Gluten-Free Diet Benefits: Microbiome Impact and Autoimmune Disease Risks

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• Evolutionary Impact of Agriculture on Nutrition
• Hygiene Hypothesis and Autoimmune Disease Rise
• Monoculture Farming and Microbiome Changes
• Gluten-Free Diet Scientific Evidence
• Low FODMAP Diet for IBS
• Medical Second Opinion for Diagnosis
• Full Transcript

Evolutionary Impact of Agriculture on Nutrition

Dr. Simon Robson, MD, provides a historical perspective on human nutrition. He notes that skeletal records show a decrease in human stature after the adoption of agriculture. This finding is counterintuitive, as one would expect more food abundance from farming. Dr. Robson suggests that intensive monoculture farming may have led to nutrient-deficient diets. This historical shift away from a hunter-gatherer's diverse diet may have had lasting consequences for human health.

Hygiene Hypothesis and Autoimmune Disease Rise

The hygiene hypothesis offers a compelling explanation for the increase in autoimmune conditions. Dr. Simon Robson, MD, explains that modern sanitation reduces our exposure to natural bacteria. Our overly clean food supply, with pasteurized milk and sterilized juices, lacks beneficial microbes. This lack of bacterial challenge can cause the immune system to malfunction. It may begin to attack the body's own tissues, leading to diseases like celiac disease, rheumatoid arthritis, and autoimmune liver disease.

Monoculture Farming and Microbiome Changes

Modern agricultural practices significantly alter the human gut microbiome. Dr. Simon Robson, MD, connects monoculture farming to detrimental changes in our gut bacteria. These microbiome changes are linked to a higher incidence of inflammatory bowel diseases. Patients with Crohn's disease, ulcerative colitis, and irritable bowel syndrome may be most affected. The shift to a limited variety of grains, like modern wheat, is a key factor in this process.

Gluten-Free Diet Scientific Evidence

The benefits of a gluten-free diet for the general population are not clear. Dr. Simon Robson, MD, states there is little scientific evidence supporting voluntary gluten avoidance. For individuals without celiac disease or a confirmed sensitivity, the diet can even be harmful. It may lead to nutritional deficiencies if not carefully managed. The interview with Dr. Anton Titov, MD, highlights that any benefits might come from reducing other harmful substances in modern wheat, not just gluten.

Low FODMAP Diet for IBS

A low FODMAP diet is an extreme dietary intervention that can help some patients. Dr. Simon Robson, MD, clarifies that FODMAP stands for Fermentable Oligo-, Di-, Mono-saccharides and Polyols. These are specific types of carbohydrates found in many grains and other foods. This diet has scientific support for managing symptoms of Irritable Bowel Syndrome (IBS). It is more targeted than a general gluten-free diet and should be undertaken with medical guidance.

Medical Second Opinion for Diagnosis

Seeking a medical second opinion is vital for a correct diagnosis of gluten-related disorders. Dr. Simon Robson, MD, and Dr. Anton Titov, MD, both emphasize this point. A second opinion helps confirm whether a patient has celiac disease, non-celiac gluten sensitivity, or another condition. It ensures the treatment plan, which may include a gluten-free or low FODMAP diet, is appropriate and evidence-based. This step prevents unnecessary dietary restrictions and focuses on effective management.

Full Transcript

Dr. Anton Titov, MD: Benefits of gluten-free diet? Mutated wheat and other grains change our microbiome. Effects of monoculture on food supply lead to increase in inflammatory bowel disease, Crohn's disease, celiac disease, and other autoimmune problems.

Cleaner lifestyle leads to autoimmune diseases. Gluten-free diet is only part of gut microbiome changes. Monoculture changes lead to decreased autoimmune disease risks.

Dr. Anton Titov, MD: Microbiome and monoculture evolution affected gut bacteria in humans. Is there any benefit to voluntarily going gluten free?

Dr. Simon Robson, MD: When farming started, human body size decreased. This could be a reflection that gut bacteria did not take well to a change to monoculture agricultural farming methods of sedentary humans.

Benefits of gluten free diet for everyone are not clear.

Dr. Anton Titov, MD: The reality behind gluten-free diets is this. They can decrease other potentially harmful substances that result from monoculture farming.

Hygiene hypothesis states that low exposure to natural bacteria and viruses makes immune system attack our own body. Hygiene hypothesis explains the rise in autoimmune diseases in modern times.

Low FODMAP Diet is an extreme variant of gluten-free diet.

Dr. Simon Robson, MD: There is little scientific evidence for benefits of gluten free diet. It can be harmful in some patients.

What does FODMAP stand for? FODMAP is Fermentable Oligo-Di-Monosaccharides and Polyols. But low FODMAP diet can help patients with Irritable Bowel Syndrome.

There might be benefits of gluten free diet for athletes. Novak Djokovic adheres to gluten-free diet.

Dr. Anton Titov, MD: Medical second opinion helps to make sure that diagnosis of gluten sensitivity is correct and complete. Benefits of gluten free diet are significant for some patients.

Medical second opinion also helps to choose the best treatment for overt or subclinical gluten sensitivity.

Dr. Simon Robson, MD: Microbiome changes that result from modern monoculture agricultural food production can be harmful for human microbiome. Microbiome changes can result in celiac disease, ulcerative colitis, Crohn's disease, and irritable bowel syndrome.

These patients might experience most benefits of gluten free diet.

Dr. Anton Titov, MD: Let's talk about inflammatory gastrointestinal diseases.

Dr. Simon Robson, MD: One of them is celiac disease, an autoimmune disease associated with gluten intolerance. Much is talked about potential benefits of gluten-free diet for patients, even for those who do not have overt gluten intolerance.

Recently there have been some publications about the existence of other types of carbohydrates in the same grains that contain gluten. One of these is called Fermentable Oligo-, Di-, Mono-saccharides and Polyols, FODMAP for short.

Some say the human body is simply not used to digest a lot of agriculture-based diets from the evolutionary standpoint. This includes the gluten-containing foods.

How does gluten damage the intestinal wall and cause celiac disease? Does subclinical gluten sensitivity exist? Is there any merit to this trend in gluten-free FODMAP-free diets?

Dr. Anton Titov, MD: That is interesting, and it is a very controversial topic. Maybe let's just touch back on some of the historical perspective that you alluded to.

It is clear that we were hunter-gatherers in the past. Then we had a balanced diet. Sometimes you look at a time when we switched over to agriculture. We can look by skeleton records and so forth.

Dr. Simon Robson, MD: Basically there was a decrease in stature. It was a time when society developed agriculture. Almost like we had the balanced diet initially with meat, berries, whatever.

Scavenging food allowed for a better balanced nutrition.

Dr. Anton Titov, MD: When patients became stuck on the land, farming intensively, it was almost like a decrease in body size and potential weight. It looks like those individuals were not getting the appropriate nutrition.

That is counterintuitive, because one would think otherwise. There would be more abundance of food when agricultural methods became available, but it is the other way around.

Dr. Simon Robson, MD: It may be a monoculture or maybe some other aspects of it. Maybe a more intensive agriculture that exhausted the land.

Maybe when you settle down on land, you had better food security. You are able to provide some food. May be agriculture increased the population that way, but for the individual it looks like there was initial fall off in body size of patients.

It is obviously controversial.

Dr. Simon Robson, MD: Clearly if you look during the Middle Ages as well, when subsistence farming existed, when there was widespread agriculture exhaustion of the land, there was widespread nutrient deficiency and some poor health.

It is only over the last 50 years or 100 years or so that the food supply has become much more diverse. Sometimes you look into American supermarket.

You have food from all around the world, at different times of the year. I mean you can go to supermarket now in the middle of early winter and find berries, fresh fruit, pineapples. So everything is there, food much more balanced.

The problem with celiac disease is that we were too successful. We have this hygiene hypothesis. You have probably heard of it.

Hygiene hypothesis states that we can lose some of the bacterial contamination. Then our immune system starts targeting the body itself. Then we have these autoimmune processes.

There is autoimmune liver disease, asthma, rheumatological disease, rheumatoid arthritis, celiac disease. What could be producing the increase in gluten sensitivity? It could be changes in our microbiome.

We make sure that the food we eat and ingest is free from bacterial contamination.

Dr. Anton Titov, MD: Our food is not spoiled, right? Also we pasteurize milk. We sterilize many of the drinking fruit juices and so forth. We lose some of the natural bacteria that we would have been ingesting.

It is a consequence of the hygiene hypothesis. Our immune system is turned on.

Dr. Simon Robson, MD: There may be changes in our microbiome. These changes provoke some of these responses to gluten.

Dr. Anton Titov, MD: Benefits of gluten free diet? Video interview with leading liver disease and gastroenterology specialist. Microbiome and monoculture farming. FODMAP and gluten.