In recent years, gluten has become a topic of great interest, both for those who suffer from disorders related to its consumption and for those who choose to avoid it for reasons of general well-being.
But what is the difference between gluten intolerance and gluten sensitivity?
First of all, gluten is a protein found in cereals such as wheat, spelt, barley, rye and some derivatives of these foods.
It gives doughs elasticity and makes bread soft and firm. However, for some people, the consumption of gluten can trigger adverse reactions of varying severity.
GLUTEN INTOLERANCE:
- CELIACY Gluten intolerance is commonly associated with celiac disease, an autoimmune disease in which the ingestion of gluten causes an abnormal immune reaction that damages the intestinal mucosa. This causes difficulties in nutrient absorption and a range of both intestinal and systemic symptoms. Symptoms vary from person to person, but may include: abdominal pain and bloating, diarrhoea or constipation, unexplained weight loss, chronic fatigue, iron deficiency and other nutritional deficiencies, skin problems (such as dermatitis herpetiformis), irritability, and neurological symptoms (such as headaches, tingling, mental fog). The diagnosis of coeliac disease is made through blood tests to detect specific antibodies (anti-transglutaminase, anti-endomysium, anti-gliadin) and through intestinal biopsy, which confirms damage to the mucosa of the small intestine. The only treatment for coeliac disease is a strict gluten-free diet for life, which restores intestinal health and prevents complications. The person with coeliac disease must consume naturally gluten-free foods or specific ‘gluten-free’ products that are commercially available and recognisable by the international symbol of the crossed-out ear of wheat (mark of the Italian Coeliac Association, AIC).
- GLUTEN SENSITIVITY NOT CELIAC Non-coeliac gluten sensitivity (NCGS) is a condition in which gluten consumption causes symptoms similar to those of coeliac disease, but without the autoimmune reaction and intestinal damage typical of coeliac disease. Symptoms may include: bloating and abdominal pain, diarrhoea or constipation, fatigue and difficulty concentrating, headaches, joint and muscle pain. Currently, there are no specific tests for NCGS. The diagnosis is made by exclusion, i.e. by first ruling out coeliac disease and wheat allergy. If the symptoms improve with a gluten-free diet and worsen with reintroduction, it may be gluten sensitivity. It is not always necessary to eliminate gluten completely. Some people find benefit in reducing their consumption or avoiding the most gluten-rich sources, but without being as strict as coeliacs.
GLUTEN AND FALSE MYTHS
In recent years, gluten has been demonised even by people who do not suffer from any intolerance or sensitivity. It is important to emphasise that eliminating gluten without a real need does not bring specific health benefits and could, in some cases, lead to nutritional deficiencies if the diet is not well balanced. Gluten intolerance (coeliac disease) and gluten sensitivity are two distinct conditions that can affect the quality of life of sufferers. While coeliac disease requires a strict gluten-free diet, gluten sensitivity can be managed with a more flexible approach. In any case, a correct diagnosis is crucial to avoid unnecessary dietary restrictions and ensure a balanced diet.
(Article by Dr Della Bianca Maddalena)
