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Wheat and Digestive Symptoms: Is It Gluten or Something Else?

by Valerie Polley | Sep 9, 2024 | 0 comments

In recent years, gluten-related disorders have gained significant attention, leading to a surge in people following gluten-free diets and new gluten-free products on store shelves. This has been driven by the increasing number of people experiencing digestive problems after consuming wheat, a primary source of gluten. However, there is widespread confusion surrounding whether these symptoms are truly due to gluten or related to other components in wheat.

In this blog post, we’ll explore the complex relationship between wheat, gluten, and other potential triggers of digestive upset, such as FODMAPs. By the end, you’ll have a clear understanding of the different causes of digestive symptoms related to eating wheat.

Understanding Wheat and Gluten

Wheat is a staple grain in many cuisines worldwide and is found in foods like bread, pasta, and cereals. It contains several proteins, with gluten being the most notable. Gluten is made up of two proteins: gliadin and glutenin. These proteins help dough rise, maintain its shape, and provide elasticity to wheat-based foods. Gluten is also found in rye, barley, and triticale.

In people with certain conditions, gluten can trigger various digestive symptoms, including gas, bloating, diarrhea, constipation, and abdominal pain. However, gluten is not the only component in wheat that may cause these symptoms. This has led to a growing interest in understanding other factors that might be at play.

Gluten-Related Disorders

Two of the most common gluten-related disorders are celiac disease and non-celiac gluten sensitivity.

Celiac Disease

Celiac disease is a well-known autoimmune disorder in which eating gluten damages the small intestine. It’s estimated that about 1% of people worldwide have celiac disease. When someone with celiac disease eats gluten, their immune system mounts an attack on the villi, which are small, finger-like projections that line the small intestine and are essential for nutrient absorption.

Symptoms of celiac disease vary widely, ranging from digestive issues like diarrhea and bloating to non-GI symptoms like anemia, fatigue, skin rash, and joint pain. In fact, there are over 250 known symptoms of celiac disease! The only effective treatment for celiac disease is a strict, lifelong gluten-free diet, which allows the intestines to heal and symptoms to improve.

Diagnosing celiac disease typically involves blood tests to look for specific antibodies, followed by a biopsy (taking a small sample of tissue) of the small intestine to confirm that the villi have been damaged. Early diagnosis and treatment are important for preventing long-term complications like osteoporosis.

Non-Celiac Gluten Sensitivity

Not everyone who experiences symptoms after eating gluten has celiac disease. Non-celiac gluten sensitivity (NCGS) is a condition where people experience similar symptoms but lack the autoimmune response and intestinal damage seen in celiac disease. NCGS is thought to be more common than celiac disease, but its exact prevalence remains unclear due to the lack of a definitive diagnostic test.

Symptoms of NCGS include bloating, abdominal pain, fatigue, and headaches, which typically improve after eliminating gluten from the diet. However, unlike celiac disease, NCGS does not require a lifelong gluten-free diet. Some people with NCGS may tolerate small amounts of gluten or certain gluten-containing grains better than others.

If you suspect you have NCGS, it’s important to work with a healthcare provider to rule out celiac disease and wheat allergy before attempting a gluten-free diet. This is because the tests to diagnose celiac disease do not work if you’re not currently eating gluten.

Beyond Gluten: Other Wheat Components and Digestive Symptoms

Some people who struggle with wheat may have other conditions that don’t necessarily involve gluten, such as wheat allergy or irritable bowel syndrome.

Wheat Allergy

Wheat allergy is another condition distinct from celiac disease and NCGS. It’s an allergic reaction to some of the proteins found in wheat. Wheat allergy is more common in children but can also affect some adults. The immune system in a person with wheat allergy mistakenly sees wheat proteins as harmful, which triggers an allergic reaction.

Wheat allergy symptoms can range from mild, such as hives and nasal congestion, to severe, including anaphylaxis – a potentially life-threatening reaction requiring immediate medical attention. Wheat allergy is diagnosed through skin prick tests, blood tests, or an oral food challenge conducted by an allergist.

Managing a wheat allergy involves avoiding all forms of wheat and carrying emergency medication like an EpiPen. Unlike celiac disease, wheat allergy does not necessarily require the elimination of gluten from non-wheat sources, such as barley or rye.

FODMAPs

FODMAPs are short-chain carbohydrates that are poorly absorbed by the human gut. This leads to fermentation by the gut bacteria and digestive symptoms like gas, bloating, and changes in bowel movements. Fructans, a type of FODMAP, are found in wheat and are believed to contribute to digestive discomfort in some people, especially those with irritable bowel syndrome (IBS).

When fructans reach the large intestine undigested, they are fermented by bacteria, producing gas and drawing water into the gut. This leads to bloating, pain, and changes in bowel movements. This explains why some people who believe they are sensitive to gluten may actually be reacting to the fructans in wheat.

One way of managing fructan intolerance is the low-FODMAP diet. The low-FODMAP diet involves temporarily eliminating high-FODMAP foods, such as wheat, then systematically reintroducing them to identify specific triggers. It should only be followed under the guidance of a dietitian to ensure nutritional adequacy.

Interestingly, some people with IBS can tolerate sourdough bread made with wheat flour because the fermentation process reduces the amount of fructans present in the bread. During sourdough fermentation, the naturally occurring bacteria and yeast break down complex carbohydrates like fructans into simpler compounds. This reduction in FODMAPs makes sourdough bread easier to digest. However, tolerance can vary from person to person, so it’s important to monitor symptoms when trying sourdough bread if you have IBS.

Tips for Identifying the Culprit

If you suspect that wheat or gluten might be contributing to your digestive symptoms, consider the following strategies:

  • Keep a food diary and symptom tracker: Keep a detailed record of what you eat and how you feel afterward. This can help you identify patterns and potential food triggers.
  • Try an elimination diet: An elimination diet involves removing the foods you suspect are causing your symptoms, such as gluten or high-FODMAP foods, from your diet for a period of time and then gradually reintroducing them. This can help pinpoint foods that are causing symptoms. It’s best to work with a healthcare provider while undertaking an elimination diet to ensure you’re still getting the nutrients you need. Also, it’s important not to eliminate gluten until celiac disease has been ruled out.
  • Work with a registered dietitian: Consulting with a registered dietitian who specializes in digestive disorders can help you identify triggers and ensure your diet remains balanced and nutritionally adequate.

Final Thoughts

Navigating the complexities of wheat and digestive symptoms can be challenging. While gluten is a well-known culprit, it’s important to consider other components of wheat, such as fructans, that might be contributing to your digestive problems. A personalized approach guided by a registered dietitian is key to effectively managing these symptoms.

For more in-depth information, practical guidance, and a personalized approach to gut health, consider booking an appointment with our dietitian at Blue Tree Nutrition.

"Processed food" has become a catch-all term for foods we're told to avoid, but food processing isn't automatically a bad thing.

Technically, many foods you probably enjoy regularly are processed. Frozen vegetables, canned beans, yogurt, nut butter, and whole-grain bread have all been changed from their original state in some way.

So when research links processed foods to certain health concerns, it's important to understand what kind of processing we're talking about.

Much of the recent research has focused specifically on ultra-processed foods (UPFs). Diets containing large amounts of these foods have been linked to a range of negative health outcomes, including digestive and metabolic health issues, inflammation, and heart disease.

This article will review what we know so far and give you tips for including more whole foods in your diet.

Processed vs. Ultra-Processed Foods: Understanding the Difference

In food and nutrition research, a system called the NOVA classification is often used to group foods according to the type and extent of processing they undergo.

Minimally processed foods include fruits, vegetables, eggs, milk, and plain grains that may have been washed, frozen, pasteurized, dried, or otherwise prepared without significantly changing them from their original state.

Processed foods are generally made by adding ingredients such as salt, sugar, or oil. Examples include canned vegetables, cheeses, or freshly made breads.

Finally, ultra-processed foods are industrial formulations containing ingredients or additives not typically used in home cooking. Examples include many sodas, packaged snacks, instant noodles, candies, and some ready-to-eat meals.

This distinction is important because simply avoiding all processed foods would mean missing out on many convenient and nutritious options (such as canned beans and vegetables).

It's also important to recognize that there's considerable variation among foods categorized as UPFs. For example, a packaged whole-grain bread and a soda may both meet the criteria for ultra-processing under the NOVA classification, despite having very different nutritional profiles. 

Instead of deciding not to eat a food simply because it's processed, it can be more useful to look at the bigger picture and consider what nutrients the food provides and how it fits into your overall diet.

How Can Ultra-Processed Foods Affect Digestion?

While we're still uncovering exactly how UPFs affect the digestive system, one possibility is that they lack fiber.

Some diets high in UPFs are lower in naturally fiber-rich foods like fruits, vegetables, whole grains, beans, lentils, nuts, and seeds. You probably know fiber is important for staying regular, but certain types of fiber (known as prebiotics) act as food for the beneficial bacteria living in your gut. A diet lower in fiber may therefore affect both digestion and the health of your gut microbiome. 

There's also research currently examining the effects of common additives found in UPFs, such as certain emulsifiers and artificial sweeteners. However, most of the research linking these additives to negative effects on the gut microbiome and intestinal barrier has been conducted in vitro (test tube) or animal studies, so more research is needed before we can confirm whether these additives are harmful in humans.

Finally, some studies have found links between UPF intake and certain gut conditions. For example, a large systematic review and meta-analysis found that higher UPF consumption was associated with an increased risk of developing Crohn's disease.

However, there's still a lot we don't know about how UPFs impact gut health, and more research in humans is needed to understand which food components or other dietary factors may be responsible.

UPFs and Inflammation

Chronic, low-grade inflammation has been linked to the development of several chronic diseases, prompting researchers to investigate whether diets high in UPFs could contribute to inflammation.

Here are a few possible explanations:

  • A diet high in UPFs may contain fewer foods rich in fiber, vitamins, minerals, and phytochemicals, which are associated with better overall diet quality.
  • A diet high in UPFs can also contribute significant amounts of refined carbohydrates, saturated and trans fats, sodium, or added sugars.
  • Certain ingredients in UPFs may alter the gut microbiome and promote gut inflammation.

However, much of the evidence connecting UPF intake with inflammation and chronic disease is observational. Studies like these can identify patterns, but they can't always tell us whether UPFs specifically are responsible or whether other differences in diet and lifestyle contribute to the association.

UPFs and Overall Health

The research on UPFs becomes more conclusive when we zoom out to consider overall health.

A 2024 umbrella review published in The BMJ found that higher exposure to UPFs was linked with increased risk across several health outcomes, with some of the strongest evidence involving heart disease, type 2 diabetes, mental health outcomes, and overall death rates.

However, it's important to note that the quality of the studies included in the review varied considerably. Only four of the 45 studies they reviewed received a moderate-quality rating; most were rated low or very low quality.

That said, there is some experimental evidence to consider. A small but well-controlled study of 20 adults found that those eating UPFs consumed an average of 500 additional calories per day and gained about 2 pounds. They lost a similar amount of weight when eating the minimally processed diet. The study showed that something about the UPF dietary pattern encouraged greater calorie intake, but it couldn't identify exactly which UPF component was responsible.

Do You Need to Stop Eating UPFs?

UPFs can provide valuable nutrients, and all foods classified as UPFs are not nutritionally identical. Instead of trying to eliminate all foods that qualify as UPFs, consider your overall dietary pattern. For example:

  • Are you including fruits and vegetables throughout the day (fresh, frozen, or canned)
  • Are you choosing whole grains and other fiber-rich foods regularly?
  • Do you include beans, lentils, nuts, and seeds in your diet?
  • Do you compare packaged foods based on what nutrients they actually provide rather than assuming that processing alone determines their nutritional value?
  • Do you use convenience foods like canned beans and vegetables to make balanced meals easier, rather than feeling overwhelmed trying to prepare everything from scratch?

If UPFs currently make up a large portion of your diet, you don't need to overhaul everything overnight. Instead, try adding more minimally processed, nutrient-dense foods alongside the foods you already enjoy.

The Bottom Line

Food processing exists on a spectrum, and processed doesn't automatically mean unhealthy.

Research suggests that diets high in UPFs are associated with several health concerns, but researchers are still working to determine why these associations exist and whether all foods classified as UPFs carry the same risks.

Rather than fearing individual foods, focus on your overall dietary pattern. A diet built around a variety of fiber-rich plant foods, adequate protein, and nutrient-dense choices can still leave room for the occasional UPFs.

If you need help incorporating more whole foods into your diet, a dietitian can help. Click here to book an appointment with us at Blue Tree Nutrition.

 

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Hello, I am

Valerie

My name is Valerie Polley. I am a Indianapolis-based registered dietitian and owner of Blue Tree Nutrition. I consult with clients both local and far away.
I have a bachelor’s degree in nutrition from Purdue University and I have been practicing for 20 years.
I thoroughly enjoy helping clients through their gut health journey. I see a range of GI issues including, but not limited to celiac disease, IBS and SIBO. I also specialize in the FODMAP elimination diet.

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