Gluten-free diet: fad or real health need? According to some, he would be the enemy to kill. For others, a deception. But what is it really? 2 million people suffer from gluten intolerance in France. Find out in this article why perhaps you feel that there are more and more gluten intolerant people.

Focus: the difference between gluten allergy and intolerance

The allergy is immediate: immediately after ingesting gluten, the symptoms appear. The immune response is highly reactive to the allergen. 

Intolerance is an autoimmune disease: the immune system turns against the body in particular against the intestinal cells which it will eventually degrade. The process is much longer and the diagnosis takes time to be established.

What is gluten?

Gluten is natural. It is a mixture of proteins (prolamins and gluteins) found in the endosperm of many grains. The prolamins are the proteins responsible for celiac disease and intolerance. 

Gluten absorbs water and then swells. During baking, some of the water is released and the starch in the flour binds with the gluten, ensuring the cohesion of the dough. 

The main cereals to contain gluten are:

• wheat
• spelt
• Kamut
• Rye
• barley

This was the story of a grain of wheat gone modern 

In order to meet consumer demands, food laboratories have developedwheat strains that improve the elasticity of the dough and thus the ever more leavened, airy and soft appearance. At the same time, in an effort to facilitate and optimize mechanical harvesting, these same laboratories have created perfectly graded and disease resistant wheat.

 From genetic modifications, today's wheat is nothing like the wheat of old.

Celiac disease, an autoimmune disease. 

The unbroken down proteins assault the intestinal lining, which eventually becomes inflamed. The enzymatic system is completely dysregulated and no longer operational due to the abnormal reaction of the immune system in the small intestine. In fact, the patient makes antibodies that will damage the inner walls of the intestines. The villi are damaged, the mesh loosens, allowing large molecules to enter the bloodstream.

The effects of gut wall inflammation

• Theinflammation in the gut prevents the proper assimilation of nutrients. There is then a risk of deficiency, anemia but also and above all of malnutrition which can be very serious. 
• The inflammation can become chronic, leading to digestive disorders, bloating, Crohn's disease and sometimes inflammation of the pancreas. 
• In addition, it is not uncommon for proteins released into the bloodstream to pass the brain barrier disrupting cognitive-behavioral functions: learning, memorization concentration, affectivity, socialization...
• The intestinal flora is greatly disturbed. The microbiota no longer plays its protective role and because of its imbalance which can result in not only physical but also psychological: depression, mood swings, psychiatric diseases, ADHD, autism ... 

Total gluten avoidance as a cure.

The only solution to overcome this widespread inflammation is thecomplete cessationof consumption of gluten-containing products. In a society wherebread is a religion and pasta is king, this may be limiting at first but it is the price of good health!

Screening and management of gluten intolerance

If suspected, your general practitioner will refer you to a gastroenterologist who will prescribe a sang test to look for tissue transglutaminase antibodies (IgA and IgG), anti-endomysium antibodies (IgA). If they are absent, it is unlikely that a gluten intolerance is causing your digestive discomfort. If the result is positive, the doctor may ask for a genetic test to determine if the HLA DQ2 and HLA DQ8 genes are activated. Finally, in order to confirm the diagnosis (and for health insurance recognition of your intolerance), a small bowel biopsy is performed.

Good to know: "Health insurance reimburses 60% of the cost of gluten-free dietary foods for patients with celiac disease confirmed by digestive biopsy. This coverage takes the form of a monthly fee, with a higher amount from the age of 10. " (source: ameli.fr)

To conclude

No, the gluten-free diet is not a fad. Intolerance isa real disease, autoimmune, complicated to manage on a daily basis. The impression that there are more intolerant people than before is due to the fact that many people can no longer stand the genetic modification of wheat as well as to a better detection of the disease.