Am I Gluten Sensitive? My Troubled Wheat Love Affair – Part 3: On Fructans, FODMAPs and Symbiotic Bacteria

fructans and health

As narrated in part one and part two of this series of short articles, I have tried for years to understand my own gluten sensitivity/wheat intolerance.

What was puzzling me is that I was not simply reacting to gluten in wheat.

In fact, I had reactions also to wheat starch, which is commonly used in gluten-free breads. However, I knew that gluten was an issue, because gluten in isolation (without the other components of wheat, like in seitan) was causing me discomfort.

So what else is in wheat? As we said, starches. And also proteins/enzymes other than gluten. As I found out in my search, some of these proteins/enzymes -called ATI (amylase tripsin inhibitors)– are engineered by plants to prevent animals, like us, to digest the starches contained in their seeds (like wheat berries). I believe ATIs and changes to them in modern wheat varieties are part of this chain reaction that has led me and other people to develop wheat intolerance*. ATI may play a role in a problem that is being observed in a growing number of people: abnormal digestion of a type of wheat starches, fructans.

*I think we should talk of “wheat intolerance” rather than “gluten sensitivity”, because the first is a broader term that may better capture all the (many) mechanisms at play, which include sensitivity to several wheat components, including gluten and fructans.

Wheat and rye are rich of a type of fructose molecules, fructans, which are indigestible by us humans. Fructans are a wide class of molecules found in most plants. Not all plants though have high concentrations of fructans, and types of fructans vary considerably between different species of plants.

Fructans together with galactans -another indigestible type of sugars present in legumes– have become the focus of a now popular diet called FODMAPs. FODMAPs diet has been devised by Monash University in Australia to help treat symptoms of IBS (Irritable Bowel Syndrome). It consists of a long list of foods high in fructans that should be avoided or strictly limited. Among them, several fruits and vegetables that we easily have access to, legumes, wheat and rye. A vegetarian will be in big trouble on a FODMAPs diet and, not only that.

If FODMAPs diet becomes the golden standard treatment for the 14% of the global population with IBS symptoms, which is, 1 billion people, we will be in big, big, trouble. Both environmentally and economically.

Among the foods to exclude we find: asparagus, artichokes, onions(all), leek bulb, garlic, legumes/pulses, sugar snap peas, onion and garlic salts, beetroot, savoy cabbage, celery, sweet corn, apples, pears, mango, nashi pears, watermelon, nectarines, peaches, plums, milk, soft cheeses, pulses, legumes, wheat, rye.

These are all foods that we have eaten for millennia and, if 14% of us (and up to 25% of Northern Europeans) was having problems with them, I don’t think these food items would ever have become so central in our agriculture and livestock rearing. We would have left the plants grow wild and picked them occasionally and used the animals only for meat. But this is not how it went. So, before excluding large parts of our food supplies, and actually some of the most environmentally sound and economically smart food choices, we should, and I sure did, ask ourselves why. What has changed? How can we change it back?

Why is it that so many people are better off avoiding foods high in fructans and galactans? And how is this related to the current epidemics of gluten sensitivity?

IBS is a condition that affects the large intestine (bowel) -and sometimes the small intestine (small bowel)- and it is characterized of one or more of the following symptoms: cramping, abdominal pain, bloating, change in bowel habits (diarrhea and/or constipation). IBS is truly an umbrella diagnosis and includes many different problems affecting the large and/or the small intestine. Most people with gluten sensitivity could be classified indeed as IBS patients.

And here we get to the crux of the issue. What is going on with our digestive system that wasn’t going on before?

gut microbiota

It has been observed that up to 80% of patients with irritable bowel syndrome (IBS) have SIBO (small intestinal bacterial overgrowth).

What does this mean? That part of us with recurrent stomach problems may have too many bacteria growing in the small intestine, where bacteria should not be too many (contrary to the large intestine).

There is also, most likely, something called dysbiosis going on. This means the taking over of some bacteria over others, which can become as severe to cause ruptures, cancer, and death.

In dysbiosis, the usual balance between the million populations of bacteria that have adapted to our gut through the millennia is disrupted. Some bacteria that should be there are simply not there, or are too few, and some other bacteria that should be present only in moderation have taken over and make big feasts with the food we give them -with unpleasant consequences for us, like in the case of IBS.

And here we can go back to our beloved wheat.

Not all fructans are the same. In wheat and rye we find mostly a type of fructan that is not common in other plants. It is called levan (sounding like levain, sourdough, which is actually a good way to pre-digest fructans).

Anyway, levan is the class of fructans we find most in wheat and rye. They have a different molecular structure compared to the most common other class of fructans, inulin -found in many vegetables and fruits- and it is reasonable to think that they are different as compared to other fructans also in terms of the impact on our bodies when we ingest them.

As one can find on up-to-date agronomy literature (Joran Verspreet, from Belgium, has written a whole thesis on the topic and published several valuable papers on wheat/rye fructans), levans are complex branched fructans that help wheat to grow and fully develop and protect the plant from unfavorable conditions, like cold weather and poor water supply.

Levan concentration in the bulk, seed and leaves changes depending on the stage of plant maturation. It is maximum when the wheat berry is formed but not yet ripe.

This does ring a bell to me… maybe increased levan levels in our wheat may have arised because of the modern practice of harvesting wheat early to reduce costs?

And how about the fact that nowadays wheat grows in any weather condition? Tolerating extreme cold as well as lack of water?

It is likely that the most modern crops are also those with the highest concentrations of branched fructans, those that make wheat more resistant.

wheat harvesst

Right, so what?

And how does this relate to an unbalanced gut flora and to too many nasty and hungry gut bacteria?

Well, when people say that we have not evolved to eat wheat, they probably have not read any literature about the gut microbiota.

Bacteria have in fact a much shorter life cycle than us humans and, since when cereals have become a staple food, about 12,000 years ago, there has been time for billions of changes in the bacteria we host. So that:

instead of human evolution we should truly talk in terms of hosted bacteria evolution.

To help digest wheat starches (and get lots of food to chew on in return) selected bacteria strains have populated our intestine. In the case of levan fructans, various strains of bacteroides are the elected bacteria. Bacteroides just love wheat and rye levan. And they can degrade the big polymers of molecules into smaller peptides. This was one of the many adaptations our bodies underwent when starting to eat more wheat.

Bacteroids growth is generally regulated by other hosted bacteria, such as lactobacilli. There we can think that if lactobacilli are reduced, maybe due to some antibioticc treatment, there will be overgrowth of certain strains of bacteroids over others strains of bacteria, and this may contribute to problems with the digestion of wheat. But the bacteria strains involved are likely to be more and the mechanisms much more complicated than this.

Recently a link was found between overgrowth of a specific bacteroide, immune response and gluten toxicity.

In summary, wheat fructans and ATIs in wheat may play a role in determining if gluten will be perceived as toxic or not by our bodies. For instance by feeding specific strains of gut bacteria that influence the immune response to gluten. Moreover, factors completely unrelated to wheat, like the selection of certain bacteria over others due to overall diet or antibiotic consumption or other environmental threats (example: chemicals in food), can also impact on the reaction to wheat and gluten.

So stay tuned and please, do let me know about your own experience of IBS or gluten sensitivity/wheat intolerance. And thanks a lot for reading and sharing! And always keep bread-ing! There are plenty of good reasons to.

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Barbara Elisi

Hi there! I am the "soul" behind Bread & Companatico. My main interest is the preservation of bread tradition and craft, with an eye to health. I hope you are having a good time reading this blog, and please don't be shy to connect with me through comments or emails and do keep on bread-ing! 🙂
16 replies
  1. Don Sadowsky
    Don Sadowsky says:

    Barbara, this is all very interesting to me, personally. I react to rye, and I had my bacterial composition tested. Lactobacillus was at below detectable levels. Your discussion of lactobacilli and their role in regulating bacterioides seems consistent. I’ll be interested in your further discussion. Thanks for posting this series.

    Reply
      • Don Sadowsky
        Don Sadowsky says:

        Thank you, Barbara, for your gracious response. I was not provided with information on bacterioides, but perhaps should pursue that.

        Reply
        • Weilia
          Weilia says:

          Hi Barbara,
          Thank you for the excellent articles! it is so interesting to know more about wheat. I started to rethink my stomach problem, maybe it is related to bread related components.

          Reply
          • Barbara Elisi
            Barbara Elisi says:

            Hi Weilia, thanks for reading!
            Well, not necessarily.
            My point, which I will develop better in the next post, is that the direction of this association can be reversed.
            I mean that it can go this way: other factors/foods—> stomach dysfunction —> wheat intolerance.
            In other words, it may not be the bread to have caused your problems, even if when you already have the problems, and until you have taking care of them reducing amounts/changing the type of wheat you eat or even cutting it out for a while (unless you do have celiac disease, in most cases you should be able to reintroduce wheat, at least some types of it, and prepared in a specific way).
            Some of the causes of your stomach problems could be additives to food by industry. Or treatment with antibiotics. Or antibiotics in food. Even pollution seems to be connected to stomach problems. And stress/anxiety. So you see… it is definitely not (only) the bread… on the contrary, bread (in moderation), if properly prepared and made with the right flour would be one healthy food in a healthy stomach. Healthier than all processed food around.
            Stay tuned!

  2. François
    François says:

    Hi Barbara, most interesting, please do not stop. Lots of ground to cover from diagnosis to cure or at least food recommendations. When you reach bread making I’ll be most interested in your input on yeast versus sourdough -both long proofing of course- (as we know almost all sourdough cultures contain natural yeasts)

    Reply
    • Barbara Elisi
      Barbara Elisi says:

      Hi Francois, and thanks a lot for keep reading and for your support.
      I also am quite impatient to jump to the “remedies” and discuss, not only fermentation, but also wheat/cereal varieties. And I can anticipate that sourdough is indeed the best way to ferment cereals, containing fructans and other indigestible starches and in some cases also gluten. There is no way to do better than sourdough. Only one strain of yeast will never be as effective in the catabolism of starches and proteins of cereals as a multitude of yeasts and bacteria that live in equilibrium with one another in a cereal medium would do.
      And I know that you would agree with my statements, as I checked you out and just read Farine’s lovely article on you and your bakery in Paris. So inspiring! I am a fan now.

      Reply
  3. Chris
    Chris says:

    Hi Barbara, early in this article you say: “In fact, I had reactions also to wheat starch, which is commonly used in gluten-free breads.”
    Is that right? I haven’t come across any gluten free bread that contains wheat starch. Many commercial gluten free breads use starches from potatoes, corn, manioc (cassava) and white rice.

    Reply
    • Barbara Elisi
      Barbara Elisi says:

      Hi Chris,

      unfortunately in Sweden the main gluten-free flour mixes are based on wheat starch.
      Anyway, I do react also to tapioca and corn starch, much less to potato starch. Basically all cereal starches are tough on my system. I will discuss possible reasons for this in the coming articles, although something that has to do with indigestible fructose and too much feed for overgrown bacteria has already been discussed here, and this problem is not confined to wheat starch. Originally, rice and corn, for instance, do not accumulate much fructans, because they grow in humid and warm weather (so they don’t need to prepare for drought and frost, which is instead the case of wheat and its relatives, cereals originally grown in temperate latitudes, with dry summers and cold winters). So, if I eat rice and corn as they are, I won’t be bothered by their fructans concentrations. However, if the starches, including the fructans, are industrially extracted in concentrated amounts and put in my bread or pasta, I will have reactions. It is pretty straight forward, really… ideally a gluten free bread should only include non industrial ingredients, but surely it will not be able to imitate wheat bread that way -which I think is ok. If we want fluffy, leavened, bread, we have to stick to bread wheat and do all we can to make that more digestible to most.

      Reply
  4. Karin Anderson
    Karin Anderson says:

    Barbara, you combine interesting research with a highly digestible presentation, eliminating the “eyes-glaze-over” and “snooze-off” factors, and separating fads from facts.
    Looking forward to part IV!

    Reply
    • Barbara Elisi
      Barbara Elisi says:

      Karin, thank you so much for your warm support!
      there is so much work behind these short articles and it makes me happy to know it makes sense at least to someone 🙂 and that I managed not to make you fall asleep 😉
      part IV will hopefully come before Easter.

      Reply
  5. Rod
    Rod says:

    Hi Barbara,
    Nice post. Just two editorial comments
    1) IBS is an abbreviation for irritable bowel syndrome not inflammatory bowel syndrome. The sine qua non of IBS is the absence of inflammatory changes. This should not be confused with IBD (inflammatory bowel disease).
    2) Most literature on IBS would not support 80% prevalence of small intestinal bacterial overgrowth in patients with IBS. Although the FDA has just approved a nonabsorbable antibiotic for treatment of this disorder in patients with IBS.
    I laud your educational efforts. It is important to distinguish between celiac sprue which leads to inflammatory changes in the small bowel contrasted to gluten sensitivity which leads predominantly to symptoms and not directly related to gluten which you have elaborately described.

    Reply
    • Barbara Elisi
      Barbara Elisi says:

      Hi Rod, and thanks a lot for the edit. Already changed in the text. Difficult to get all typo-free without peer-review.
      1) I was indeed driven to my typo by the alternative diagnosis “inflammatory bowel disease” (IBD), which I did not discuss here not to overdo it with medical concepts, but which is most likely part of the picture. As you notice in fact people with celiac disease are at increased risk of IBD. And in IBD it is clear the role of gut microbiota, so that diagnosis should surely be part of this whole picture. But not to be confused with IBS, for sure!
      2) I agree that not all literature report such high rates, in fact in the article I wrote “up to 80%”, meaning that lower rates have also been reported. I took my figures from this paper: http://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-10-23
      I think it is relevant, anyway, to stress the fact that in a (not yet clarified) proportion of IBS subjects we have SIBO.
      Happy to hear specifically targeted antibotics are been approved for IBS, this could help. My question is: how much such treatment can help in the long run? How to prevent the bacteria from overgrowing again in the small intestine, after the treatment?

      Reply

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