Gluten and health

[Article updated on 19/09/2023]

For around ten years, gluten has been at the heart of conversations related to food. Sometimes criticized, even demonized, this famous gluten is at the center of debates, with some considering it responsible for all their ills, and others using it as a sales argument for various food products.

To begin with, what is gluten?

The simplest way to define it is to present this substance as a set of proteins, the same ones that we find in other foods on our daily plates, or almost.

These proteins are present in cereals, and more specifically straw cereals, such as wheat, barley, rye, spelt or oats. People with intolerances (we will come back to this) are often familiar with the acronym SABO (for Rye, Oats, Wheat and Barley) in order to easily avoid the consumption of these cereals. This set of proteins can also be broken down into two subsets: gliadin and glutenin, both of which will give elastic and viscous properties to the food that contains them. We can also remember the image of bread dough, which when kneaded gradually takes on this elastic texture which will allow it to obtain this very particular taste and texture when baking. . We find this property all the way back to the etymology of the word which in Latin was already a synonym for “glue” or “gum”, so it’s difficult to be more evocative.

Gluten is therefore not new, it has existed as long as the cereals mentioned above. However, it is only very recently that its controversy emerged. This phenomenon is explained by the fact that gluten is notably responsible for celiac disease, which affects a (tiny) part of the population.

For the patients we will discuss below, this very serious pathology can quickly become very debilitating on a daily basis. But there has also been a real fashion phenomenon since the end of the 2000s and beginning of the 2010s, very supported by manufacturers and the marketing associated with their products, and which continues to fuel confusion around this vast subject. .

Evolution of recognition of gluten-related diseases

Celiac disease is a pathology that will affect the immune system of people who are genetically predisposed to developing this pathology.

This protein then causes atrophy of the intestinal villi in the small intestine, leading to partial destruction of the wall of this organ. The walls of the small intestine being the main routes of absorption of many nutrients, the alteration of this absorbent function will lead to serious deficiencies linked to these malabsorptions, in particular in iron, calcium and certain vitamins (to name but a few). these nutrients).

To date, there are no treatments available to treat these patients; the only solution lies in following a strict gluten-free diet throughout their life. For both infants and adults, the symptoms that detect celiac disease are generally intestinal discomfort associated with chronic diarrhea and/or vomiting as well as hypotrophy and weight loss. These symptoms are sometimes accompanied by neurological and dermatological disorders and joint problems.

The real recognition of celiac disease in France dates from 2002. Since then, patients suffering from such a pathology have benefited from social security assistance of around €45 per month for an adult and €33 € for a child in order to finance the purchase of sometimes very expensive gluten-free diet products. This reimbursement rate is still in force today, although it guarantees recognition of the disease for these patients, it does not allow the products consumed by celiac patients to be fully financed.

Gluten: a fashion effect?

So where does this confusion and all the excitement around gluten come from? As mentioned previously, the increase in people affected by celiac disease has opened a window for manufacturers. More and more gluten-free products have appeared on supermarket shelves, sometimes even entire shelves are offered by the biggest brands. The vagueness around gluten has therefore been cultivated to sell these often more expensive products, and it is difficult for the consumer to disentangle the truth from the falsehood.

There are of course celiac patients who must absolutely avoid consuming any form of gluten, but there are also those “intolerant” or “hypersensitive” to gluten who may present certain similar symptoms without being strictly celiac (and therefore not recognized by the social Security).

However, gluten is not responsible for all ailments and some people can experience real digestive discomfort due to the consumption of other foods.

Some studies show that other wheat proteins and certain poorly absorbed and fermentable sugars (categorized as FODMAPs) could also be the cause of these symptoms.

It is therefore important to be accompanied by health professionals who can establish a precise diagnosis and help avoid erroneous interpretations. Generally speaking, the vast majority of the population can afford to consume gluten throughout their life without suffering any malabsorption, deficiency, or any symptom whatsoever.

It is therefore not always necessary to consume gluten-free foods. Some products could even be more harmful than their equivalent containing this substance, because to obtain similar textures and tastes it is often necessary to add numerous ingredients, additives, and sometimes even to use additional industrial processes which will bring in these foods in the category of ultra-processed products, which is generally not good news for the consumer.

It is therefore important to raise awareness among the population regarding the reality of gluten and celiac disease, in order to ultimately enable an increase in diagnosis and screening as well as medical care for patients as soon as the first symptoms appear. , without encouraging the consumption of adapted and modified products when this is not necessary.