Fashion is "gluten-free" but confusion prevails between "real" intolerant, allergic and "
"With unanswered contours. There are also those who choose to stop gluten for personal reasons, confident that they do not support or harm it. As a result, a comprehensive research program"
from the plant to the plate
"Performed in France to try to see more clearly.
"There are three distinct pathologies", says Brigitte Jolivet, president of Afdiag, a union that has been campaigning since 1989 to make life easier for gluten intolerant. The "real" intolerant, for which it is important to exclude gluten, are victims of celiac disease. This condition destroys the small intestine and causes anemia, diarrhea, weight loss, leg pain and even stunt in children. There is no treatment, besides the gluten-free diet for life. 1% of the population would be affected (ie 670 000 people in France) of whom only 10 to 20% were properly diagnosed.
The second group concerns allergic patients, which are much less numerous (0.1 to 0.5% of the population). A third group, "hypersensitive" may comprise 0.5 to 15% of the population, which is at least "vague", notes Ms Jolivet. Inflammation, fatigue, indigestion disturbances are caused by gluten
without scientific evidence
According to Jolivet.
As much as the celiac disease responds to a clear diagnosis, on the basis of a blood sample (dose of IgA antibodies) replaced by social security and confirmed by endoscopy of the duodenum (small intestine), both
Is hard to get caught. "
We are not sure that gluten is responsible
"Says Corinne Bouteloup, gastro-gastroenterologist at Clermont-Ferrand University Hospital, to conduct a clinical study as part of the GlutN research project.
From the plant to the plate
To see more clearly, this major research program was launched with the National Institute of Agricultural Research, Inserm and University Hospital of Clermont-Ferrand in particular. "
We will study things from the plant to the plate
"Explains Catherine Ravel, who coordinates the project.
INRA studies the meltability of bread and pasta, from a collection of 16 lines of soft and 8 lines durum wheat. "
The idea is to offer hypersensitive people a product that they would tolerate
She said. At CHU Clermont-Ferrand, Corinne Bouteloup will send sixty patients (excluding intolerant and allergic) to a double-blind diet with or without gluten, which controls their response.
The goal is to find biomarkers, because at the moment, doctors are quite inconvenient to diagnose, lack of tools
Says Catherine Grand Ravel. Blood, urine and stool tests should be used to establish the famous "markers" to diagnose gluten sensitivity.
The clinical study, funded by the National Research Agency, will be launched in early 2019 with first results at the end of the year. 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 some cereals, including wheat. But the industry also uses massively "vital gluten" for its texture power (volume and elasticity). "
Our grandparents ate real bread and not industrial bread, pizzas, prepared dishes, cold curves … Many products to which gluten was added
"Reminds Corinne Bouteloup. Now,"
vital gluten is highly concentrated, so possibly more resistant to digestion
"If we can show that it's actually a gluten quality issue and its add-ons, we might change the practice
She said. In parallel with these two programs, an epidemiological study tries to better understand "gluten-free" from the Nutrinet study, which interviews users about nutritional health.
20,000 answers to a questionnaire if gluten was retained
Says Emmanuelle Kesse-Guyot, Research Director.
People who have celiac disease have been excluded, and we are interested in the fact that people who exclude gluten of their choice have special characteristics. What are they eating? Why do they decide to rule out gluten? For comfort, physical well-being or belief (it's bad for my health, for the environment)?
What we know is that people who exclude gluten also exclude other things, which can lead to shortcomings
She observes. "
We struggle with the dietician with whom I work to get patients back to the least restrictive diet that is possible. We see people coming in consultation who do not know what to eat because of restrictions
"Reports Corinne Bouteloup.
After seeing many of them, I think that a large majority of people who say they are better when removing gluten are actually better because they remove fruktans that are also found in gluten-free cereals.. Fructans are part of "Fodmaps", another "suspected" that pops up strongly. This acronym stands for some carbohydrates.
Footprints are found naturally in many foods, in cereals are fructans, in many fruits and vegetables are fructose, polyols, non-melted sugars and fermented in the large intestine
Explains Corinne Bouteloup.
On the basis of ten years of experience, she suspects that "
Just those who take away many things are often people who are not sensitive to gluten but are not tolerant of Footmaps.
"It's my clinical feeling" She states "But I have not yet had the opportunity to start a study about this. It takes time, small hands, money …"
The sales of "gluten-free" groceries increased by 12% last year, in a large set of "health" foods that exceeded 6 billion euros in supermarkets in 2017, according to a study from Xerfi.