Koumbi Lemonica, Giouleme Olga, Vassilopoulou Emilia
Department of Nutritional Sciences and Dietetics, International Hellenic University (IHU), Thessaloniki, Greece.
Medical School, Aristotle University, Thessaloniki, Greece.
Curr Dev Nutr. 2020 Dec 31;4(12):nzaa176. doi: 10.1093/cdn/nzaa176. eCollection 2020 Dec.
During the last 30 y, a gluten-free diet has been classified among the most popular fad diets mainly due to the ambiguous notion that gluten avoidance promotes health. Gluten intolerance has been implicated in non-celiac gluten sensitivity (NCGS) and irritable bowel syndrome (IBS), 2 disorders with overlapping symptoms and increasing trend. Together with gluten, other wheat components; fermentable oligo-, di-, monosaccharide, and polyols (FODMAPs); and amylase trypsin inhibitors (ATIs), are implicated in the pathogenesis of both disorders. Gut microflora alterations in IBS and NCGS have been described, while microbiota manipulations have been shown to be promising in some IBS cases. This literature review summarizes our current knowledge on the impact of wheat ingredients (gluten, FODMAPs, and ATIs) in IBS and NCGS. In both disorders, FODMAPs and ATIs trigger gut dysbiosis, suggesting that gluten may not be the culprit, and microbiota manipulations can be applied in diagnostic and intervention approaches.
在过去30年里,无麸质饮食已被列为最流行的时尚饮食之一,主要是因为人们普遍认为避免摄入麸质有益健康,但这种观念并不明确。麸质不耐受与非乳糜泻性麸质敏感(NCGS)和肠易激综合征(IBS)有关,这两种疾病症状重叠且呈上升趋势。除了麸质,小麦的其他成分,如可发酵的寡糖、二糖、单糖和多元醇(FODMAPs)以及淀粉酶胰蛋白酶抑制剂(ATIs),也与这两种疾病的发病机制有关。已有研究描述了IBS和NCGS患者肠道微生物群的改变,而微生物群调节在一些IBS病例中已显示出前景。这篇文献综述总结了我们目前对小麦成分(麸质、FODMAPs和ATIs)对IBS和NCGS影响的认识。在这两种疾病中,FODMAPs和ATIs都会引发肠道菌群失调,这表明麸质可能并非罪魁祸首,微生物群调节可应用于诊断和干预方法中。
Curr Dev Nutr. 2020-12-31
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