Those with celiac disease must eliminate gluten from their diet, those with non-celiac gluten sensitivity must reduce it to feel better. By doing so, however, you risk nutritional deficiencies if food choices are not well thought out: this is underlined by a recent review by McMaster University in Canada, according to which in both conditions it would be advisable to be guided by a nutritionist.
No to self-diagnosis (even gluten-free diets make you fat)
The researchers underline that the dangers of nutritional deficiencies arise above all from incorrect diets because, for example, in some cases the composition of ready-made gluten-free industrial products may include less protein and more fat and sugar than their counterparts with gluten. Furthermore, people often self-diagnose a sensitivity to gluten and also ban it because they think they are losing weight, but there is no relationship between the gluten content of the diet and weight loss and even gluten-free diets can make you gain weight. , if they are not correct and balanced. This is why it is important to first arrive at a correct diagnosis, then get advice from a nutrition expert; this is also necessary in the case of non-celiac gluten sensitivity, which is identified above all by exclusion because the absence of specific tests allows its diagnosis only with blind stimulation tests, which are very complex and difficult in clinical routine.
Gluten sensitivity
Patients with non-celiac gluten sensitivity are not allergic to wheat or celiac but have gastrointestinal (pain, bloating, diarrhea, sometimes gastroesophageal reflux) or general (joint pain, tiredness, headache, foggy mind, anemia) symptoms after eating foods with gluten and mainly wheat derivatives. It is estimated that the problem affects around 5 percent of the population, as suggested by studies with blind tests, i.e. administering gluten “secretly”. The problem and underlying mechanisms are complex and self-suggestion may also play a role, with many reporting symptoms and self-diagnosing hypersensitivity after eating gluten-containing foods. Furthermore, celiacs must follow a careful diet and cannot recover, while those who are only sensitive have more intense symptoms as the amount of gluten increases and can gradually resolve the disorder. The confusion on the topic has led to the trivialization of the gluten-free diet, which is necessary for celiacs but may not be definitively and chronically necessary for those who are sensitive.
A new “culprit”?
According to new hypotheses, however, at the basis of hypersensitivity to gluten-wheat there could be an intolerance to fructan, one of the FODMAPs or polyols, mono-, di- and oligosaccharides found in many types of foods including fruit, vegetables , legumes, wheat, sweeteners, fruit juices: FODMAPs are not absorbed and favor fermentation by intestinal bacteria and this, especially in those who suffer from irritable colon and have a lower tolerance threshold for intestinal fermentation than normal, leads to pain, swelling, diarrhea. There are no specific tests to identify intolerance to FODMAPs, which are much more difficult to avoid than gluten because they are present in many food categories: we therefore speak of low FODMAP content diets, which each patient constructs together with a doctor and dietitian because there there is a strong individual variability and someone may have discomfort after eating fruit and not vegetables or vice versa, or have symptoms only above a certain quantity.
Green light for pediatric screening
On 13 September the Senate gave the green light to early screening, starting from 3-4 years of age, and information campaigns throughout the country to prevent type 1 diabetes and celiac disease. The bill for the identification of type I diabetes and celiac disease in the pediatric population, passed unanimously, delegates to a ministerial decree the definition of criteria for the adoption of a multi-year screening program on a national basis for the detection of antibodies for type 1 diabetes and celiac disease. It also provides for the establishment of an Observatory and provides for the carrying out of periodic information and awareness campaigns by the Ministry of Health. The screening will start from 2024 and an expenditure of 3.85 million euros is expected for each of the years 2024 and 2025 and of 2.85 million euros per year starting from the year 2026. The ministry will also promote periodic information campaigns on the importance of early diagnosis in pediatric age, with funds amounting to 150,000 euros per year starting from 2024.
2023-09-14 06:00:10
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