"Gluten-free" epidemic? The research seeks to make it clearer



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The fashion is "gluten-free", but the confusion of the government is between "real" intolerant, allergic and "
hypersensitive

"With undivided contours, there are also those who decide to stop gluten for personal reasons, self-esteem, not to support or not to affect it. As a result, a comprehensive research program"
from plant to plate

"It is being implemented in France to try to make it clearer.

"There are three different pathologies", says Brigitte Jolivet, president of Afdiag, who has been running a campaign since 1989 to make life easier for gluten intolerance. "Real" intolerant, for which it is essential to exclude gluten, are victims of celiac disease. This condition destroys the lining of the small intestine and causes anemia, diarrhea, weight loss, bone pain and even stunning in children. No treatment, except gluten-free diet for life. 1% of the population would be affected (ie 670 000 people in France), of which only 10 to 20% are correctly diagnosed.

The second group refers to allergic patients, which are much less (0.1 to 0.5% of the population). The third group, "hypersensitive" could affect 0.5 to 15% of the population, which is at least "unclear", notes Mrs Jolivet. Inflammation, fatigue, digestive disorders are given at the expense of gluten
without scientific evidence

According to Mrs Jolivet.

What celiac disease responds to a clear diagnosis, based on a blood test (a dose of IgA antibodies), which is restored by social security, and confirmed by endoscopy of the duodenum (small intestine)
hypersensitive

It's hard to conceal. "
We are not sure that gluten is responsible

"Says Corinne Bouteloup, a gastro-gastroenterologist at the University of Clermont-Ferrand, who will undergo a clinical study in the GlutN research project.

From plant to plate

For a clearer understanding, this extensive research program was introduced with the National Institute for Agricultural Research, Inserm, and especially with the Clermont-Ferrand University Hospital. "
We'll research things from the plant to the plate

"Explains Catherine Ravel, who coordinates the project.

INRA studies the digestibility of bread and pasta, from the collection of 16 types of soft wheat and 8 types of durum wheat. "
The idea is to offer hypersensitive people a product that would carry it

She said. Coronne Bouteloup at CHU Clermont-Ferrand will bring sixty patients (except intolerant and allergic) to a double-blind diet with or without gluten to control their reaction.

"
The goal is to find biomarkers, because for now doctors are quite disturbed to put diagnosis, lack of tools

"True Catherine Grand Ravel. Blood, urine and sludge tests should be used to identify known" markers "for diagnosing gluten sensitivity.

Gluten added

A clinical study funded by the National Research Agency will begin in early 2019 with the first results at the end of the year. As Corinne Bouteloup says, "
Generally, they do not eat more gluten today because we eat a lot less bread, but the quality of gluten has changed

".

The so-called "homemade" gluten is naturally present in some cereals, including wheat. But the industry also uses a massive "vital gluten" for its textured power (volume and elasticity). "
Our old parents ate real bread, not industrial bread, pizzas, prepared dishes, cold cuts … Many of the products that were added to gluten

", She remembers Corinne Bouteloup. Now,"
vital gluten is highly concentrated and may be more resistant to digestion

".

"If we can prove that there is a gluten quality problem and its additive, it might be possible to change practices
She said. In parallel with these programs, an epidemiological study seeks to better understand "gluten-free" from the Nutrinet study, which explores nutritional users.

"
20,000 questions were answered on the gluten questionnaire

"Says Emmanuelle Kesse-Guyot, Research Director.

"
People who have celiac disease are excluded and are interested in whether people who exclude gluten with personal choice have special characteristics. What are you eating? Why choose to exclude gluten? For comfort in the abdomen, physical well-being or belief (bad for my health, for the environment)?

"

Shortcomings

"
What we know is that people who exclude gluten also exclude other things, which can lead to defects

He's watching. "
We are struggling with a dietitian with whom I work to bring patients back to the least restrictive diet. We see people coming to a consultation who does not know what to eat because of restrictions

", Reports Corinne Bouteloup.

"
For many I see them, I think that the vast majority of people who say that they are better off when they remove gluten, actually become better because they remove fructans, which are also in processed cereal spoons.
. Fructans are part of the "Fodmaps", another "suspect", which is strongly appearing. This acronym designates certain carbohydrates.

"
Fodmaps are found naturally in many foods, cereals are fructified, in many fruits and vegetables are fructose, polyols, sugars that are not digested and fermented in the colon

Explains Corinne Bouteloup.

Based on ten years of experience, it is suspected that "
More specifically, those who remove many things are often people insensitive to gluten, but impatient to Fodmapov.

"This is my clinical feeling," It notes, "But I have not had the means to start a study on this. It needs time, small hands, money …"

Gluten-free sales were 12% last year, in a large array of "health" foods that in supermarkets exceeded 6 billion euros in 2017, according to a study by Xerfi.

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