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The Rise of Gluten Intolerance: No Guts for Gluten

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Last week, we explored modern wheat as one potential factor contributing to the rise of celiac disease and gluten intolerance. There is no definitive scientific consensus on this troubling phenomenon with various experts pointing to various causalities. Remember, correlation is not causation and with so many variables at play, understanding these issues can be complex.

This week, we’ll take a look at the interaction between gut health and gluten-related disorders.

Genetics, gluten and…germs?

Nearly everyone with celiac disease has one of two versions of a cellular receptor called the human leukocyte antigen or HLA, either HLA-DQ2 or HLA-DQ8. These and several other HLA-DQ genes raise the risk for non-celiac gluten sensitivity. Thus, the right genetics in combination with exposure to gluten must be present for celiac disease to develop.

Still, there are plenty of people who have the genetic predisposition to develop celiac disease, eat wheat, but appear to tolerate gluten. Thus, genes plus gluten does not necessarily equal celiac disease. There is a missing component to this equation. As we discussed last week, modern wheat is one possibility, but some scientists are looking at another trigger: microbial health.

One study, which compared celiac disease rates among 5,500 Finnish and Russian children, found 1 in 100 Finnish children and 1 in 500 Russian children tested positive for the disease. The Russians also have lower rates of other autoimmune diseases and allergies compared to the Finnish. Neither differing wheat consumption nor genetic differences accounted for the celiac disease rate disparity. Instead, it appeared that the Russian children had exposure to a greater variety and quantity of microbes than the Finnish.

Hardly human

Our bodies, particularly our guts, are full of bacteria. Think you’re an individual? In some ways, you are more microbe than you are human. By some estimates, the number of microbes living in the average adult human outnumbers human cells 10 to one. Of all the genetic information you carry, 99% of it is microbial.

In one study of celiac patients, bifidobacteria (a native gut bacteria) was found to be low compared to healthy control subjects while E. coli was high. E. coli appears to increase the inflammatory response of human intestinal cells to gluten while bifidobacteria increases tolerance. This is one example demonstrating how microbes may play a role in the human immune response.

A loss of diversity or an imbalance in our microbial communities may predispose us to a tremendous range of chronic diseases and infections. It can be difficult to determine whether disease causes imbalance or whether imbalance leads to disease. Both mechanisms may be at work creating a positive feedback loop. The bottom line is that the health of our microbial inhabitants is vitally important to our own health.

The hygiene hypothesis

Let’s go back to the Finnish and Russian kids. This is an example of the hygiene hypothesis: that a lack of early childhood exposure to infectious agents, bacteria and parasites can hinder the developing immune system. Simply put, if we don’t interact with enough bacteria and other microbes in our environment, they fail to colonize our bodies and we are more susceptible to illness.

So, how do we support our symbiotic microbial communities? There are a number of ways.

Vaginal birth, breast milk, pickles and playing in the dirt

Most of the microbes in a baby’s gut are acquired at birth when the baby is exposed to its mother’s vaginal and intestinal microbes. Babies born by caesarean section, which is a comparatively sterile procedure, do not acquire the same bacteria and have higher rates of allergy, asthma and autoimmune disease.

Also, breastfeeding is one of the most powerful ways to support a baby’s developing microbiome. Breast milk is both prebiotic (meaning that it provides food for the baby’s gut bacteria) as well as probiotic (meaning that bacteria, in particular the protective bifidobacteria, is supplied naturally in the milk).

As adults, We can similarly help our gut microbes along by choosing to eat probiotic foods populated by friendly bacteria. This includes fermented foods like yogurt, sauerkraut, kim chi, pickles and kombucha.

We also live in a culture that is germ-phobic. We have been taught to obsessively apply hand sanitizer, to disinfect our homes with caustic chemicals like bleach, to use antibiotics as a first response to minor illness or infection. Of course, there is a place for all these things, but often, they do more harm than good. Kids need to eat some mud and lick the dog. And unless you are severely immunocompromised, you should probably ditch the sanitizer and just wash your hands. In the name of cleanliness, we have traded bacteria for synthetic chemicals and are probably worse-off as a result.

Back to the gluten

So what is the lesson? The rise of celiac disease, gluten intolerance and countless other autoimmune diseases, allergies and health issues may have roots in the balance of the symbiotic microbes that colonize your gut. This is a fascinating area of science with huge implications for our present, our future and our understanding of the world.

I’ll leave you with the words of Hippocrates, wisdom from over 2,000 years ago, “All disease begins in the gut.”


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