Restaurants and “gluten-free” products that are multiplying, stars and sports champions who praise the “zero-glu” diet: fad or real health problem? Still, between the real celiac patients and the simple addicts to a new nutritious trend, we must also reckon with the “sensitive” to gluten. Specialists now agree on the existence of a non-celiac gluten sensitivity (SGNC).
What are the differences with gluten intolerance?
Gluten intolerance, also called celiac disease, is an abnormal immunological reaction to gluten, a group of proteins contained in certain cereals: wheat, rye, barley and oats. This leads to an alteration of the intestinal membrane resulting in malabsorption of nutrients.
The symptoms are many and varied: abdominal pain, diarrhea, bloating, fatigue, anemia… but also sometimes neurological and joint disorders. About 1% of the population would be affected. In recent years, doctors have seen more and more patients with the same symptoms, but in whom the tests for celiac disease are negative. “Gluten sensitivity is a bit of a bastard form of gluten intolerance, notes Professor Bruno Bonaz, gastroenterologist at the Grenoble University Hospital. Can it eventually lead to this one? For now, we don’t know.”. More common, NCGS is estimated to affect 6% of the population.
How do you know if you are gluten sensitive?
“We start by making sure that it is not gluten intolerance, with blood tests to look for specific antibodies (anti-tranglutaminase IgA), or even a biopsy of the small intestine“, explains Bruno Bonaz. If the pathology is ruled out, NCGS can be suspected. The problem is that there are no specific biomarkers for this disease. The only certainty: a “gluten-sensitive” person suffers from various digestive disorders. quickly after consuming foods containing gluten, and sees her condition improving when she stops consuming them.The improvement is rapid because the intestinal membrane is not altered as in the case of an intolerance.
What to do if you think you are concerned?
No self-diagnosis and gluten-free diet without prior medical advice. “I see a lot of people who have cut gluten out of their diet because they feel better about it.observes Bruno Bonaz. The problem is that then it is more complicated to diagnose a possible gluten intolerance”. In fact, the antibodies and intestinal lesions characteristic of this disease disappear when you stop consuming gluten. Gold the diet is not the same in case of intolerance or sensitivity.
“Intolerant people must follow a strict, restrictive and expensive diet“, recalls the doctor. In the case of gluten sensitivity, there is a certain degree of tolerance specific to each one.We gradually reduce the quantities of gluten and we observe what happens in terms of digestive comfort”explains dietitian Virginie Grandjean-Ceccon. For some, removing the main sources of gluten (bread, pasta, cakes) is enough. For others, it will also be necessary to track down the gluten hidden in processed foods”. The diet must therefore be completely adapted on a case-by-case basis.
Should you reduce your wheat consumption as a precaution?
Several hypotheses have been put forward to explain the recent increase in SGNC. Among them, the fact that wheat has undergone many genetic modifications in recent years to meet the needs of the food industry. Thus, its gluten content (necessary for bread-making) has been increased. Another lead: ATI (amylase/trypsin inhibitor), a protein associated with gluten. “To make wheat more resistant to insects, the ATI content has been increasedsays nutritionist Barbara Konitzer. According to a research group from the University of Mainz in Germany, it could lead to abnormal immune reactions“.
Finally, wheat is more present than before in our diet, via processed products, in which it is used (often in the form of starch) for its binding and thickening properties. In short, even if the reasons for SGNC are not yet clearly identified, it is strongly recommended to vary your diet by varying the cereals (and thinking of legumes) and to cook at home!
- Foods that contain gluten: bread, pasta, breakfast cereals, wheat, oats, spelled, kamut, rye, barley.
- Foods that do not contain it: rice cakes, crunchy buckwheat toast, soy vermicelli, soba noodles (100% buckwheat), rice vermicelli, rice, quinoa, amaranth, millet, kasha (grilled buckwheat), legumes (lentils, split peas, dried beans, etc.) , Corn or buckwheat flakes, muesli made from chestnut flakes, puffed quinoa grains, amaranth…
In video: how to prepare a gluten-free flour mix for your pie dough?
Our Experts:
- Professor Bruno Bonaz, gastroenterologist at Grenoble University Hospital
- Virginie Grandjean-Ceccon, dietitian
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