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Fashion is "gluten-free" but confusion reigns between "real" intolerant, allergic and "hypersensitive" with undecided contours. Suddenly, an extensive research program "from the plant to the plate" is conducted in France to try to see more clearly.
"There are three distinct pathologies," says Brigitte Jolivet, president of Afdiag, an badociation that has been campaigning since 1989 to make life easier for gluten intolerants:
1. The true intolerant
The editorial advises you
For them, 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 stunting in children.
There is no treatment, except the gluten-free diet for life. 1% of the population would be affected (ie 670,000 people in France) of which only 10 to 20% correctly diagnosed.
2. Allergy sufferers
Allergic to gluten, which reacts to its absorption in their immune system. The disorders are then manifested according to the same spectrum as other types of allergies: sneezing, itching, digestive disorders, angioedema … Gluten allergic are much less numerous than intolerants (only 0.1 to 0.5% Population).
3. The "hypersensitive"
It is to this third group of people, said "hypersensitive", that researchers are particularly interested today. Digestive hypersensitivity could affect 0.5 to 15% of the population. Often badociated by those who suffer from gluten absorption, these disorders could actually have a different origin.
Because there is no scientific proof on the subject. As much the celiac disease responds to a clear diagnosis, on the basis of a blood test (dosage of IgA antibodies) reimbursed by social security, and confirmed by an endoscopy of the duodenum (small intestine), as the "hypersensitive" are difficult to pin down.
"We are not sure that gluten is responsible," explains Corinne Bouteloup, gastro-gastroenterologist at the University Hospital of Clermont-Ferrand, who will conduct a clinical study as part of the GlutN research project.
A vast study to see more clearly
This research program was launched with the National Institute of Agricultural Research, Inserm, and the University Hospital of Clermont-Ferrand in particular.
According to Corinne Bouteloup, "overall, we do not eat more gluten today, because we eat much less bread, but the quality of gluten has changed".
The so-called "native" gluten is naturally present in certain cereals, including wheat. But the industry also uses mbadively "vital vital" for its texturing power (volume and elasticity).
"Our grandparents ate real bread and not industrial breads, pizzas, ready-made meals, cold cuts … A lot of products to which gluten was added, but this vital gluten is very concentrated, so it may be more resistant to If we manage to show that it is indeed a quality problem of gluten and its addition, we could perhaps modify the practices "
Better understand the consumers of "gluten-free"
In parallel with these two programs, an epidemiological survey attempts to to know better the "gluten-free" from the Nutrinet study that asks users about the nutrition-health link.
"20,000 responses to a questionnaire on gluten were retained," says Emmanuelle Kesse-Guyot, research director.
"We excluded people who have celiac disease, what we are interested in is whether people who exclude gluten by personal choice have special characteristics.What do they eat? Why do they decide to exclude gluten? "For abdominal comfort, physical well-being, or belief (it's bad for my health, for the environment)?"
"What we do know is that people who exclude gluten also exclude other things, which can lead to deficiencies, "she observes.
Fodmaps, really responsible for digestive disorders?
"We fight with the dietitian with whom I work to get patients back to the least restrictive diet possible. people who do not know what to eat by dint of restrictions ", reports Corinne Bouteloup.
"To have seen a lot, I think a big majority of people who say they are better when they remove gluten, in fact are better because they remove the fructans that are also in cereals containing gluten. "
The fructans are part of the "Fodmaps", another "suspect" that emerges strongly. This acronym stands for certain carbohydrates.
"Fodmaps are naturally found in many foods, in cereals they are fructans, in many fruits and vegetables they are fructose, polyols, sugars that are not digested and ferment in the colon"
On the basis of ten years of experience, she suspects that "precisely, those who remove a lot of things are often people not sensitive to gluten but intolerant to Fodmaps ".
In fact, people who are sensitive to fodmaps (suffering from chronic digestive disorders, also known as irritable bowel syndrome) exclude not only wheat products, but also often certain dairy products rich in lactose, legumes, fruits and vegetables. vegetables they digest badly, alcohol, tea or coffee, too irritating …
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