Should We Still Be Eating Wheat

By Helen Tran, APD

Wheat has featured in the human diet for more than 8,500 years, but more recently the media has led us to question if wheat is good for our health. A recent example of this manipulation of consumer perception is the documentary ‘What’s with Wheat?’ hosted by Australian Nutritionist, Cyndi O’Meara.

But it’s true that wheat isn’t tolerated by a small subset of the population, including those with diagnosed coeliac disease, a wheat allergy or non-coeliac wheat sensitivity, so we’ve taken a look at what the science says for the rest of us.

Does wheat cause a rise in coeliac disease and wheat sensitivity?

It’s suggested that modern wheat varieties created by genetic research, has led to the addition of a ‘new’ protein in wheat called gliadin, which in turn has led to an increase in the number of people with Coeliac disease and wheat sensitivity. But this notion is flawed. All varieties of wheat contain gliadin, including ancient and modern varieties, suggesting that we have always been exposed to gliadin in our diets.^(1,2)

Similarly, results from a study examining data from the 20^th and 21^st centuries in the United States do not support the theory that wheat breeding has caused a rise in gluten content in wheat.⁽³⁾ Another theory is that fructan in wheat has increased, but once again there is no well-designed research to support this. In one study, some ancient wheat species had a higher fructan content than modern wheat species.⁽⁴⁾

Overall, the evidence does not support the notion that modern wheat has a higher gliadin, gluten or fructan content compared to ancient varieties. It may be likely that the rise in coeliac disease and wheat sensitivity in the last 50 years comes from improvements in detection methods and an overwhelming increase in our awareness of how specific foods make us feel.

Does eating wheat lead to obesity and type 2 diabetes?

The relatively recent abundance of wheat products on our supermarket shelves has been identified as one factor responsible for the global increase in incidences of obesity and overweight. Whilst it’s tempting to find a single culprit for this very concerning trend, it is an oversimplification. This assertion overlooks the multiple interacting factors that can contribute to weight gain, including genetics, individual psychology, environment, dietary intake and level of physical activity.^(1,5)

Contrary to this claim, a recent analysis of the Australian National Nutrition Survey found that people who eat the recommended amount of core grain food each day are no more likely to be overweight than those who limit grain foods. Research also shows those people who eat whole grains, including whole grain wheat, have been shown to have the least amount of abdominal fat accumulation compared to those people who eat refined grains or limit all grains.⁽⁶⁾ In fact, eating foods made with whole grain wheat may have positive effects on long term weight management.⁽¹⁾

Currently, there is no clear evidence that wheat (whole grain or refined) is associated with an increased risk of type 2 diabetes. In fact, well-designed studies show that individuals who regularly eat whole grains (most of which are wheat based) are at a reduced risk of developing type 2 diabetes, compared to those who eat the least.^(1,8,9)

The protective effects of whole grain wheat comes from the dietary fibre, vitamins, minerals and phytochemicals it contains. So to reduce our risk of type 2 diabetes, the answer doesn’t lie in cutting out wheat completely, but in choosing whole grain and high fibre wheat foods instead with an aim to increase our intake of whole grains, including whole grain wheat.

Does eating wheat cause inflammation?

It’s been proposed that plant defense proteins called amylase trypsin inhibitors may cause chronic inflammation and activate the immune system^(10-12) but there is currently no evidence which supports this theory.

There is however, mounting evidence to suggest that higher intakes of whole grains may be protective against cardiovascular disease, hypertension, metabolic disorders and specific cancers. ^(13,14) Prebiotic fibres in fibre-rich grains stimulate the production of short chain fatty acids, such as butyrate, that have been shown to enhance the intestinal barrier function.⁽¹⁵⁾

This limited research shows that further research is needed before definitive conclusions can be drawn about the effects of wheat on inflammation.

Does eating wheat change the behaviour of children with Autism Spectrum Disorders?

More and more parents of children with Autism Spectrum Disorders (ASD) are adopting a gluten free diet to manage their child’s behaviour.⁽¹⁶⁾ It’s been hypothesised that children with ASD may have a leaky gut and peptides of gluten in gluten-containing foods could enter the central nervous system. The theory suggests that gluten peptides may intensify brain opioid activity and disrupt normal brain function.⁽¹⁶⁾ Scientific evidence for the leaky gut theory remains inconclusive and evidence to either support or refute the use of a gluten free diet for managing ASD is inadequate.

In the absence of evidence of an effect of gluten on ASD, it is not recommended that children are placed on a gluten-free diet as this diet has been shown to be deficient in nutrients that are important for a child’s growth and development, including B vitamins, iron, zinc and magnesium.

Instead it’s recommended that time and resources would be best spent on more robustly designed interventions.⁽¹⁷⁾ Until more evidence is available, a gluten free diet should only be adopted by children with coeliac disease or wheat sensitivity.

So what’s the bottom line?

Given the evidence, there appears to be no benefit in removing wheat from the diets of the general population. In fact, eating whole grain foods, predominately those that are wheat-based, have been shown to reduce chronic disease risk and are a leading source of essential nutrients in the Australian diet including fibre, B vitamins, iron, magnesium and iodine. Although more research is required to identify the specific link between wheat (whole grain and refined) and health outcomes, it appears that wheat may not negatively affect our health like the many claims that appear consistently in the media.

As such, it’s important not to rely solely on claims appearing in the media but consider the positives and negatives of all available evidence. After all, it’s up to us to make the best decision for our health.

For more information on the multiple benefits of wheat and whole grains, download the GLNC Grains for Health Report here or visit our website for recipes, factsheets and more here.

References

1.    Brouns FJPH, van Buul VJ, Shewry PR. Does wheat make us fat and sick? Journal of Cereal Science. 2013;58(2):209-15.

2.    Prandi B, Tedeschi T, Folloni S, Galaverna G, Sforza S. Peptides from gluten digestion: A comparison between old and modern wheat varieties. Food Research International.

3.    Kasarda DD. Can an increase in celiac disease be attributed to an increase in the gluten content of wheat as a consequence of wheat breeding? Journal of agricultural and food chemistry. 2013;61(6):1155-9.

4.    Ziegler JU, Steiner D, Longin CFH, Würschum T, Schweiggert RM, Carle R. Wheat and the irritable bowel syndrome – FODMAP levels of modern and ancient species and their retention during bread making. Journal of Functional Foods. 2016;25:257-66.

5.    Newell B, Proust K, Dyball R, McManus P. Seeing obesity as a systems problem. New South Wales Public Health Bulletin. 2007;18(12):214-8.

6.    Molenaar EA, Massaro JM, Jacques PF, Pou KM, Ellison RC, Hoffmann U, et al. Association of lifestyle factors with abdominal subcutaneous and visceral adiposity: the Framingham Heart Study. Diabetes care. 2009;32(3):505-10.

7.    Aune D, Norat T, Romundstad P, Vatten LJ. Whole grain and refined grain consumption and the risk of type 2 diabetes: a systematic review and dose–response meta-analysis of cohort studies. European Journal of Epidemiology. 2013;28(11):845-58.

8.    Wu H, Flint AJ, Qi Q, van Dam RM, Sampson LA, Rimm EB, et al. Association Between Dietary Whole Grain Intake and Risk of Mortality: Two Large Prospective Studies in US Men and Women. JAMA Intern Med. 2015.

9.    Kucek LK, Veenstra LD, Amnuaycheewa P, Sorrells ME. A Grounded Guide to Gluten: How Modern Genotypes and Processing Impact Wheat Sensitivity. Comprehensive Reviews in Food Science and Food Safety. 2015;14(3):285-302.

10. Cuccioloni M, Mozzicafreddo M, Ali I, Bonfili L, Cecarini V, Eleuteri AM, et al. Interaction between wheat alpha-amylase/trypsin bi-functional inhibitor and mammalian digestive enzymes: Kinetic, equilibrium and structural characterization of binding. Food chemistry. 2016;213:571-8.

11. Junker Y, Zeissig S, Kim S-J, Barisani D, Wieser H, Leffler DA, et al. Wheat amylase trypsin inhibitors drive intestinal inflammation via activation of toll-like receptor 4. The Journal of experimental medicine. 2012;209(13):2395-408.

12. Jones JM, Peña RJ, Korczak R, Braun HJ. CIMMYT Series on Carbohydrates, Wheat, Grains, and Health: Carbohydrates, Grains, and Wheat in Nutrition and Health: Their Relation to Digestion, Digestive Disorders, Blood Glucose, and Inflammation. Cereal Foods World. 2016;61(1):4-17.

13. Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, et al. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. Bmj. 2016;353.

14. Brahe LK, Astrup A, Larsen LH. Is butyrate the link between diet, intestinal microbiota and obesity-related metabolic diseases? Obesity Reviews. 2013;14(12):950-9.

15. Christison GW, Ivany K. Elimination diets in autism spectrum disorders: any wheat amidst the chaff? Journal of developmental and behavioral pediatrics : JDBP. 2006;27(2 Suppl):S162-S71.

16. Hurwitz S. The Gluten-Free, Casein-Free Diet and Autism: Limited Return on Family Investment. Journal of Early Intervention. 2013;35(1):3-19.

Making the Most of the Whole Grain Opportunity

By Rebecca Williams

New research examining global whole grain intakes suggests that Australia is doing better than some countries for whole grain consumption⁽¹⁾. However we still have a long way to go to meet the amount of whole grain recommended for good health and chronic disease risk reduction.

According to the most recent National Nutrition Survey only 34% of grain food consumed came from whole grain or high fibre grain foods⁽²⁾. This aligns with GLNC’s own research, which shows that more than 40% of Australians eat less than one serve of whole grain food per day⁽³⁾. An intake of three serves of whole grain a day is recommended to promote health and reduce chronic disease risk^{(4, 5)}, however in Australia only one in three people meets this target⁽³⁾.

Whilst Australia is doing much better than the UK - where just 17% of people meet this target and the US where only 8% eat enough whole grain - we’re not doing nearly as well as countries like Denmark, Sweden and Norway⁽¹⁾. Residents in these countries typically consume twice as much whole grain as the average Australian and may experience fewer instances of chronic disease as a result.

One of the reasons Australians are not meeting whole grain recommendations may be because they are confused about which foods are whole grain foods. The 2014 GLNC Consumption Study found that less than half of survey respondents were able to identify that oats and wholemeal pasta were a source of whole grain⁽³⁾. One of the contributing factors to consumer confusion may be that unlike other nutrients, the Food Standards Code does not regulate whole grain content claims, and consequently foods making whole grain claims may vary in the amount of whole grain they contain. Data from the 2016 GLNC product audit showed that the whole grain content of packaged breads with whole grain content claims on pack varied from around 8g to 60g of whole grain per serve⁽⁶⁾.

To ensure consumers are getting consistent information on whole grain content, the Grains & Legumes Nutrition Council launched the Code of Practice for Whole Grain Ingredient Content Claims in 2013. The Code helps to regulate whole grain content claims through the establishment of a benchmark for the minimum amount of whole grain a product must contain to make a whole grain ingredient content claim.

A recent impact assessment revealed significant uptake of, and a high level of compliance with, the Code by food industry. This should instil confidence in the Australian public’s ability to identify foods which contain a significant amount of whole grain.

Since the Code was launched Registered Users of the Code have added over 100,000 tonnes or more than 400 Olympic swimming pools of whole grain to the Australian food supply through new and renovated products. This is great news as it means that with increasing innovation in the whole grain category, it’s easier than ever for Australians to choose foods that are high in whole grain. 

While food industry is doing its part to support consumer choice, quantified public health recommendations would encourage consumers to choose whole grain more often. Based on the evidence for better health outcomes, this recommendation should be to choose whole grain for at least three of your six serves of grain foods a day.

The average Australian would need an increase of just 1.5 serves of whole grain a day to meet the recommended three serves and reap the significant health benefits of higher whole grain intake. This could be as simple as swapping the white bread in your sandwich for a wholemeal variety, or opting for a whole grain breakfast cereal in the morning. If you're in need of some inspiration, why not check out some of the delicious whole grain recipes available on the GLNC website.

Registered Users of the GLNC Code of Practice in Australia and New Zealand include:

If you're interested in registering with the Whole Grain Code of Practice or simply want to find out more click here.

References

1. Mann KD, Pearce MS, Seal CJ. Providing evidence to support the development of whole grain dietary recommendations in the United Kingdom. The Proceedings of the Nutrition Society. 2016:1-9.

2. ABS. 2011-2012 Australian Health Survey: Consumption of food groups from the Australian Dietary Guidelines, 2011–12 — Australia. Australian Bureau of Statistics, 2016.

3. GLNC. 2014 Australian Grains and Legumes Consumption and Attitudinal Report. Unpublished: 2014.

4. NHMRC. Australian Dietary Guidelines Providing the scientific evidence for healthier Australian diets. 2013 Accessed online January 2014.

5. Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, et al. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. Bmj. 2016;353.

6. GLNC. GLNC 2015-2016 Grains and Legumes Product Audit. Unpublished: Grains & Legumes Nutrition Council 2016.

Should We Eat Wheat?

Should We Eat Wheat?

Australians are increasingly mindful of the effect food has on health. In some cases this is a good thing as shown in a recent report where 40% of people stated one of their food priorities for the next 12 months was to eat more fruit and vegetables. Great news.

However, sometimes the temptation to label food as ‘good’ and ‘bad’ is too strong and people go in search of a single food that is the cause of all modern health problems.

Grains are not immune to this, and in recent times wheat has come into the spotlight. Some people, no doubt with all the best intentions, have become suspicious that eating wheat may be causing health issues. So, what are they concerned about and are their concerns valid?

Does eating wheat lead to obesity?

The key to this piece of the puzzle is to consider the quality of the food, not just the wheat it is made with. It’s true, wheat is found in many foods that if eaten in large quantities may lead to weight gain. Foods such as pies and sausage rolls, pizza, cakes and biscuits. However, wheat is also an important ingredient in core gain foods that provide essential nutrients in our diet. These are foods such as bread, breakfast cereal, pasta and couscous. Research in Australia has shown that people who eat the recommended six serves of these core grain foods, including those made from both refined and whole grain wheat, have similar BMI and waist circumference to those who eat the least amount of core grain foods. A large number of studies also show that people who eat more whole grain and high fibre core grain foods are less likely to be obese and less likely to gain weight over time. So it is the quality of the wheat-based foods that is important rather than the wheat itself.

Has wheat changed over time, causing increased rates of coeliac disease?

There is speculation that modern varieties of wheat contain higher levels of gluten than older varieties and this change is responsible for the apparent increase in coeliac disease during the second half of the 20th century. In an age of rapid technological advances it is no wonder people question the effect of technology on the food we eat. However, we cannot let suspicion take the place of evidence. Results from a comprehensive study examining data from the 20th and 21st centuries does not support the theory that wheat breeding has increased the gluten content of wheat.

There is also the suggestion that modern wheat is ‘created by genetic research’ and this has led to the inclusion of an unnatural protein, gliadin, which is responsible for stimulating appetite and causing weight gain.  In fact, gliadins are present in all wheat lines and in related wild species. Seeds of certain ancient types of wheat have even greater amounts of total gliadin than modern varieties.

Gluten should be avoided by everyone

Some theories suggest that even in healthy people gluten causes damage to the lining of the gut, increasing permeability of the gut wall and that this leads to an autoimmune response that can cause damage to the neurological system. The effect of gluten on the gut wall is well known in people with coeliac disease. However, there is no evidence to suggest this is true for people without coeliac disease.

In fact, research on the leaky gut concept suggests it may be caused by substances which damage the gut lining including an infection, alcohol, medications, or alternatively can be associated with inflammation, untreated coeliac disease or due to small intestinal bacterial overgrowth. Other than in the case of untreated coeliac disease grain foods and legumes are not identified as causes of leaky gut. 

In contrast to the suggestion that grains and grain foods cause a ‘leaky gut’, there is evidence shows fibre-rich grains contain prebiotic fibres which provide a surface for beneficial bacteria to thrive on producing short chain fatty acids, such as butyrate which has a demonstrated ability to enhance the intestinal barrier function

The Bottom Line – Should we Eat Wheat?

Stories from friends or even doctors about positive health changes resulting from cutting out a food can be very compelling. In fact, research from GLNC shows that family and friends are the second strongest influence over people’s health decisions after their GP. However as Oscar Wilde once said,  “The truth is rarely pure and never simple”. 

People are right to be making decisions about what they eat based on the effect on their health. But the key is not to make quick decisions based on the experience of a few people. Instead, we need to do the more difficult thing: think carefully about the information we receive and consider all the well-designed research, both negative and positive.

So, what does the whole picture tell us about wheat? It tells us that there are a number of reasons to eat wheat-based core foods, especially whole grain and high fibre choices: you’re more likely to be a healthier weight and get the essential nutrients you need, and you’re less likely to develop type 2 diabetes or heart disease than if you cut them out. In contrast, there is very limited evidence of the negative effects other than some compelling personal stories and anecdotes from doctors about patients.

The choice is yours.

References

IPSOS. FoodChats Annual Report 2015 – 2016. http://ipsos.com.au/wp-content/uploads/2016/05/Food-CHATs-report-abridged.2016.pdf

Grains & Legumes Nutrition Council (GLNC). Grains for Health. 2016. http://www.glnc.org.au/wp-content/uploads/2014/10/Grains-for-Health-Report-FINAL.pdf

Kasarda DD. Can an increase in celiac disease be attributed to an increase in the gluten content of wheat as a consequence of wheat breeding? J Agric Food Chem. Feb 13 2013;61(6):1155-1159.