Sunday , May 29 2022

Gluten-free "epidemic"? Research is trying to see more clearly



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Fashion is "gluten-free," but confusion reigns between "real" intolerant, allergic and "
hypersensitive

"With undecided contours, there are also those who choose to stop gluten for personal reasons, considering that they do not support it or do not hurt it." As a result, an extensive research program "
from plant to plate

"He is headed to France to try to see more clearly.

"There are three distinct pathologies," says Brigitte Jolivet, president of Afdiag, an association that has had a campaign since 1989 to make life easier for gluten intolerance. Intolerant "real", for which it is vital 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 stinging in children. There is no treatment, except for gluten-free diet for life. 1% of the population would be affected (ie 670,000 people in France) of which only 10 to 20% were diagnosed correctly.

The second group refers to allergic patients, which are much less numerous (0.1 to 0.5% of the population). A third group, "hypersensitive" can refer to 0.5 to 15% of the population, which is at least "vague", notes Ms. Jolivet. Swelling, fatigue, digestive disturbances are considered for gluten
without scientific evidence

According to Mrs. Jolivet.

Both celiac disease responds to a clear diagnosis based on a blood test (IgA antibody dose) reimbursed by social security and confirmed by a duodenal endoscopy (the small intestine), both
hypersensitive

It's difficult to get down. "
We are not sure that gluten is responsible

"Says Corinne Bouteloup, a gastro-gastroenterologist at Clermont-Ferrand University Hospital, who will conduct a clinical study as part of the GlutN research project.

From plant to plate

To see more clearly, this vast research program was launched with the National Institute for Agricultural Research, Inserm and the University Hospital in Clermont-Ferrand in particular. "
We'll study things from the plant to the plate

"Explains Catherine Ravel, who coordinates the project.

INRA studies the digestibility of bread and pasta, from a collection of 16 soft wheat lines and 8 hard wheat lines. "
The idea is to give people hypersensitive a product they will tolerate

She said. At CHU Clermont-Ferrand, Corinne Bouteloup will present sixty patients (excluding intolerance and allergy) to a double-blind diet, with or without gluten, controlling their response.

"
The goal is to find biomarkers, because doctors are now disturbed to do a diagnosis, lack of tools

"Catherine Grand Ravel says Blood, urine and stool tests should be used to establish the famous" markers "to diagnose the sensitivity of gluten.

Added gluten

The clinical study, funded by the National Research Agency, will be launched in early 2019 with the first results at the end of the year. According to Corinne Bouteloup,
In general, we no longer eat gluten today, because we eat much less bread, but the quality of gluten has changed

".

The so-called "natural" glutathione is naturally present in certain cereals, including wheat. The industry also uses massive "gluten vital" for the texturing power (volume and elasticity). "
Our grandparents ate real bread and not bread, pizza, prepared meals, cold cuts … Many products to which gluten was added

"Corinne Bouteloup recalls," Now,
the vital gluten is highly concentrated, so it is more resistant to digestion

".

"If we can show that it is actually a gluten-quality problem and adding it, we could probably change the practices
She said. In parallel to these two programs, an epidemiological study attempts to better understand "gluten-free" in the Nutrinet study, which interviews users about the nutritional-health link.

"
20,000 responses to a gluten questionnaire were retained

"Says Emmanuelle Kesse-Guyot, research director.

"
People suffering from Celiac Disease have been excluded and we are interested in whether people who exclude gluten by personal choice have particular characteristics. What does it eat? Why do I decide to exclude gluten? For abdominal comfort, physical well-being or faith (is it bad for my health, for the environment)?

"

deficiencies

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

Notice. "
We struggle with the dietitian with whom I work to renew patients to the least restrictive diet. We see that people entering the consultation do not know what to eat because of the restrictions

", Reports Corinne Bouteloup.

"
After seeing many, I think a large majority of people who say they are better off gluten are actually getting better because it eliminates the fructans found in cereals containing gluten.
. Fruits are part of Fodmaps, another "suspect" that grows strong. This acronym represents certain carbohydrates.

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

Corinne Bouteloup explains.

Based on ten years of experience, she suspects that "
just those who eliminate a lot of things are often people who are not sensitive to gluten but with intolerance at Fodmaps.

"It's my clinical feeling," She notes, "But we have not yet had the means to launch a study on this. It takes time, small hands, money …"

Gluten-free food sales rose 12% last year, in a large set of "healthy" foods that exceed 6 billion euros in supermarkets in 2017, according to a study by Xerfi.

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