Wheat gluten intolerance and whole grains

Wheat gluten intolerance and whole grains are inexorably tied up with the fact that fibre slows gastric emptying.

The normal physiology

Whilst physiology is a highly complex subject it can be broken down into  basic concepts that are not that difficult to understand. Knowledge is power; grasp this and you will be able to deal with your gluten intolerance.

Food is made up of three macronutrients; protein, carbohydrate and fat.

All are important but today we are looking only at protein; and more specifically that called gluten which is found in wheat, barley and rye. Less than 1% of people enjoying a typical Western diet suffer from a condition known as Coeliac Disease; a severe autoimmune response to these grains. Yet one-third of Americans are trying to avoid this important foodstuff; why is that?

The mouth

The digestion of all protein, fat and carbohydrate begins in the mouth with thorough chewing. This can not be overemphasized; the breaking down of our food into smaller pieces and complete mixing with the digestive enzymes in saliva should begin before it enters the stomach.

If suffering from bloating, indigestion and diarrhoea the first step is to take more time over our meals and chew everything thoroughly; it's the only way to achieve proper mixing with the saliva. Eat more slowly and consider mindfully the taste and texture of your food.

Oddly that also means not simply swallowing soup and porridge, for example. They too need to be mixed thoroughly with saliva to start the proper digestion of our food. There is considerable merit in "fletcherising;" chewing every mouthful 32 times.

• Chew your food thoroughly
  

The stomach

The most important stage of gluten digestion then continues in the stomach. Cells in the wall produce an enzyme called pepsin that starts the process of breaking down proteins. This can only happen at a very low pH so a large amount of concentrated hydrochloric acid is added to the mixture.

Antacids will disturb this digestion of gluten by raising the pH; pepsin cannot function properly.

On a personal note, an anecdote it's true and not to be construed as hard evidence, my truly severe nightly indigestion was not caused by too much acid but a helicobacter infection. Neither antacids nor proton pump inhibitors helped a jot; but a probiotic fermented in our own kitchen overwhelmed the pathogens and solved 90% of the pain in just two weeks.

Proteins consist of long chains of building blocks known as amino acids; there are 20 of them. Each contains a nitrogen and an acid group; and a long variable side-chain.

Gluten contains large amounts of one of the amino acids called proline; it has a completely different ring structure to all the other 19.

It takes pepsin much longer to digest a chain of amino acids that contains large amounts of proline; grains need to stay in the stomach for a longer period.

Gastric emptying is controlled by one of the "incretin" hormones known as GLP-1; it is normally secreted by cells in the small and large intestines. It is being used by modern weight-loss drugs so that food stays in the stomach for longer; but reduces the normal output from our own gut so you have to stay on them for life.

Fibre

Fibre from our food also delays gastric emptying improving the digestion of gluten before it enters the small intestine where absorption occurs. However only 5% of those enjoying typical grocery store meals are getting the recommended daily allowance.

Food leaves the stomach faster, poor digestion of gluten is likely and GLP-1 signals to the appetite centre of the brain are lessened; so we continue to feel hungry for longer and eat more than is necessary.

Small intestine

Short chains of partially-digested gluten then enter the small intestine where more enzymes are added. Should they not be completely broken down into individual amino acids then they will be absorbed by cells in the villi; where they will be recognised by our immune system as foreign proteins, setting up an inflammatory attack on them.

Bloating, abdominal discomfort and diarrhoea are likely; this is gluten intolerance and in its severe form, Coeliac Disease. There is damage to the lining of the gut which becomes angry, and inflamed, pieces sloughing off in the stool. 

For the less than 1% who have the autoimmune Coeliac disease it means complete abstinence from all wheat, barley and rye; with one important exception. Most can enjoy carefully produced sourdough bread.

• Strict and lifelong gluten free diet
  

The pancreas produces enzymes like trypsin that continue this process of digestion of the short-chain protein fragments into single amino acid units ready for absorption. 

Many factors can affect this process; chemical food additives, fat and the normal flora for example. There is much research and anecdotal evidence that a widely diverse microbiome contributes greatly to the happy tum; less bloating and stabilisation of the transit time.

Gluten-sensitivity on the other hand is a somewhat nebulous diagnosis, probably real but poorly understood; and without any of the inflammatory changes of the gut lining.

Commercial bread

Most commercial bread is baked using the Chorleywood process which takes about an hour and a half; plus two more to cool before packaging. Larger amounts of yeast and various chemicals are added; typically ascorbic acid, emulsifiers and enzymes such as transglutaminase.

That is about half the time compared with traditional baking methods; and a fraction of that when using sourdough.

Gluten sensitivity remains a controversial and poorly understood condition; but these chemicals and the short production time have been fingered for much of the symptoms which may have been erroneously attributed to gluten.

• Do these symptoms appear when enjoying a sourdough bread cooked using the longer fermentation time and without any of the above mentioned chemicals?
• Do the symptoms disappear on a gluten-free diet?
• Do they reappear when eating commercial bread?

The point being that gluten may be the falsely-accused cause of your symptoms.

Colon

Friendly bacteria, viruses and yeast cells making up the microbiome rapidly ferment the remaining fibre when it reaches the colon; they release short chain fatty acids that supply energy to the cells of the intestinal wall and normalise the inflammatory response in the whole body.

Wheat gluten intolerance and whole grains are intimately connected; without the fibre one cannot have a normal microbiome, nor satisfactory motility of the gut.

Whole grains

Whole grains have become increasingly difficult to find. It's virtually impossible to purchase 100% flour or cornmeal, for example. They have a shelf-life of only about one week and are rarely stocked on grocery store shelves; the fats start to go rancid once the grain is cracked.

The subject is muddied by the Big Fat Lie; millers are allowed to label their grains as wholemeal provided they do not extract more than 40% of the fibre and germ. Wheat gluten intolerance increases in leaps and bounds.

Essential amino acids

There are 20 amino acids; 9 of them are "essential." We cannot live healthy lives unless we consume them regularly from our food.

The gluten in wheat is not a complete protein. So bread is usually consumed with another protein; peanut butter, cheese or egg for example.

Wheat gluten intolerance and whole grains

Wheat gluten intolerance and whole grains are intimately connected. The bran in 100% real bread keeps food in the stomach for longer; exposing all the proteins to digestive enzymes for longer, reducing the likelihood of short chains of amino acids being absorbed into the blood stream.

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