Bread, pasta, flour... Many foods contain gluten, a substance responsible for intolerance. And this disease would be underdiagnosed... The answers of our specialists to understand and recognize the pathology.
The eviction of gluten is becoming fashionable: to lose weight, some people who are not intolerant to this protein decide to no longer consume products that contain it.
Yet, for the 600,000 intolerant people in France (figure provided by the French Association of Gluten Intolerants), the gluten-free diet is far from being a pleasure.
What is gluten intolerance known for?
"The consumption of gluten leads to inflammation of the intestinal mucosa and leads to a destruction of the intestinal villi allowing the body to absorb nutrients (minerals, vitamins, fats, carbohydrates, and proteins)," explains Dr. Georgia Malamut, hepato-gastroenterologist at the Georges Pompidou European Hospital in Paris.
"In 20% of cases, this intolerance causes abdominal pain, diarrhoea, bloating, and vomiting. But for the majority of patients, it is asymptomatic or has atypical symptoms: joint pain, muscle cramps, fertility disorders, repeated miscarriages... »
In the long term, gluten intolerance, also known as celiac disease, can lead to slower growth in children, fatigue, osteoporosis, autoimmune diseases, and neurological disorders. It can occur at all ages, and in 20% of cases, it even appears after the age of 60.
What tests to diagnose gluten intolerance?
"In the presence of suggestive symptoms, the diagnosis is based on a blood test to look for the specific antibodies of the disease, antitransglutaminases," says Dr. Malamut.
It is then confirmed by intestinal biopsies performed during an endoscopy under general anesthesia.
Does the ban all cereals?
The only treatment for celiac disease is to follow a strict gluten-free diet. This protein is hidden in cereals such as wheat, barley, rye, spelled, and wheat. It is, therefore, necessary to exclude from your diet the products prepared with these cereals.
Concretely, this means doing without bread, pasta, rusks, couscous semolina, biscuits, pastries, pizzas, hamburgers, bread crumbs, and flour. Beware also of certain industrial products!
Soy sauce, minced meats that are not "pure beef ", sausages, sauces, cube broths, seasonings, and soups. Thanks to this diet, the symptoms disappear within a month, and within a year the state of the intestinal mucosa normalizes.
So what can we consume?
Fortunately, there are many gluten-free foods such as meats and fish, fresh and dried vegetables, fruits, eggs, milk, corn and its derivatives (starch, flour, and polenta), rice, potato starch, tapioca, quinoa, soybeans, buckwheat, and teff, a cereal from Africa. As well as all dietary products stamped "gluten-free".
Are gluten-free products refunded?
These products are quite expensive, at least more expensive than their counterparts with gluten. But since food is the only existing treatment, they are partly covered (up to 60%) by Medicare. One condition: this reimbursement only concerns celiac patients whose diagnosis has been confirmed by intestinal biopsy. Four categories of gluten-free products are concerned: flours, bread, biscuits, pasta.
Why follow a gluten-free diet when you are not intolerant?
"Some people are hypersensitive to gluten without being intolerant to this protein," says Dr. Malamut. For them, its eviction has an interest, because it brings them rapid intestinal well-being. »
But for others, going without gluten has no advantage. "If we support this protein, it is useless to remove it on the pretext that it is harmful: it is totally false, says the specialist. Similarly, if it is for weight loss, it is again useless, because gluten-free products or alternative cereals are just as caloric as others. »
Are there any risks of deficiencies with a gluten-free diet?
"None," says Dr. Malamut. Gluten is not essential for a balanced diet. In addition, patients are found in alternative cereals the nutrients they need. »
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