Bread, gluten, and coeliac disease

by • 09/29/2017

Gluten.

 

Come on, say it with me.

 

Gluten. The innocuous-sounding, di-syllabic word that strikes fear in the hearts of nutritionists and fitness enthusiasts alike has enjoyed its fair share of attention as of late. However, is it even half as bad as what they say? Or is it worse?

 

Gluten is a protein that’s found in most wheat products, particularly bread. Gluten functions as a glue of sorts, binding the ingredients together. Without it, your loaf of bread would look more like a deflated bike tyre.

 

“But if it's protein, how could it be bad?”

 

Unfortunately, not all protein is created equal. Wheat protein, in particular, falls considerably far behind in terms of amino acid concentration, compared to animal protein. Digestibility of wheat protein is also found to be very poor. When using the Protein Digestibility Corrected Amino Acid Score (PDCAAS) to determine the standing of wheat protein, scores of 0.42 (whole wheat) and 0.25 (wheat gluten) on a scale of 0 to 1 are quick to highlight wheat's shortcomings as a main source of protein.

 

The real issue with gluten however, is the number of physiological disorders that it's been associated with. Coeliac disease is an autoimmune disorder that targets the gastrointestinal tract, particularly the small intestine. It is a hereditary condition, which means that people stand a higher chance of having it activated if it runs in the family. Coeliac disease is caused by an abnormal immune response to the presence of gluten, leading to the creation of several auto-antibodies that adversely affect a number of different organs, eliciting reactions such as inflammation. It also puts affected people at risk of developing arthritis or even colon cancer.

 

The scary thing about coeliac disease is that it's asymptomatic, meaning that a person can carry the disease without exhibiting any overt symptoms. This is further complicated by the fact that coeliac disease shares many symptoms with other gastrointestinal disorders, such as indigestion and irritable bowel syndrome.

 

Aside from related diseases, ingestion of gluten-containing foods can also highlight gluten intolerances. Intolerance is nowhere near as dangerous as disease, despite sharing similar symptoms, albeit on a smaller scale. The main difference between the two is that your gastrointestinal tract doesn't take as big a hit, only that it cannot properly process gluten, which usually results in bloating and gas.

 

The rise of gluten-related disorders is often attributed to the westernisation of diet and the increasing use of wheat-based foods. Considering how easily bread is made available these days, thanks to its industrialisation, it comes as no surprise how this is actually possible. However, in light of the media attention gluten has received, several companies have begun to offer gluten-free alternatives, including bread.

 

Another concern surrounding the excess consumption of most bread types is the fact that it triggers a sharp increase in blood glucose. This is most common in refined bread, such as white bread. Other bread types like whole-wheat/grain and sprouted grain bread feature much higher amounts of fibre, which lowers the bread's glycaemic index (GI) value and load (GL) considerably.

 

Purple bread has also made headlines recently. A team of scientists from Singapore's national university unveiled anthocyanin-infused bread, which preserves the texture of white bread but at only 80% of the digestion rate. This translates into better blood glucose control, making it safe in moderate amounts for diabetics.

 

Anthocyanins, responsible for the bread's purple hue, are a class of antioxidants. These handy plant pigments not only help rid the body of damaging free-radicals, but can also help with its nutrient-partitioning capabilities, allowing it to make better use of the carbohydrates from the bread.

 

Does this mean that bread is safe for consumption after all?

 

It all depends on your current state of health. If you're overweight, have poor insulin sensitivity, or are pre-disposed to, or suffering from diabetes, then you would be better off avoiding or at least de-emphasising the presence of bread in your diet, even the wholewheat ones. People with coeliac disease or gluten-intolerance are best avoiding most types of bread altogether, save for the gluten-free variety. If you're unsure of whether or not your body can tolerate gluten, a biopsy remains the medical industry's gold standard for determining it. You can also observe your own body for any signs of intolerance or gluten-related disorders.

 

If you're an active individual in decent health, then bread is far from the dietary demon most headlines make it out to be. It remains a good complementary source of dietary carbohydrates and is convenient for consumption. Not to mention pretty darn tasty too. It would be advisable to stick to the lower GI and GL variety of breads however, for the sake of continued health.

 

When it comes to determining if bread is good for you, take the same approach as with all other kinds of food; ask yourself if it's in line with your nutritional goals and requirements. Bread is one of the world's oldest foods, having seen countless people through some pretty dark times. Give it the respect it deserves and think twice before putting it into your mouth.

 

References

  • Young, V. R. & Pellet, P. L. (1985), “Wheat proteins in relation to protein requirements and availability of amino acids”, American Journal of Clinical Nutrition, 41(5), 1077-1090
  • National Institute of Diabetes and Digestive and Kidney Diseases (n. d.), “Coeliac Disease”. Retrieved from: http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/celiac-disease/Pages/facts.aspx
  • Lebwohl, B., Ludvigsson, J. F. & Green, P. H. (2015), “Coeliac disease and non-coeliac gluten sensitivity”, British Medical Journal, 5. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4596973/
  • Lundin, G. E. & Wijmenga, C. (2015), “Coeliac disease and autoimmune disease-genetic overlap and screening”, Nature Reviews Gastroenterology & Hepatology, 12(9), 507-515
  • van Heel, D. A. & West, J. (2006), “Recent advances in coeliac disease”, Gut, 55(7), 1037-1046
  • Tovoli, F., Masi, C., Guidetti, E., Negrini, G., Paterni, P. & Bolondi, L. (2015), “Clinical and diagnostic aspects of gluten related disorders”, World Journal of Clinical Cases, 3(3), 275-284
  • Volta, U., Caio, G., Tovoli, F. & De Giorgio, R. (2013), “Non-coeliac gluten sensitivity: questions still to be answered despite increasing awareness”, Cellular & Molecular Immunology, 10(5), 383-392
  • Serra-Majem, L. & Bautista-Castaño, L. (2015), “Relationship between bread and obesity”, British Journal of Nutrition, 113(2), 29-35
  • Rasmussen, O., Winther, E. & Hermansen, K. (1991), “Glycaemic responses to different types of bread in insulin-dependent diabetic subjects (IDDM): studies at constant insulinaemia”, European Journal of Clinical Nutrition, 45(2), 97-103
  • He, J. & Giusti, M. M. (2010), “Anthocyanins: natural colorants with health-promoting properties”, Annual Review of Food Science and Technology, 163-187

 

 

by • 09/29/2017