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. Benefits of gluten free diet? 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. Leading expert in gastrointestinal and liver diseases shares his view. When farming started, human body size decreased. This could be refection that gut bacteria did not take well a change to monoculture agricultural farming methods of sedentary humans. Benefits of gluten free diet for everyone are not clear. Video interview with leading expert in liver diseases. 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. Benefits of gluten free diet and FODMAP. Dr. Anton Titov, MD. Let's talk about inflammatory gastrointestinal diseases. Dr. Simon Robson, MD. One of them is a 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 is 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-sacharides and Polyols. FODMAP for short. Some say the human body is simply not used to digest a lot of agriculture-based diets. This is 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. Simon Robson, MD. Harvard Medical School. 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 that we were hunter-gatherers or whatever in the past. Then we had a balanced diet. Sometimes you look at a time when we switched over to agriculture occurred. 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. Dr. Anton Titov, MD. 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, so 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. Dr. Simon Robson, MD. 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. Dr. Simon Robson, MD. 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. Benefits of gluten free diet? Dr. Anton Titov, MD. Video interview with leading liver disease and gastroenterology specialist. Microbiome and monoculture farming. FODMAP and gluten.