The debate on bread/gluten in the nutritional blogosphere is rather sad. On one side you have alarmists who use weak evidence to make the case that bread is toxic and on the other side you have nutritional “experts” who tear apart that weak evidence and then jump to the conclusion that there is no problem with bread.
One side preaches fear. The other side fails to understand risk. Without repeating myself, head over to the post 10 Awful Nutritional Myths Gets One Half Wrong.
Thankfully not everyone is in the alarmist or denialist camps. In this post, I want to list some ideas on why a large number of people feel awful when they eat bread and why they feel better when they stop. This is far from settled science. This post is about extending the discussion. My opinion is based on my own experience, the experience of people I know, and everything I’ve read.
Also, I now prefer to say bread over gluten or wheat. Where the problem resides is something I do not know, but I do believe there is a problem.
Photo by Thomas Hawk
#1 Hygiene Hypothesis
I covered the hygiene hypothesis back in 2013. The brief version is that sensitivities can develop or become more pronounced if one has poor gut flora. My issues developed after taking a large number of antibiotics. When I talk to others with bread sensitivity, the majority were taking antibiotics prior to their issues.
#2 The Dose
Maybe it is the dose that makes the poison? Bread is viewed by many to be a poor source of nutrients. Eating a lot of calories with little nutrition can displace the number of calories we eat of more nutrient-dense food.
When I dumped the bread, I added a lot of different foods to my diet. My nutrient diversity went up. So when health improves is it because nutrient density increased or because of something in the bread?
#3 Iron Overload
Thankfully I’m not alone in seeking an explanation for the bread problem. Duck Dodgers and Richard Nikoley recently put out easily the most interesting nutrition post I’ve read in a very long time. Please read Iron, Food Enrichment and The Theory of Everything.
The short version is that many health problems started with the iron fortification of flour. And since WW2, the amount of iron in our diet has increased a lot. In the article, you will learn how iron disrupts gut flora and can lead to metabolic issues. I really encourage you to read the entire thing.
#4 Metabolism
The premise here is that as there is a connection between metabolism and food intolerances. Lowering metabolism reduces the body’s ability to respond to foods that are more likely to cause problems. Restrictive eating which seems like the logical path, could further reduce metabolism and make problems worse.
From a 2012 interview with Matt Stone on Our Nourishing Roots.
I treat dietary restriction as a last resort, not a first line of defense. And as metabolism improves, the inflammatory response often regulates itself in such a way that former triggers of allergic and inflammatory reactions no longer elicit such a reaction.
#5 Bread is a Processed Food Today
I have to bring this up again. The denialists who are so quick to attack those of us who avoid bread as being neurotic, fearful, and orthorexic are quick to dispense the nutritional advice to avoid processed foods. Yet almost all bread is processed to some degree. It baffles me how they fail to see this inconsistency.
How we make bread today is a lot different than how traditional cultures made bread. See the article Be Kind to Your Grains…And Your Grains Will Be Kind To You. Many people, especially those in the WAPF camp, believe the problem with bread lies in modern processing, and using traditional methods of preparation is a healthier option.
I’m Better Now
About six months ago I was in a meeting we had catered from a local taco place. In California, authentic taco places use corn tortillas, so I am not concerned about wheat. At the meeting, I had two fish tacos. Felt great. Days later I learned the taco place uses corn for all their tacos except the fish tacos, which they use flour tortillas. But I had no headaches, no skin flareups, or disrupted sleep. So I’m clearly in a better place than I was five years ago.
Here is What I Did
Before I rattle off my list, I want to say that unlike the alarmists and the denialists, who believe they know more than they do, I am aware I do not know the cause and degree of the problem.
- I stopped eating wheat and replaced those calories with more nutrient-dense foods.
- When I did want something “bready”, I selected a gluten-free option. Denialists will say that there is no evidence that GF is more healthy. I disagree and explained why in the post The 10 Health Myths Article Gets One Wrong. I wrote that post before the Duck Dodgers iron fortification post. His info further supports my case.
- Since December 2010 I have donated blood like clockwork every 8 weeks. I wish I had written the numbers down, but my iron levels have dropped.
- Fermented foods. I consumed dairy kefir and kimchi regularly. If the hygiene hypothesis is correct then this likely helped a lot.
- I am a big believer that resiliency should be our goal. In the post Wheat Resiliency, I cover how I use trace exposure to teach my body how to process wheat. If the dose is the problem, then minimizing the dose would be an effective strategy.
- Increased my metabolism as measured by morning waking temperature from 97.0 to 98.4. In tech terms, I have a faster processor now. For ideas on increasing metabolism, read the book Diet Recovery 2: Restoring Mind and Metabolism from Dieting, Weight Loss, Exercise, and Healthy Food by Matt Stone.
Thank you, anonymous donor by Brian. I donate blood every 8 weeks. Lowers my iron level and helps someone in need.
To sum up, I believe there is a problem with bread, but we don’t fully understand it. The alarmists are lacking evidence and the denialists are confusing the lack of evidence as a lack of risk. I’ve taken the middle ground and doing so has served me well.
Jacob
Jul 2, 2015 — 4:21 pm
You probably already read this but:
https://chriskresser.com/3-reasons-gluten-intolerance-may-be-more-serious-than-celiac-disease/
I do like reading the actual research and I can tell you that everything I’ve seen published in 2015 points out to gluten intolerance being real (last study I saw estimated 7% of the population).
Research even showing that wheat intolerance in general is linked to autoimmune issues. Research showing gluten free might be better than low-FODMAP for people with IBS.
And this doesn’t address the people who might have an intolerance to the fructans in wheat.
There doesn’t seem to be any controversy in the literature. Just among bloggers.
Generally speaking, blogger =! Scientist/Researcher.
I think you should try eating 600 calories a day from wheat – this is what the average American does.
See if your issues come back 🙂
Jacob
MAS
Jul 2, 2015 — 4:29 pm
@Jacob – I hadn’t read that. Thanks for sharing.
Diana
Jul 2, 2015 — 6:15 pm
I got tired of eating gluten-free bread when I want bread, because to me it is like eating cupcakes in terms of nutritional value. Recently, I discovered I can eat homemade quick breads (no yeast, no fermentation) made with organic sprouted wheat flour (purchased). I can also eat homemade fermented sourdough bread made with einkorn flour. What I still can’t eat is organic wheat natural sourdough bread (Della Fattoria, in Petaluma), without consequences. So it seems like I either have to eat soaked and sprouted, or fermented, grain breads. Highly inconvenient, but it means I get fewer calories from bread, which is easy to overeat. I haven’t tried any commercial sprouted wheat breads. Alvarado Street Bakery makes them, and they don’t look very appetizing.
Also, regarding tacos. Some Mexican restaurants will serve “corn” tortillas that are actually wheat flour tortillas with little specks of corn masa in them. Some places will specify that their tortillas are gluten-free, meaning they serve the real deal corn masa tortillas. (It irks me that they have to write that…100% corn masa should be enough.)
Nick
Jul 2, 2015 — 11:25 pm
Hi MAS, you might find this article interesting too: http://www.newyorker.com/magazine/2014/11/03/grain
Robert
Jul 3, 2015 — 4:00 am
I’m a long time reader of your blog and you have introduced me to some useful things and ideas. I wanted to point out that a lot of the “controversy” surrounding bread and gluten is an internet filter bubble. No one in the mainstream medical community believes in non-celiac gluten sensitivity. It’s well known among gastroenterologists that depressed, somatic patients, modern day neurotics, overly focus on the sensations emanating from their gut. Consider that eliminating gluten or bread, for internet worrywarts, may trigger a placebo effect and constantly reading about paleo or gluten free may lead to confirmation bias. Your taco experience suggests a placebo effect: gluten that you didn’t know about doesn’t bother you.
People develop eating disorders, and it’s no wonder that do so in our food environment that mixes the messages that very tasty food is constantly available and that we should remain fit and slender. No one wants to hear that they should stop smoking, stop drinking, eat normally portioned meals at home, and exercise every day. Yet how many internet diet hobbyists do this consistently for a couple of years before looking for answers like gluten or whatever?
Lastly, some people have foods that disagree with them, especially as they age. They might avoid raw onions or large amounts of tomatoes, or something else that triggers reflux or gas. I get a tummy ache if I eat too much pasta, so I either eat less or I accept the consequences. I don’t make sweeping pronouncements because of my digestive issues.
I don’t mean this to come across as argumentative only to throw out there the mainstream view, which I believe to be correct. I’m curious what you did to raise your morning temperature?
De
Jul 3, 2015 — 5:33 am
But what about breadfruit.? It is a thing.
MAS
Jul 3, 2015 — 8:10 am
It is interesting to read the comments from Jacob and Robert. Each seem intelligent and researched and they reached the opposite conclusion.
This is was the point of the post for me. It was me saying I don’t know.
I believe something in bread, be it gluten, FODMAPS, iron, or whatever can be problematic for some people. It may be the dose, gut flora, metabolism, or something else. Since it is easy to replace bread with foods with more nutrition, I don’t see a problem with reducing or in some cases eliminating bread products. Even if it is only for a short period. If there ends up being no risk, then I had a lot of potatoes, rice and grains I knew nothing about years ago.
I am approaching the question as an investor would, which means I am assuming I have incomplete information. I do think in the next few years more layers to this story will unfold. And my bet is that both sides will be wrong to some degree.
@Robert – As for body temperature, I may need to do a post on that. The info is scattered across a few posts.
Marc
Jul 3, 2015 — 10:33 am
I believe Jack Bezian has some of the answers. Answers to needed questions, not more arguments.
Jacob
Jul 4, 2015 — 5:32 am
Mas –
I believe this is where you do need to read the research and not pay attention to bloggers or journalists who are trying to get clicks by commenting on controversy.
The “internet filter” is the skeptic / pubmed crowd that doesn’t actually read the research or they harp on particular study that think proves their point. If any of these guys were able to truly debunk the research, the peer reviewed journals would print retractions. Why don’t they write a letter to the editor and point out the study flaws?
They can’t, because their wrong. So they blog and pretend to know better (in the name of Science no less!).
Very conservative journals on gastroenterology agree that NCGS is real. University journals that are publishing materials in 2015 reviewing the totality of the literature all agree it’s real and recommend doctors discuss gluten free with their patients who have IBS.
Of course we all know the system is slow – it will take years for MD’s to catch up with this. It’s a slow process.
These journals have a peer review process and strict editorial guidelines. If they publish something erroneous, at the very least they will allow a LTE (letter to the editor) to be published.
So who are the gluten doubters? It’s religious scholars like the guy who authored “The Gluten Lie”. But even he caveats his interview with saying “Experts agree it’s a real thing!”.
Writing a book called “Gluten & FODMAPs probably irritate millions of people but there are faddish aspects to this and not everyone has to be afraid of Gluten, maybe you can eat some in moderation…maybe others can’t…it’s complicated” wouldn’t have sold him many copies. So instead he presents himself as a PHD and that we’re being lied to about gluten.
And therein lies the problem, people are looking to a religious studies dude, some random “science” blogger or journalist and basically dismissing this.
Last point I’ll make is that the average person with celiacs takes 7+yrs to get their diagnosis and goes thru several doubting doctors in the process.
Robert’s point about doctors viewing patients as hypochondriacs or psychologically broken speaks is nothing he should be proud of. It’s a real problem in the medical establishment and one that does real harm to patients.
Anemone
Jul 6, 2015 — 10:18 am
I had no idea that iron overload was a thing. I’m kind-of jealous. I have a history of anemia, and have traditionally eaten a lot of red meat to compensate. (Both my sisters are also vulnerable to anemia.) Unfortunately that’s expensive, and I’m not able to get a lot of calories that way with my current income (disability). Last year when I tried to re-feed I switched to high dairy/low meat and ended up severely anemic and fat (BMI 40) and prediabetic, with no metabolic improvement (36.2 last time I checked). So now I’m eating red meat every day whether I want to or not (my appetite is messed up from fear of food money running out – if I were rich I’d probably be feasting on the stuff) and taking iron pills and waiting to see what my latest bloodwork says.
So I go and read that iron article, and now I’m wondering about the iron pills, and the loaf of bread in my cupboard that I might not eat now, and the other cheap foods I’m eating, and wondering how this will affect my gut/health, and wondering if I have any choice given my poverty. 🙁
Lots to think about.
Given the existence of iron overload, and the low bioavailability of fortified iron, I can see a strong case to end fortified foods.
P.S. I’m O- and have felt guilty about not donating blood after the one time I did and was weak for 5 weeks after. Now that I know there are high iron people who donate, I don’t have to feel guilty any more.
Dan
Jul 6, 2015 — 10:19 am
I stopped eating grains and refined sugars and started following a modified paleo diet two years ago. Within 6 months I lost twenty pounds and, more importantly, went from a 33 inch waist to a 29. I’ve been active my entire life, yet at 55 I am stronger and fitter than I have ever been.
Given all the variables, it is extremely difficult (perhaps impossible) to identify the specific role bread plays in our diet. Nevertheless, the results for me are irrefutable. I love bread and will always miss it, but I’ll never go back.
MAS, I stumbled across your blog recently and really enjoy your posts, particularly on exercise and fitness. I tried the goblet squats as an alternative. Thank you for the suggestion. Keep up the good work.
MAS
Jul 6, 2015 — 11:35 am
@Anemone – I’m curious about your 36.2 metabolism score. What is that?
@Dan – Congrats and thank you!
Anemone
Jul 6, 2015 — 12:00 pm
Temperature first thing in the morning.
MAS
Jul 6, 2015 — 12:04 pm
@Anemone – Thanks. The American in me did not see that as a Celsius number, which works out to 97.2 F. On the low side. I will be posting this week on how I raised my body temp from 97.0 F to 98.5 F (or 36.1 C to 36.9 C).
Anemone
Jul 6, 2015 — 12:28 pm
It never even occurred to me that I should put a °C to clarify – my mind automatically converted your °F to °C (inaccurately, as it happens, but close enough) so I forgot it wouldn’t make sense to Americans. Sorry about that.
Matrixik
Sep 2, 2015 — 12:47 am
Hi, read some about Zonulin (found by Alessio Fasano). So maybe it will give you some more food for thoughts.
Duck Dodgers
Sep 14, 2015 — 1:24 pm
MAS, great post and thanks for the kind words. As a fellow underweight ectomorph, I just whipped up another batch of ice cream this weekend.
We have a new post up about the history of wheat tolerance, which may be of interest to you.
How Wheat Went From Superfood To Liability
As we investigated the history of wheat tolerance, we were surprised to learn that wheat gluten was once considered the most nutritious part of the wheat, right up until the 19th century.
We didn’t put it in the article, but we even found evidence that some cultures intentionally added wheat gluten to their foods. Pretty amazing.
While you often hear reports that modern wheat is more reactive than ancestral wheat, that’s not entirely true. The comparison is often made to Einkhorn, which is the least reactive wheat. However, Einkhorm was always a minor cereal from the beginning of the Neolithic—it didn’t contain enough gluten to make a decent bread (it was only used for porridge or gruel). Early cultures always preferred a higher-gluten wheat. Furthermore, certain ancient types of tetraploid wheat (e.g.; Graziella Ra, Khorasan wheat/Kamut) have even greater amounts of total gliadin than modern accessions.
Since gluten used to be well tolerated, even up until the 1950s, we suspect that modern gluten sensitivity is mainly due to fortification of flour that became popular in the US since WWII. For the most part, gluten sensitivity (not talking about celiac, mind you) seems to be much rarer in non-fortified countries. This implies that iron fortification is disrupting gut flora and making gluten more difficult to digest.
No doubt, gluten is fairly toxic if you don’t have the right gut flora in place. For me, it took about 3-4 weeks to regain flora and tolerance by slowly reintroducing real whole wheat. There were times I didn’t feel great during that reintroduction period, but I soon began to feel excellent.
As to why whole grains can be an ideal source of carbohydrates. As unborn plants, seeds contain all of the minerals necessary to manage metabolisms and keep the destructive side of iron in check. Technically all plants and animals contain this balance, but most people don’t tend to swallow carcasses and nose-to-tail is out of fashion. So, when we eat meat, we tend to favor muscle meat, which promotes the same imbalance that fortification promotes—iron without manganese and copper. Manganese and copper are required to manage our iron homeostasis. Mn and Cu are essential for two very important enzymes (SOD, MnSOD, etc.) that are responsible for our most powerful endogenous antioxidants. Copper is also responsible for getting iron in and out of cells. So, when we consume refined foods we don’t obtain this mineral balance. You can make up for this deficit with other complimentary foods (chocolate, hemp, seaweed, etc.) But, when we eat muscle meat or fortified foods, we promote an imbalance that makes it extremely difficult for us to manage the oxidative stress. (and Phytates act as antioxidants, chelating excess iron, for those with varied diets—they are only a liability for those with extremely limited diets.)
If you, or anybody, chooses to regularly eat wheat as a staple, it must be whole wheat to obtain the health benefits, which are mainly believed to come from the unique phenolics and phytonutrients.
Cheers.
MAS
Sep 14, 2015 — 5:39 pm
@Duck – Thank you for the comment. Sorry for the delay. WordPress holds comments with 4+ links for my review.
Love your articles on FTA. Glad to see the discussion has been extended.
Duck Dodgers
Sep 15, 2015 — 9:51 am
Thanks, MAS.
btw, When making ice cream, I’ve used the following recipe for an ice cream base.
6 yolks
3 cups of Heavy Cream
1 Tbsp of vanilla extract (plus the insides of a vanilla bean if I have one handy)
1 Tbsp of raw potato starch or arrowroot (a thickener)
1 Tbsp of vodka (makes it easier to scoop)
1/2 cup Grade B maple syrup
Believe it or not, it doesn’t have a maple taste—it tastes like regular vanilla ice cream.
Sugary tree saps, and especially maple syrup, are excellent sources of manganese. Just 1 Tbsp of maple syrup is 30% of your DV for Mn. It’s a great sweetener.
When trees don’t have enough manganese, their leaves turn yellow and their growth is stunted.—they have trouble carrying and metabolizing their own sugars.
Indeed, Mn is important for the metabolizing of carbohydrates. (Conversely excess iron, at least in animals, makes carbohydrate metabolism more difficult).
So, when possible, consider favoring whole sweeteners that contain natural antioxidants (honey) or Mn (tree syrups). Or find other ways to obtain those compounds and elements through other foods.
Cheers
MAS
Sep 15, 2015 — 7:58 pm
@Duck – Thanks for the recipe. Never knew about he vodka trick.
Duck Dodgers
Sep 16, 2015 — 7:49 am
You bet. Really any alcohol would lower the freezing point of ice cream. Most of us forgot this from grade-school science class:
Wikipedia: Freezing-point depression
…it’s just that vodka is least likely to influence the taste. You could add whiskey if you’d prefer. 🙂
Instead of alcohol, corporations add a little propylene glycol to ice cream to make it scoopable. It’s actually the same compound used in commercial anti-freeze and aircraft de-icing fluid.
See: Wikipedia: Propylene glycol: Applications
Companies don’t have to put propylene glycol on their ingredient list because it is GRAS (Generally Regarded as Safe) by the FDA.
Code of Federal Regulations: Title 21: Food and Drugs: Volume: 3: Section 184.1666 – Propylene glycol
I much prefer vodka, but I suppose most parents would rather feed their kids a cryptically-worded antifreeze than a little booze.
MAS
Sep 16, 2015 — 9:53 am
@Duck – I had no idea. I was making some homemade ice cream earlier this summer. I tended to go through it pretty quick, so it didn’t get too hard. But I like your vodka idea.