Department of Nutrition, School of Medicine, University of Chile, Santiago 8380453, Chile.
Institute of Nutrition and Food Technology, University of Chile, Santiago 7830490, Chile.
Nutrients. 2023 Jun 30;15(13):2975. doi: 10.3390/nu15132975.
A gluten-free diet (GFD) is the treatment of choice for gluten-related disorders. It has been associated with macro- and micronutrient deficiencies. Recently, consumption of arsenic-contaminated rice has raised concern because of the potential greater risk that it may represent for people on GFDs, whose rice consumption is high, since it is a fundamental cereal in GFDs. We reviewed the data published over the last 20 years in Medline and Scielo, in English, French and Spanish, on four metals (As, Hg, Cd, and Pb), to assess whether the evidence suggests that celiac disease or consumption of a GFD is associated with increased levels of blood/urinary metal concentrations. The review revealed a few articles that were directly related to the four metals and their relationships with a GFD. The evidence supports that rice-based products are a relevant source of As and other metals. Clinical studies and evaluations based on NHANES have indicated that persons on GFDs have higher As and Hg blood/urinary levels, suggesting that the diet and not the disease is responsible for it. The levels described are statistically significant compared to those of persons on complete diets, but far from toxic levels. The question of whether higher exposure to heavy metals associated with a GFD is biologically relevant remains unanswered and deserves study.
无麸质饮食（GFD）是治疗与麸质相关疾病的首选方法。它与宏量和微量营养素缺乏有关。最近，由于砷污染大米的消费可能对那些大量食用大米的 GFD 患者构成更大的风险，引起了人们的关注，因为大米是 GFD 的基本谷物。我们回顾了过去 20 年在 Medline 和 Scielo 上以英语、法语和西班牙语发表的关于四种金属（砷、汞、镉和铅）的数据，以评估乳糜泻或 GFD 消费是否与血液/尿液中金属浓度升高有关。该综述揭示了一些直接与这四种金属及其与 GFD 关系相关的文章。有证据表明，以大米为基础的产品是砷和其他金属的重要来源。基于 NHANES 的临床研究和评估表明，GFD 患者的血液/尿液中砷和汞含量较高，这表明是饮食而不是疾病导致了这种情况。与完全饮食的人相比，描述的水平具有统计学意义，但远低于毒性水平。与 GFD 相关的更高的重金属暴露是否具有生物学相关性仍未得到解答，值得进一步研究。
