Gluten-free Diet: Everything You Need to Know

Gluten-free Diet: Everything You Need to Know

Gluten is a general name for the proteins found in wheat (wheatberries, durum, emmer, semolina, spelt, farina, farro, graham,...), rye, barley and triticale – a cross between wheat and rye. Gluten helps foods maintain their shape, acting as a glue that holds food together. Gluten can be found in many types of foods, even ones that would not be expected.

The gluten big 3 are: wheat, barley and rye, in which gluten is a major dietary component.

In genetically susceptible individuals, the consumption of gluten triggers the development of coeliac disease (CD) – an autoimmune disorder commonly seen in populations of European ancestry.

Coeliac disease (CD) is an inflammatory disorder of the small intestine caused by a permanent intolerance to gluten proteins in predisposed individuals. In these patients, gluten peptides trigger an abnormal immune response that causes the typical CD tissue lesion characterized by villous atrophy, crypt hyperplasia, and increased numbers of lymphocytes. The only therapy for the patients is to adhere to a life-long gluten-free diet (GFD).

A gluten-free diet (GFD) is now the most commonly adopted special diet worldwide. It is an effective treatment for coeliac disease (CD) and is also often followed by individuals to alleviate gastrointestinal complaints.

However, beyond these medical indications, more and more individuals are starting on a GFD to improve their health and/or to control weight. The diet’s popularity has risen rapidly in the last few years, making it one of the most popular diets worldwide, along with a low-carbohydrate diet and a fat-free diet. The numbers of those adopting the diet for non-medical reasons now surpass the numbers of those who are addressing a permanent gluten-related disorder.

Where lies the root of popularity of Gluten free diet (GFD)?

Processed and ultra-processed foods are staple of modern western diet, with bread, and pastry holding big stakes in everyday diet for majority of modern population. Mentioned foods almost universally come with abundant gluten content.

An unhealthy diet, that is high in processed and ultra-processed foods, is a primary cause of poor gut health, or dysbiosis. Of course, other practices in the modern day world can also be contributors.

Probably the biggest health issue of continuous consumption of processed foods, next to excess calorie intake is - inflammation. All processed and ultra-processed foods consumed regularly will eventually cause inflammation.

They can alter the bacteria that live in our gut, and that alteration has the ability to interact with our immune system and eventually trigger it in a way that it can eventually become systemic inflammation.

GFD diet advantages (on non-coeliac persons):

Convincing evidence is available to support the benefits of a GFD for certain patient populations without a gluten-related disease (especially patients with IBS - irritable bowel syndrome and NCGS (nonceliac gluten sensitivity)).

Benefits of gluten-free diet, or reduced gluten intake, foundations can be found regarding to gut microbiota alterations. On a taxonomic level it is identified that eight bacteria change significantly in abundance on GFD, i.e. Veillonellaceae, Ruminococcus bromii, to name a few.

The strongest effect was seen in the decrease of Veillonellaceae during GFD, Gram-negative bacteria known for lactate fermentation. Veillonellaceae is considered to be a pro-inflammatory family of bacteria; an increase in Veillonellaceae abundance was consistently reported in IBD, IBS, and cirrhosis patients. It is conceivable that a decrease in Veillonellaceae abundance might be one of the mediators of the GFD’s beneficial effect observed in patients with IBS and gluten-related disorders.

Ruminococcus bromii is important for the degradation of resistant starch in the human colon and is increased when on a resistant starch diet. A decrease in abundance of Ruminococcus and its fermentation products might explain the beneficial effect of a GFD that is experienced by some IBS patients.

Potential downsides:

Nutrition-wise, no significant differences in dietary intake were found in energy and macronutrients as a result of the GFD except for significant reductions in polysaccharide intake. Previous studies on the nutritional quality of the GFD also indicated that it is associated with reductions in the intake of polysaccharides together with energy compared with the standard gluten-containing diet of healthy individuals, according to the present results. Consequence is reduction in bacterial populations generally regarded as beneficial for human health such as Bifidobacterium and Lactobacillus, and an increase in those of opportunistic pathogens such as Escherichia coli and total Enterobacteriaceae.

It appears that many individuals who participate in a GFD, that do not have a physiologic requirement for the diet and likely do not derive substantial benefit. However, key is always in quantity of any nutrient consumed, gluten included.

Existing evidence for potential harms of a GFD include possible nutritional deficiencies, financial costs, and negative psychosocial implications.

Microbiota impact:

Gluten-free diet influences immunostimulatory activity of the intestinal microbiota. Immunostimulatory properties of the colonic content of investigated individuals, representing an altered microbiota, were remarkably reduced after following a GFD, inducing a significantly lower production of the pro-inflammatory cytokines TNF-α.

GFD could contribute to reduce the pro-inflammatory signals in the gut by introducing modifications in the microbiota structure. In addition, the faecal samples of individuals under a GFD induced significantly lower production of the anti-inflammatory cytokine IL-10 than those of individuals on a standard gluten-containing diet. IL-10 inhibits the production of pro-inflammatory and Th1 cytokines such as TNF-α and IFN-γ.

A GFD diet clearly influences the abundance of several species, in particular those involved specifically in carbohydrate and starch metabolism. Growing evidence supports the hypothesis that changes in both the composition and function of the intestinal microbiome are associated with a number of chronic inflammatory diseases including celiac disease (CD).

It appears that GFD and its downstream effects on the microbiome do not cause major inflammatory or metabolic changes in gut function in healthy participants. However, the lower abundance of Veillonellaceae, the pro-inflammatory bacterium linked to Crohn’s disease and other gut disease phenotypes, suggests a reduction in gut inflammatory state. This change in bacterial composition might be linked with a beneficial effect of GFD for patients with gut disorders such as gluten-related disorders and/or IBS.


As foundations of toxicology say: dose makes the poison!

If you have diagnosed Coelicac disease, your allowed dose for gluten is set on strict 0! Patients with IBS (irritable bowel syndrome) and NCGS (nonceliac gluten sensitivity) should definitely prosper too without gluten in ther diet.

If you do not have diagnosed Coeliac disease or other mentioned health issues, your health status will largely depend both on amounts and on quality of foods (gluten containing foods included) consumed through your diet.

One thing we know is that gluten is usually overconsumed in modern, Western diet, often in each meal during the day. Then the "dose" becomes the problem, and gluten overconsumption could over time possibly trigger inflammation in your gut and then consequently whole body system.

That does not mean you should totally avoid foods containing gluten. What we suggest to you is:

  • check the nutritional labels on your bread/pasta/pastry, try to find those with reduced gluten content
  • try to find and buy sourdough bread and pastry (with as much sourdough content as possible, check labels!). Sourdough is naturally leavened bread, which means it doesn’t use commercial yeast to rise. Instead, it uses a ‘starter’, a fermented flour and water mixture that contains wild yeast and beneficial live bacteria cultures to rise. Mentioned live cultures may make it easier to digest, and in addition - the fermentation process decreases the amount of gluten present in the product.
  • consume such foods occasionally, not in every meal. These types of foods, abundant in starchy carbs, are best consumed after physical exercise. During this time, your muscles are like a big sponge and will use the carbs more efficiently.

However, if you still want to stick with strict GFD (and you do or do not have CD), we warmly suggest to you to try introducing regular consumption of fermented foods and drinks in order to diminish those detrimental effects of gluten-free (or any restrictive) diet on your gut health. Cidrani micro-drinks offer abundance of postbiotics which bring health to our gut and body!

Other potential downside of GFD is reduced intake of beneficial polysaccharides, but Cidrani got you covered here as well! Polysaccharides of some medicinal mushrooms, such as Chaga (Inonotus obliquus, IOPS) are one of the main bioactive components in Chaga, which have been shown to exhibit antioxidant, antiviral, hypoglycemic and hypolipidemic effects. Polysaccharides from our functional product Kombuchaga could be a game changer if you practice GFD diet.