Whether by conviction, to lose weight, detoxify or simply to do good, fashion is Predatory regimes. Gluten free plan by celebrities touting the gluten free plan is leading the office. But why is this very difficult diet to follow?
While gluten free plan foods and other “plan” products have made a place in supermarkets, some newcomers are also beginning to settle: gluten-free
products, ie, products not containing wheat proteins, rye and barley. Even restaurants indicate more and more about their gluten-free cards. In theory, oat-based products are not affected, but in practice, “oats are often contaminated with gluten” deplores Magali Lafleur, the French Union of Specialised Nutritionist. To be labeled “gluten free” and disposed of the blocked ear, the product concerned should contain less than 20 mg / kg gluten. This is the average threshold for celiacs – or intolerant to gluten – may experience the symptoms. “Although there is individual variability in the sensitivity rates.
Symptoms of celiac disease
Besides, what are the symptoms of celiac disease? “This is indeed one of the problems related to the diagnosis of celiac disease. Many patients express little or no symptoms In addition, these symptoms are not specific and can completely match other digestive diseases common “says Dr Francis Abramovici, GP. Most often, celiac disease is accompanied by fatigue, abdominal pain, chronic diarrhea followed by weight loss, bone diseases (osteoporosis) and anemia.
Indeed, celiac disease characterized by inflammation of the intestine, the villi of the small intestine are progressively destroyed: result, the vitamins and minerals will be absorbed more easily and it is this malabsorption which may be the causing deficiencies.
Nevertheless careful not to be confused with celiac disease gluten allergy (much rarer and immediate effects) or hypersensitivity whose symptoms are very similar but has a different physiological origin.
The gluten free plan: for whom?
In France, an estimated 600 000 people are celiac, between 0.5 and 2% of the general population. Since there is a genetic vulnerability, having one of his sick parents increases the risk of being too. “But again, the problem is that a large proportion of coeliacs do not express or few symptoms and do not seek: only 10-20% of them are actually diagnosed” hammers the GP.
The diagnosis of celiac disease is done in two stages: first with a blood test that dose antitransglutaminases the antibody IgA and the weight of IgA gene dosage. And if the test is positive (although there are about 10% false positives), the patient should undergo a biopsy of the small intestine to highlight villous atrophy. Only and only then may be asked definitive diagnosis of celiac disease.
And there, the only existing treatment is so essential: the gluten-free diet. “If the diagnosis has not been asked, it is better not to start gluten free diet, warns Prof. Christophe Cellier For monitoring of such a scheme is likely to distort the exams. By removing gluten from their diet, . the associated immune reaction is reduced villous atrophy and also tends to disappear So, even if the patient is actually celiac, examinations indicate that it is not: it is false negatives. ”
The gluten free plan, a true fashion phenomenon
But in practice, even faced with a patient with symptoms, if any, of celiac disease, the general practitioner can “be difficult to sort with the most common digestive disorders” says Dr Francis Abramovici .
Indeed, according to a survey Opinion WAY1, all general practitioners are familiar with the theory on the diagnosis of celiac disease: 87% of patients who were diagnosed were due to the blood test antibodies and biopsy of the intestine hail. Nevertheless, the number of diagnoses remains low with 73% of physicians surveyed said they had had any celiac patient during the past year. Moreover, when asked about the prevalence of the disease, doctors estimate it at 1 in 1000 while she was in fact 1 in 100²!
Did they have to do to celiac patients without noticing? By chance he made no celiac patient has consulted? Impossible to know but obviously the admission of Dr. Francis Abramovici “GP does not necessarily think to this disease.” Lack of information, training, time … The reasons for underdiagnosis seem obvious.
For Dr. Francis Abramovici, this should go through continuous training for professionals but also by “a better dissemination of information in the specialized medical press. Doctors should also easier to use the blood test, a simple examination to help and diagnose patients. ”
The interest of the gluten free plan
If the gluten free plan is the only treatment for celiac people, there is a plan very popular and more and more followed. Is there a risk to diet gluten free medical indication? For Professor Christophe Cellier, “apart from the risk of distorting any analysis, no, this plan is absolutely not hazardous to health. Whether the beneficial effect felt by the people is real or not, the key is that ‘they feel good, does not it? “. Nevertheless, careful not to multiply the restrictive regime of the same type (lactose free, meat, etc.) under penalty of deficiencies.
This diet is very restrictive, those diagnosed celiac symptoms but do they have an interest in following such a diet? “Obviously meets RPLS Christophe Cellier For futures, celiac disease can lead to several other more or less serious diseases. Bone loss (which affects 50% of patients), insulin-resistant diabetes, vitiligo, chronic lymphocytic thyroiditis and, rarely, a bowel cancer. While it is possible that these diseases do not occur, the risk is real. ” Moreover, a finlandaise3 study followed for two years in patients with celiac disease but not expressing symptoms: a first group was to follow a gluten free diet and another change nothing. Result, none of the patients who followed the diet without gluten did not want to stop it: 85% of them wanted to extend beyond the study and 67% felt that follow this diet was self-evident (13% of them found it difficult to follow and easy 5%).
They not only expressed in better health, but most of the analyzes also showed a clear improvement in their digestive functions. According to the gastroenterologist, “celiacs with symptoms experience a clear improvement 2-3 months after initiation of the regime. And in the long term, it nevertheless seems that this plan is quite difficult to keep a patient since about 2 eventually abandon “.
Positive effect of no-Mode glue, it is becoming easier for celiac patients – and others – to get gluten free plan products, but also to afford eating out, since the offer no-glue extends increasingly.