Jesta ball in the gut FODMAPs draw water into the bowel and ferment on bacteria causing gas the wall of the bow tends to stretch more and that's an important stimulus for the nervous system in the gut so that if you've got a sensitive bowel you've got irritable bowel syndrome then this will cause sensations of bloating pain and you'll get secondary changes in how the bowels work in my kid diarrhea you might get constipation you might get an alternating type pelvic normally FODMAPs are beneficial for gut bacteria but not for people who are sensitive to them FODMAPs are not only found in wheat staples like bread rye pasta and grains they're also found at high levels in garlic onions and artichokes and fruit like apples mangoes and watermelon the good thing is we find the foods which are low in FODMAPs which you can replace so instead of having apples and pears you can have strawberries or kiwi fruit and then there are the legumes most people understand when you talk about leggings I understand the effects of tin of baked beans on the Bell many of the foods that you mentioned that contained food maps are eliminated in the Paleo diet do you think that's why many people find they improve their well-being on the Paleo diet whenever you modify your carbohydrate intake particularly you are likely to producing FODMAPs so I think you're correct in that the that some of the improvement of people experience with the Paleo diet will be due to that the problem with the Paleo diet is that you're so restricting a whole lot of other things which are unnecessary and they're not sustainable Joshua has had tummy upsets as well as behavioral issues since he was a child my parents have been really supportive they started taking me to pediatricians since I was 2 trying to find out why had some of the issues that I did oh thank you I had quite severe ADHD and I had headaches and other issues like that Joshua's doctors suspected it could be something dietary related not knowing whether he was intolerant to gluten or FODMAPs Joshua was put on a gluten-free diet his gut problems and his ADHD symptoms improved dramatically Joshua assumed that he had celiac disease but never had a definitive diagnosis when I was 18 and went off to university I decided to go off my diet and eat whatever and I got really sick just feeling so bad really bloated really sluggish just feeling really unwell and then I went back on to my diet really strictly and so I went totally off of gluten and I thought oh I'm feeling heaps better maybe I'm celiac maybe I shouldn't talk to my GP about this testing for celiac disease while you're still on a gluten-free diet is problematic dr. tied-in says it often gives false negative results one of the biggest problems I see in my clinic are patients coming in who have already started a gluten-free diet who feel better but then realize they should be tested for celiac disease because they appreciate that it has important medical implications and then I'll have to tell them well we can't actually test you with the blood test because it won't become positive even if you do have celiac disease because you're gluten free one way to confirm a diagnosis of celiac disease is to have a genetic test so Joshua decided that he should find out once and for all he gets the results in a week an emerging theory that might explain the rapid rise of gluten intolerance nowadays is the way in which bread is baked the process of Panna fication the process of modification in the past was an overnight process in which you take the flour you put the water you put east in there and then for 1618 hours you have this dough growing this overnight process would allow enzymes from the yeast to effectively break down the gluten the process we're not capable of doing ourselves because we humans lack those enzymes but bread making techniques have changed what used to be an overnight process now only takes about two hours now during these two hours what you have is the enzyme we're not able to completely dismantle the toxic element of gluten and therefore even if we eat the same kind of wheat we have an increased amount of toxic component gruel that we ingest because of the fact that not being dismantled during the Panna fication wheat farmer Craig has another theory he believes the rise of gluten intolerance has more to do with the modern techniques of processing wheat he says the current methods of milling wheat may contribute to gut problem it's a very highly refined process the endosperm and the starch I milled down and all the other ingredients within the grain are extracted and then they're added back in at whatever ratio proportion the end product requires this modern processing produces high volumes at lower cost and is commonly used for the mass production of the sliced white bread that you find in supermarkets that's why Craig now processes more of his week through a stone mill instead of a roller mill the whole grain goes into the stone mill and it is ground into flour in one process and the flour comes out the other side it is a very simple process and there is no distractions in nutrition or deterioration of the brain through that process Craig says the demand for this type of wheat is increasing while it still contains gluten he says there's no harsh chemical processing and he thinks people might mistakenly blame gluten for their gut problems when it's likely to be their sensitivity to the chemicals used to process the wheat we don't bleach it we don't extract any of the brain or the wheat germ there is absolutely no chemicals added to any of the products that we process and that just gives us the comfort of supplying the end-user foodstuff that is 100% nutritional to the highest level this type of less refined flour may be used by artisan Baker's for making sourdough which is popular with health-conscious consumers now that more and more Australians are cutting gluten from their diet our supermarket shelves are increasingly being stocked with gluten-free products this is the typical range of products available to those looking for gluten substitutes that's so good for my clients with celiac disease because I've got so much more variety than they used to have when I started practicing but even those people without celiac disease often think we're freeze healthier well it's funny you know they're all here in the health food aisle but they're not necessarily healthier and in fact what you find that if you grab something like the pancake mix if we compare the standard pancake mix here per 100 grand we're looking at about 840 kilojoules so this one's close to 1400 kilojoules so what's the double yes I often when they removed the gluten and they have to add in additional fat and sugar to make it more palatable yeah so gluten free not always healthier definitely not dietician Melanie McGrath says people without celiac disease who insist on going gluten-free put their health at risk research shows that people who follow a gluten-free diet are at higher risk of nutritional deficiencies particularly fiber and B vitamins but also magnesium calcium and bian there's also research to show that it can have an impact on the microbiome as well so I think that there is a lot of confusion that the gluten-free diet is healthier when in fact it's not but Fasano says it all depends on how you go gluten-free if you intend to go naturally gluten-free so you don't use any substitutes so you eat only fresh fruits fresh vegetable meat fish nuts what you do is to embrace the diet that our species of all with and you can lose weight and you're going to feel great but if you are talking about a gluten-free diet in which you indulge with gluten-free pasta and cookies and cakes and bread and beer you will come back to my clinic as many people will see the disease they do complaining that they gain 20 pounds since I saw them the previous time why because you substitute gluten with fat and sugar people really need to work at making sure they get an adequate balance of vitamins and nutrients and fiber in their diet and at the end of the day a gluten-free cake is still a cake the my key message would be that if you don't need a gluten-free diet you don't need to bother but instead focus on having a whole food less processed diet and you'll still get the same health benefits Joshua is returning to the doctor with his wife Carmen to receive his gene test results look the last time we chatted we talked about the fact that going on a gluten-free diet seemed to at least partly help some of your symptoms so we've gone ahead and done the gene test and I have the result with us today um hey feeling about things business hey yeah I've actually got some really good news for you your gene tests has come back as shown you don't have the genes that gives us if to believe the co-actors a great result uh Wow so this tells us that your susceptibility for celiac disease is very low and that the likelihood of the conditions less than 1% yeah oh yeah real close off being cleared for celiac disease means that Joshua doesn't have to be as meticulous about his diet he will still reduce his FODMAPs but doesn't have to worry about a strict gluten-free diet like someone with celiac disease loaf owner does very different to gluten free diet good and free diet means you've got to be a detective and you've got to find out where gluten is and everything you do eat and everything you cook you can't cook chips in a fat which had the fish batter in it because there might be gluten in it low fodmap diet is just reducing the total amount of FODMAPs that you eat so they're much easier to do cuz it gives you a lot bigger choice and you don't have to be a walking detective I was fantastic to speak to Josh and particularly with these really good results well now we can say at least that the gluten that he believes was triggering symptoms is not true to celiac disease I guess sometimes desires that fear in the back of your mind that if it is celiacs there are serious medical consequences of having that and just really relieved that I don't have those and I don't have to be on a strict strict diet probably can afford to be a little bit more luxe with some of the dietary restrictions and not be too concerned if there's a little bit of pollution here and there yeah it's really exciting it's really good I'm really happy to learn more about gluten or the fodmap diet you can visit our website

Channel: ABC Science

Views: 272,759

Rating: 4.6938572 out of 5

Keywords: Feeling (Quotation Subject), Gluten (Chemical Classification), Celiac Disease (Disease Or Medical Condition), Gut, Gut Bacteria

Id: rktpxe9gFfA

Length: 26min 48sec (1608 seconds)

Published: Tue Nov 24 2015