“Novak Djokovic had to overcome many obstacles to gain a place in the history of tennis. He trained in Serbia, a country where this sport was almost unknown, and he maintained his rigid training discipline during the war in Kosovo, when Belgrade, his city, was under siege and his family lived in an anti-aircraft shelter . However, it was not these difficulties that put his career at risk: it was gluten . “
It is 2014 when the book of one of the best tennis players in the world, Novak Djokovic, is published. In his book, Novak explains the benefits he has gained in terms of physical and mental performance since he excluded gluten from his diet, suggesting readers to follow his own example. In the course of the book the tennis player attributes to the gluten a series of faults including those that may be the cause of depression , poor digestion and various mental disorders . Obviously he is not the only famous character who in recent years has led a series of battles against gluten. Jennifer Aniston in several interviews stated that she follows a gluten-free diet since 2010 also followed by other music and TV stars such as Miley Cirus, Victoria Beckham and Gwyneth Paltrow.
All this has done nothing but create what is defined as a ” sociogenic mass instagram “, that is the fear and belief of many people in the world that gluten – and consequently the foods that contain it – is absolutely to avoid.
In fact, there are millions of people all over the world who decide, suddenly, and most of the time without any medical advice, to follow a gluten-free diet.
The celiac disease or celiac disease is an autoimmune disease widespread in 0.5-1% of the world population. However, the prevalence of this disease has increased over the last 10-20 years, probably due to the increase in the diagnosis that until a few decades ago were more difficult to conduct.
It is a chronic inflammatory disease caused by a hypersensitivity to gliadin , one of the components of gluten, with the involvement of antibodies such as transglutaminase which causes damage to enterocytes by increasing the permeability of the intestinal barrier , thus reducing its functionality and causing malabsorption phenomena. Among the most frequent gluten intolerance symptoms there are: diarrhea , steatorrhea and weight loss (due to malabsorption); but also extraintestinal or atypical symptoms such as osteoporosis, anemia, dermatitis afflicting almost 50% of patients. We reiterate an important concept, intoleranceslead to losing weight, food fads instead would often want to pass overweight as a result of certain intolerances to certain foods …
The glutamine , component of gliadin, in genetically predisposed individuals, is in fact deaminated to glutamic acid by making the gliadin transglutaminase more akin to HLA-DQ2 / DQ8 inducing a powerful response from the T cells gliadin would also be able to act sparking directly toxic effects on enterocytes through the formation of pro-inflammatory interleukins such as IL-15.
The only available treatment for celiac disease is at the time to follow a gluten-free diet for the rest of life thus eliminating entirely the products containing gluten. Some studies indicate in the 50 mg the minimum threshold that can trigger celiac in damage to the small intestine wall.
Sensitivity to gluten: does it really exist?
In addition to gluten intolerance, there have also been significant increases in cases of other gluten-related diseases, including non-celiac gluten sensitivity , defined simply as NCGS.
It has been defined as a clinical entity only since 2010 and according to FNOMCeO in a document written in 2016:
” NCGS refers to those patients who, without being affected by celiac disease or from an allergy to mediated IgE wheat, present a series of intestinal and extraintestinal manifestations that arise promptly after ingestion of foods containing gluten and disappear quickly to a gluten-free diet “.
There is currently no valid test to diagnose gluten sensitivity. The diagnosis is largely hypothetical and is based on the exclusion of foods containing gluten for some time and then reintroduce them and evaluate the clinical manifestations.
Regarding the existence of a non-celiac gluten sensitivity, the opinion of the scientific community is not unanimous. In 2011 Biesiekierski had for the first time conducted a double-blind controlled study on 34 subjects suffering from irritable bowel syndrome divided into two groups to evaluate the clinical manifestations followed by the reintroduction of foods with gluten after a period of abstinence. The study found that the group that consumed gluten worsened their health.
In reality, as also underlined by the same researchers, the study presented different methodological flaws in its management. Biesiekierski and his group then decided to restore the study by improving the control of some parameters considered fundamental for the validity of the research.
This time, in fact, they decided to control the caloric intake and the exclusion of foods containing FODMAP , an acronym that stands for Fermentable, Oligo-, Di-. And Mono-saccharides And Polyols, which according to several studies would be able to trigger common and overlapping disorders with irritable bowel syndrome .
After following a low-FODMAP diet for two weeks, the 37 subjects in the study were divided into three groups. The first group was made to consume a diet high in gluten (16g / day) per second a diet with low intake of gluten (2g / day) and third placebo (gluten-free) for the course of a week. This first phase was followed by a two-week washout period (interruption of the diet) before the participants subsequently exchanged between the three groups.
At the end of the study all the participants had improved their disorders as a result of a low-FODMAP diet while only 16% of the participants (ie 6 subjects) found disorders associated with gluten consumption.
The authors themselves of the study stated in conclusion that although there may be a sensitivity to gluten between 1% and 6% of the population, in many circumstances it would be a real imaginary disease caused by the nocebo effect as a result of the consumption of gluten. On the contrary, the placebo effect would occur following a gluten-free diet (one of the reasons why people who exclude gluten from the diet often admit they feel better). The idea that glutin hurts is therefore often a more psychological than a physiological idea.
Besides the walnut effect, NCGS would probably be caused by consuming foods containing FODMAPs (so we go far beyond gluten-free flours ). These are found in many products that also contain gluten such as bread , pasta and various cereals. Those who tend to exclude products containing gluten from their diet would actually also limit the consumption of FODMAP considerably, thereby improving many of the symptoms often associated with gluten consumption.
How gluten is created
Not many people know that gluten is a protein that does not exist in naturebut it is born through the work of man. Cereals have a protein component in the grain that will mainly feed the embryo during germination. Among the most present proteins we find gluteline and prolamine. Gluten formation takes place through the processing of flour and kneading in water. Through processing the proteins start to aggregate providing the characteristics useful for the bakery of the products and thus creating gluten. This could be one of the reasons why the oats even if they possess a prolamine (the avevina) generally, if not contaminated, is well manageable even by celiacs. Oat is a cereal that is often not processed and reaches the almost raw consumer.
Cereals containing gluten or without are:
|CEREALS WITH GLUTEN||GLUTEN-FREE CEREALS|
Food gluten-free instead are: legumes, potato , chestnut, sesame, tapioca, sorghum, soy.
Does gluten make you fat?
One of the reasons that drives people to follow a gluten-free diet while not presenting any form of intolerance would be the belief that the exclusion of gluten can promote weight loss and weight loss. In the well-known site of the Huffingtonpost, for example, the singer Miley Cirus claimed to have followed a gluten-free diet for a long time and this had helped her to lose excess pounds.
There is currently no data in the literature that has shown that the intake of foods containing gluten can promote fat accumulation. As already expressed in other articles, in fact the increase or reduction of fat mass is mainly determined by the caloric balance . When you are in excess of calories you get fat, when you are in deficit you lose weight.
In contrast, the opposite effect is documented in celiac subjects . That is, it is shown that the exclusion of gluten can promote the increase of body weight probably for an improvement of the intestinal villi surface that facilitates the absorption of nutrients present in foods and therefore increases the intake of calories .
It should also be considered that in reality many of the gluten-free foods have a higher caloric density than their gluten counterparts. Comparing, for example, the various types of Brezel – very common bread in Germany and Switzerland – the alternative with gluten provides a caloric amount of 108 kcal and 1 gram of fat, while the gluten-free counterpart contains about 140 kcal and 6 g of lipids . In fact, gluten-free products often contain a quantity of fats (above all saturated) and sugars greater than their conventional counterparts.
Eating gluten-free hurts?
Eating gluten-free can lead to negative consequences including the appearance of eating disorders , nutritional deficiencies, increased exposure to toxic metals (arsenic) and an alteration of the microbiota (intestinal flora).
Often those who decide to follow a gluten-free diet tend to replace pasta and bread with large portions of rice . Studies have shown that populations and sub-populations that rely almost exclusively on rice increase their exposure to toxic metals such as arsenic, which is abundant, especially in this food. Children and pregnant women are the people most at risk.
It has also been noted that the exclusion of gluten-free foods increases vitamin and mineral deficiencies such as folic acid, vitamin C, vitamin B12, magnesium, calcium, zinc and iron.
The gluten-free products are also poorer in dietary fibers because of the fact that they are often made with refining processes that exclude the bran , or the outer part rich in fibers. The dietary fiber have an important protective role towards the health of the organism and in particular in the prevention of cancer, diabetes and cardiovascular disease (read what are the foods rich in fiber).
Another risk in eating gluten-free is the appearance of dysbiosis . About this, Patricia Grace-Farfaglia writes:
” a consequence of the gluten-free diet is that it alters the intestinal microbiome favoring the appearance of pro-inflammatory species of bacteria and fungi. […] Changes in the diversity and composition of the intestinal flora favor a reduction of lactobacilluse bifidobacterium . ”
It is advisable, in the case, to take advantage of probiotics such as fermented milk .
Finally, but no less serious, there is the possibility among those who decide to follow a gluten-free diet to manifest binge eating disorder or eating disorders as explained by Levinovitz in the book ” The Gluten Lie “.
In fact, the exclusion of foods containing gluten would put people at risk of developing phenomena such as orthorexia , that is, an obsessive obsession with eating that is considered healthy but which can lead to malnutrition and social isolation. An eating disorder almost like anorexia and bulimia even if not yet recognized as a psychiatric pathology in the DSM-5 but that has all the characteristics to become soon, as explained by Irene Campagna in a dossier of the magazine ” Le Scienze ” of August 2017.
” Gluten is for this decade what were the carbohydrates in the previous one and the fats in the ’80s and’ 90s; the black beast, the bad boy, the cause of all that afflicts you and whose elimination can make you heal. ”
Do not mince words Jeffrey Kluger , in an article published in “Time”, to describe the spread of phobic disorder that has affected the newly gluten.
Not only does the exclusion of gluten-free foods do not bring any real benefit to those who are not affected by celiac disease but it can be a practice that can hide the dangers for the health of the organism because often the gluten-free products are poor in fiber and vitamins and more rich in sugars and saturated fats.
The gluten-free eating is therefore a bad fashion and, to quote Marino Niola in the book Homo dieteticus, at the end “true celiacs will remain alone with their usual problem, while the others will happily return to the baguette and look for a new food to exorcise.
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