Ancient Wheat for Irritable Bowel Syndrome

It's great to see so many interesting papers exploring the role of wheat in various common digestive issues. The last interesting paper I wrote about explored the role of FODMAPs in wheat in causing digestive problems sometimes called "gluten sensitivity." A new paperEffect of Triticum turgidum subsp. turanicum wheat on irritable bowel syndrome: a double-blinded randomised dietary intervention trial, explores whether or not ancient wheat might be less likely to cause these type of issues in IBS patients. 

The variety tested was Triticum turgidum ssp. turanicum AKA Khorasan wheat, a heritage wheat from the Fertile Crescent. If you've spent much time in a health food store you might know "kamut," which is the trademarked version. In this study, twenty IBS (irritable bowel syndrome) patients were told to exclude all grain products except either modern wheat (the "control group") or ancient Khorasan wheat for six weeks. Unfortunately from the outset it's clear the study is very small. And the "control group" is pretty odd. Modern diets aren't particularly diverse, but few of us get ALL our grain calories just from wheat. It also would have been interesting to see a wheat-free, whole wheat, or entirely grain free group. Or even a group eating a non-wheat heritage grain like buckwheat. The symptoms were scored via questionnaire, though they also measured some inflammatory markers. 

Makes me wonder whether or not the improvements seen in the ancient wheat group were from not eating modern wheat or from adding the ancient wheat to the diet, especially since the study notes that the ancient wheat was far more nutritious than the common modern variety. It was significantly richer in potassium, iron, magnesium, selenium, and zinc, as well as antioxidants. The study noted that the patients eating the ancient wheat had lower levels of pro-inflammatory cytokines.

I would caution people against interpreting this study as meaning modern wheat is inflammatory. It may mean this ancient wheat is anti-inflammatory. The antioxidant compounds that were richer in the ancient wheat such as polyphenolscarotenoids and flavonoids also lower these inflammatory markers in studies. And none of the ranges of the inflammatory markers was high enough to be considered pathological. Ultimately, the theory that IBS is an inflammatory disease remains controversial. 

While the present study demonstrates an improvement in the inflammatory profile, the specific role of cytokines in IBS is not fully understood, and, to date, there are no unifying trends in cytokine profile changes among the various studies conducted(7). Potential reasons include the small sample sizes in the reported studies where the entire spectrum of cytokines was often not measured(7). Diet provides a variety of nutrients as well as an array of functional constituents (flavonoids and soluble fibres) that modulate inflammatory processes. No single functional constituent, responsible for improvements in the inflammatory profile, has yet been identified in ancient wheat products. Probably, the beneficial efforts are attributable to synergistic effects within the spectrum of various functional constituents present.…Although the present results are promising, the number of participants (twenty in total) represents the major limitation of the present study. Further and larger studies need to be conducted before drawing any firm conclusion on the effects of such foods in IBS.

Regardless, the IBS patients eating ancient wheat, reported significantly less bloating, fatigue, and abdominal pain. And they reported better stool consistancy. BMI went unchanged.

The author of Wheat Belly said this study is no excuse to eat ancient wheat, comparing the relationship between modern and ancient wheat to low-tar cigarettes vs. regular cigarettes, citing the fact that human populations became less healthy after they adopted wheat farming. The reality is that there are multiple reasons why some markers of health declined upon the adoption of agriculture in some places, such as living in villages where diseases were more easily spread and economic inequality (If only people would be as eager to denounce economic inequality as they are to demonize wheat). With this kind of logic, it would be wise to not only give up wheat, but to give up living in cities and towns. I find it interesting that the few blogs I've seen on this study come to their own conclusions pretty far from what the researchers concluded in their own paper. 

As far as other theories about ancient wheat, another paper that showed similar effects that just came out, Role of Kamut® brand khorasan wheat in the counteraction of non-celiac wheat sensitivity and oxidative damage notes:

Ancient wheat, not subjected to recent major genetic improvements in agronomic and processing characteristics, has been speculated to be better suited to be introduced into the diets of people suffering from non-celiac WS, although scientific or clinical evidences are lacking. Colomba and Gregorini (2012) pointed out that ancient wheat (Graziella Ra and Kamut®wheat) have greater amounts of both total and α-gliadin than modern ones (Cappelli, Grazia, Flaminio, and Svevo), thus challenging the “low-immunogenicity” hypothesis. In that work, a large series of α-gliadin epitope variants, mainly consisting of one or two amino acid substitutions were detected in all the accessions (including ancient ones); although their T-cell stimulatory capacity would need to be further. investigated, the role of other wheat components than gluten in the triggering of non-gluten WS must also be carefully considered.

It's also worth noting that different varieties of wheat show different prebiotic effects on the gut microflora and Khorasan wheat has shown to be one of the better prebiotic varieties, which feeds potentially beneficial gut flora.

I do think that given the growing evidence that certain carbohydrates (FODMAPS) play a large role in IBS, IBS patients would probably do best to try to lower those and get their condition under control before they try ancient wheat. The inflammatory markers this paper measures can be lowered by other dietary changes that are probably also more fun than ancient wheat, such as drinking wine. It's also worth mentioning that even ancient wheat is still not safe for those with celiac disease. 

It's not as excitingly dangerous as a "wheat belly "or the idea that wheat is going to cause you to be slowly poisoned like a chain smoker, but personally I've tried kamut and it gives me gas, an IBS symptom I notice this paper didn't comment on. I still haven't figured out a way to tell restaurants "no thanks on the bread, it gives me uncontrollable farting for hours" gracefully. I think "I only eat ancient wheat" sounds a little too pretentious, so I usually eat around it or eat only smaller amounts.