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Can a Gluten-free Diet Damage Gut Bacteria? 06/09/2009 - Results of a recent small population study done in Spain suggest that a gluten-free diet may change gut bacteria balance by decreasing beneficial bacteria and increasing detrimental bacteria. Certainly, gut health is an issue to most people with celiac disease. Recent studies suggest that people with celiac disease benefit from bifidium and lactobaccilus supplements, so it's possible that such benefit is in part an offsetting of damage due to gluten-free diet; at least, a connection seems possible.

The Spanish study follows just ten individuals for just one month on gluten-free diets. A large-scale, long-term study might make very different observations, and reach very different conclusions.

The study found no significant differences in dietary intake before and after the gluten-free diet except for reductions (P=0.001) in polysaccharides. Bifidobacterium, Clostridium lituseburense and Faecalibacterium prausnitzii proportions decreased (P=0.007, P=0.031 and P=0.009, respectively) as a result of the GFD analysed by fluorescence in situ hybridisation (FISH). Bifidobacterium, Lactobacillus and Bifidobacterium longum counts decreased (P=0.020, P=0.001 and P=0.017, respectively), while Enterobacteriaceae and Escherichia coli counts increased (P=0.005 and P=0.003) after the GFD assessed by quantitative PCR (qPCR). TNF-alpha, interferon-gamma, IL-10 and IL-8 production by PBMC stimulated with faecal samples was also reduced (P=0.021, P=0.037, P=0.002 and P=0.007, respectively) after the diet.

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The study doesn't provide any real evidence to support a conclusion one way or the other, especially their conclusion that a gluten-free diet "may constitute an environmental variable to be considered in treated Coeliac disease patients for its possible effects on gut health."

The fact is that beneficial, probiotic bacteria in the human gut are influenced by diet. The more fruits, vegetables, and high fiber foods we consume, the healthier our bacteria will be.

The Spanish study makes no mention of the subjects' diets. Were they fed high fiber, low fat diets rich in fruits and vegetables, or did they eat a standard western diet with no gluten?

It would be interesting to compare the gut bacteria levels of people before celiac disease diagnosis and after celiac disease diagnosis to see if a gluten-free diet improves gut bacteria overall, or if the Spanish results would be seen again.

Br J Nutr. 2009 May 18:1-7. welcomes your comments below (registration is NOT required).

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8 Responses:

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said this on
09 Jun 2009 8:28:09 PM PDT
I had to comment on this, I have been a celiac 17 years, 7 years ago, I started fighting the biggest battle in my life, unknown to me then! I have 'Candida Albicans' I have done most the research on the gluten-free prebiotic diet and probiotics, I am getting ready to test this week once again to see if I have any bad bacteria and how bad the yeast still is in my gut! It has made me a very ill person, I went into malabsorption 3 years ago and got down to a very unhealthy 95 pounds and hospitalized over and over for dehydration. I take a regiment of probiotics and a very strict prebiotic diet. I have helped many celiacs in the Myspace community get the same diagnoses from their doctors, if I had ever known the danger of this illness, I would have started probiotics years ago and watched my diet intake much better, I never dreamed what this does to a person, now I know 1st hand! My immune system is very weak and I suffer through many flu viruses, this community needs to know the facts about 'Candida Albicans.' How in the world is this called a study testing 10 people? This article just made me very upset! I live it 1st hand everyday!

Ignacio Abel
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said this on
10 Jun 2009 6:02:52 AM PDT
This is what Elaine Gottschall explains on her book Breaking the vicious cycle.

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said this on
10 Jun 2009 12:18:51 PM PDT
I fully agree with you. When I watched this article before yours, I thought that there must be some error, as you said, maybe the diet they took when they went gluten-free was not good enough. I don't believe gluten-free people, even if not celiac, are not healthier.
From my experience, even if only my daughter is celiac, all the rest of the family has large improved our health: no more infectious in her sister, no more gastroenterites for anybody, and more.

Jody J
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said this on
10 Jun 2009 12:30:03 PM PDT
Thanks, Jefferson - I saw the article that came over yesterday referencing this study and was very skeptical. Thanks for shedding some light on the size and duration of the study. Very informative!

Jaime R.
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said this on
10 Jun 2009 9:04:42 PM PDT
This is very interesting, because I have had many problems with overgrowth of bad bacteria in my gut since being diagnosed with Celiac over three years ago. It had gotten so bad at one point that I had diarrhea for eight months straight that was almost as bad as my undiagnosed Celiac. It was like all of my symptoms were coming back again. Antibiotics have helped me several times when falling into this overgrowth of bad bacteria. Now I know!

nm gds
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said this on
10 Jun 2009 10:37:39 PM PDT
Quote study: 'Bifidobacterium, Lactobacillus and Bifidobacterium longum counts decreased (P = 0·020, P = 0·001 and P = 0·017, respectively), while Enterobacteriaceae and Escherichia coli counts increased (P = 0·005 and P = 0·003) after the GFD assessed by qPCR. TNF-α, interferon-γ, IL-10 and IL-8 production by PBMC stimulated with faecal samples was also reduced (P = 0·021, P = 0·037, P = 0·002 and P = 0·007, respectively) after the diet.'

If the markers of immune stimulation decrease while using gluten free diet like - TNF-alpha, interferon-gamma, interleukin-10 (IL-10) and IL-8, the other possible explanation would be that the changing flora in fact is less immune triggering, rather that that the body's ability of immune reaction is decreased.

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said this on
11 Jun 2009 3:19:52 PM PDT
I wanted to comment to Jan. This is just my speculation, but I don't believe, in my opinion, that a gluten-free diet in and of itself causes yeast overgrowth in the gut. It may be due to having an abundance of starch and sugar consumption. Yeast especially feeds off sugar. I read in Dr. James Braly's book, 'Dangerous Grains' that our far back ancestors were not farmers, but hunters and lived a healthier life than we do today and they were grain-free of all kinds as there was a point in history where we did not consume grains. Definitely, though, a good probiotic every day should help with this problem.

Mary Ellen
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said this on
07 Jul 2009 3:10:50 PM PDT
I would have to agree with Jan. I have had huge problems with Candida and suspect that it is indeed due to increased starch intake. My own gut healing took well over 2 years after starting a gluten-free diet because of Candida. Gluten free baking is full of starches which act like sugar in the blood stream. I often wonder if anyone has done any research on what a healthy diet looks like for the celiac. Maybe those of us struggling with Candida need to just give up the idea of finding substitutes for bread and cakes and do without. And if Jamie is reading this...antibiotics make the Candida overgrowth even worse because it kills the good bacteria that control the yeast.

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Even one positive can be diagnostic. This is one: Gliadin deamidated peptide IgG 33.9. If unsure, a biopsy of the small intestine will provide definite confirmation. There is a control test to validate the other ones, but I don't see it there. What is does is validate the others by checking on the overall antibody levels. But it is to detect possible false negatives. A positive is a positive. I think your daughter has joined our club.

My daughter, almost 7 years old, recently had a lot of blood work done, her Dr is out of the office, but another Dr in the practice said everything looked normal. I'm waiting for her Dr to come back and see what she thinks. I'm concerned because there is one abnormal result and I can't find info to tell me if just that one test being abnormal means anything. The reason for the blood work is mainly because of her poor growth, though she does have some other symptoms. IgA 133 mg/dl Reference range 33-200 CRP <2.9 same as reference range Gliadin Deamidated Peptide IgA .4 Reference range <=14.9 Gliadin deamidated peptide IgG 33.9 Reference range <=14.9 TTG IgA .5 Reference range <=14.9 TTG IgG <.8 Reference range <=14.9

Just watch out. I just went to the expo in Schaumburg, IL, and ended up getting glutened. I realized afterward that I ate all these samples thinking they were gluten free, and they weren't. One company was advertising some sugar, and had made some cake, but then I realized.... How do I know if this contains any other ingredients that might have gluten? Did they make it with a blender or utensils that had gluten contamination? Makes me realize the only safe things would be packaged giveaways with gluten free labeling. My fault for not thinking things through. It was just too exciting thinking i could try it all and enjoy without worry.

No fasting required for a celiac blood test unless they were checking your blood glucose levels during the same blood draw.

I wish! I got the flu this winter as well as a couple of colds. I do have 3 lids, the youngest in preschool, so there's always a lot of germs around. Lol