Is Reducing Gluten/Grain Consumption Right for Everyone?
Written by Editor   
Friday, April 13, 2018 08:40 AM

Naomi Bonfanti, Guest Contributor
TCA Bronze Sponsor, Innate Response 

Is gluten bad for everyone, or just some people? It seems today, with so much attention being focused on gluten, this is a question that many people are asking. But by telling all of our patients to avoid gluten are we inadvertently lowering whole grain consumption and encouraging an excessive intake of saturated fat from animal products? After all, we all need to eat something, and if some, or all grains, are off the menu, what takes their place? Perhaps avoiding whole grains is not the ideal choice, knowing that most people struggle to consume enough fiber and lack the necessary fruit and vegetable intake to meet the recommended daily servings. Promoting an extreme view on grains to the masses without considering the likely real-world outcomes could elevate cardiovascular risk and other conditions related to reduced nutrient and fiber intake.

It is known that high amounts of saturated fat from animal sources elevates cardiovascular risk. Conversely, the beneficial nutrients and fiber that whole grains offer do the opposite. This benefit was detailed in a recent systematic review where replacing saturated fat with PUFA, MUFA, or high-quality carbohydrate was shown to lower CHD events.1 Observational studies also show a positive association with the consumption of whole grains and a decreased risk of chronic diseases, like cancer and cardiovascular disease. For example, whole grains that contain high amounts of β-glucans, like oats, may be especially beneficial by reducing blood cholesterol. Furthermore, the fermentation of the fiber in grains may modulate gut hormonal production, and regulate inflammation and blood pressure.2

 A review published in 2018 stated that cereal grains and grain pulses offer bioactive polyphenols and dietary fiber which are beneficial to health. Both polyphenols and fiber support healthy gut microbiota and may be effective against systemic inflammation. Furthermore, fiber from fruits and vegetables along with nuts, seeds, and whole-grains that include the grain kernel are cardioprotective and help to improve blood lipids, hypertension, and platelet aggregation.3 Also, we know most individuals consume about half of the recommended amount of fiber in their diet, and fiber intake, along with the known benefits, is correlated to longer telomere length and less biologic aging.4

At the same time, implementing a gluten-free diet is a big sacrifice that requires patient (and family) commitment. Additionally, gluten-free diets demand that changes are made in the preparation of food, which can affect other family members if cooking is done at home. A grain-free diet takes it to another level and may cause a menu to become too limited and too focused on animal protein, so it should be implemented only when needed. And keep in mind,  the over-consumption of meat and animal products that result from eliminating all grains exposes our patients to the genetically modified feed being used in the farming industry. A whole food, plant-based diet with moderate to low animal protein, which includes whole grain intake is a better solution to benefit a majority of people.

Overall, there may be more value in switching to whole-grain food for most people and eliminating refined grains entirely, than removing all grains or adopting a gluten-free diet. That said, there are individual exceptions that must be considered. For example, a gluten-free diet may encourage favorable gut microbiome changes and the reduction of Clostridia class organisms in the gastrointestinal tract, which could benefit a patient with dysbiosis.5 Additionally, patients who suffer from celiac disease or autoimmune disorders may benefit from a gluten-free diet.

If implementing an ideal diet for an individual was as simple as adopting a “one-shoe-fits-all” approach there wouldn’t be a need for trained professionals. An adequate dietary plan should be individualized and include attainable short-term and long-term goals that measure health benefits. Compliance is the key, along with ways to document success. If a gluten-free or grain-free diet is deemed appropriate, working with a patient to design practical steps to implement this is essential.

 

References: 

  1. P.M. Clifton, J.B. Keogh, A systematic review of the effect of dietary saturated and polyunsaturated fat on heart disease, Nutrition, Metabolism and Cardiovascular Diseases, 2017. 27;12:1060-1080.
  2. Frank Thies, 14 - Whole Grains and Disease Risk, In Vegetarian and Plant-Based Diets in Health and Disease Prevention, edited by François Mariotti, Academic Press, 2017, Pages 249-269.
  3. Asgary S, Rastqar A, Keshvari M. Functional Food and Cardiovascular Disease Prevention and Treatment: A Review. J Am Coll Nutr. 2018 Mar 12:1-27.
  4. Tucker LA. Dietary Fiber and Telomere Length in 5674 U.S. Adults: An NHANES Study of Biological Aging. Nutrients. 2018 Mar 23;10(4).
  5. Bonder MJ, Tigchelaar EF, Cai X, Trynka G, Cenit MC, Hrdlickova B, Zhong H, Vatanen T, Gevers D, Wijmenga C, Wang Y, Zhernakova A. The influence of a short-term gluten-free diet on the human gut microbiome. Genome Med. 2016 Apr 21;8(1):45.