I-Gluten ithathe indawo enkulu engxoxweni yamanje mayelana nempilo nempilo., ikakhulukazi ngenxa yobudlelwane bayo nezifo ezihlukahlukene kusukela ku-pathologies yokugaya kuya kwezimo zezinzwa nezengqondo. Labo abahlushwa i-autism, migraines, isifo sikashukela, noma ezinye izimpawu ezibonakala zingachazeki bayanda ukuthola izinkomba zendima engenzeka ye-gluten ekuphileni kwabo kwansuku zonke.
Liyini iqiniso mayelana nokuxhumana phakathi kwe-gluten nezifo eziyinkimbinkimbi njenge-autism ne-migraines? Kungabathinta kanjani abantu abanesifo sikashukela, futhi yiziphi izimpawu ezingaziwayo ezihlotshaniswa nokusetshenziswa kwaso? Ngokubuyekeza okuphelele, okucacile, nokwakamuva, sizophendula yonke le mibuzo ngokuhlanganisa ulwazi lwakamuva nolufanele olutholakalayo.
Iyini i-gluten futhi kungani iphikisana kangaka?
I-Gluten iyiphrotheni ekhona kokusanhlamvu okunjengokolweni, ibhali nerye. Le phrotheni inika ukunwebeka kanye nokuthungwa emikhiqizweni eminingi yebhikawozi, kodwa ukusetshenziswa kwayo kuye kwaxhunyaniswa nokuthuthukiswa kwezifo ezithile, kokubili ukugaya kanye nokugaya ukudla. Intshisekelo ku-gluten ikhule kakhulu eminyakeni yamuva, ikakhulukazi kulandela ukuhlonzwa kweziyaluyalu ezifana nesifo se-celiac kanye ne-non-celiac gluten sensitivity (NCGS). Funda kabanzi mayelana nezinzuzo nezingozi ze-gluten.
Njengamanje, izinhlobo ezintathu ezinkulu zokusabela okubi ku-gluten ziyabonwa: ukungezwani nokolweni (uhlamvu lwe-allergic), isifo se-celiac (imvelaphi ye-autoimmune) kanye nokuzwela kwe-gluten okungeyona i-celiac (izinqubo ezingakaqondwa ngokugcwele). Ngayinye yazo ihilela izimpawu ezihlukene kanye nokuxilongwa, okuvula uhla olukhulu lwezethulo zomtholampilo ezingase zibe khona.
Isifo seCeliac: okungaphezu kwesifo sokugaya ukudla
Isifo se-Celiac (CD) sichazwe njengesifo esingelapheki esizimele esithinta ngokuyinhloko amathumbu amancane., okubangelwa ukusetshenziswa kwe-gluten kubantu abathambekele kofuzo—ikakhulukazi abathwali be-HLA DQ2 ne-DQ8. Ukusabalala kwayo kuzungeze i-1% emhlabeni jikelele, kuvame kakhulu eYurophu futhi kungavamile e-East Asia.
Esinye sezici ezimangalisa kakhulu zesifo se-celiac ukuhlukahluka okukhulu komtholampilo. Ingabonakala ngazo zombili izimpawu zakudala zokugaya (uhudo, i-malabsorption, ubuhlungu besisu, ukuqunjelwa, ukuncipha kwesisindo kanye nokuncipha kokukhula) kanye nezimpawu zokugaya ukudla okwengeziwe, ngisho nangendlela engabonakali. Ngakho-ke, kubhekwa njengesifo se-multisystemic esinenkulumo eguquguqukayo kakhulu. .
Futhi, Kukhona amafomu angaziwa kancane njengesifo se-celiac esithule futhi esicashile., ezingase zingabonakali iminyaka kuze kube yilapho ziqala izimpawu ezicacile noma izinkinga.
Ukuxilongwa, izimpawu, nokwelashwa kwesifo se-celiac
Ukuxilongwa kwesifo se-celiac kuye kwavela eminyakeni yamuva ngenxa yokusetshenziswa kwezimpawu ezithile ze-serological. (i-anti-tissue transglutaminase, i-anti-endomysium kanye nama-anti-deaminated peptide antibodies ye-gliadin), ucwaningo lwezakhi zofuzo kanye ne-duodenal biopsy. Njengamanje, ezimweni ezithile zezingane, i-biopsy ingakhishwa uma kuhlangatshezwana nemibandela ethile.
Ukwelashwa kwesifo se-celiac kuhlanganisa ukukhishwa okuphelele nokuhlala unomphela kwe-gluten ekudleni. Lokhu kuvumela ukujwayelekile kwe-mucosa yamathumbu kanye nokunyamalala kwezimpawu, kanye nokuvimbela izinkinga (i-osteoporosis, ukuntuleka komsoco, i-lymphomas yamathumbu). Ukudla kufanele kube okuqinile futhi kudinga ukuqapha, njengoba i-gluten ikhona kumaphesenti aphezulu kakhulu okudla okucutshungulwayo.
Ukuzwela kwe-gluten okungeyona i-celiac: inhlangano evelayo
Ukuzwela kwe-gluten okungeyona i-celiac (NCGS) kuchazwa njengokuvela kwezimpawu ezifana ne-celiac ngemva kokungenisa i-gluten, kodwa ngaphandle kwezimpawu zokuzivikela komzimba noma isici sokulimala kwamathumbu e-CD. Kulinganiselwa ukuthi kungase kuthinte phakathi kwe-6 ne-12% yabantu, nakuba ukutholakala kwayo kungokukodwa futhi kuyaqhubeka kudala impikiswano emphakathini wezokwelapha ngenxa yokuntuleka kokuhlolwa kwe-serological noma i-histological.
Abantu abane-NCGS bangase bahlangabezane nakho Izimpawu zokugaya ukudla (ubuhlungu besisu, ukuqunjelwa, isifo sohudo, ukuqunjelwa) kanye nezimpawu zokugaya ukudla (ikhanda elibuhlungu, ukukhathala, ubuhlungu bamalunga, ukuphazamiseka kwezinzwa nengqondo). Ukuthuthukiswa ngokudla okungenalo i-gluten ngokuvamile kubonakala. Kodwa-ke, kuye kwaboniswa ukuthi i-gluten ayiyona njalo imbangela yodwa, njengoba izimpawu ngezinye izikhathi zingabangelwa ezinye izingxenye zikakolweni, njenge-fructans (FODMAPs).
I-Gluten ne-migraines: ingabe kukhona ubuhlobo obuqondile?
I-Migraines yizinkinga eziyinkimbinkimbi ze-neurological ezithinta phakathi kwe-12 ne-15% yabantu, ikakhulukazi abesifazane abasebasha.. Zibonakala ngekhanda elinamandla, elishayayo, elibuhlungu elihlangene, ngokuvamile elihambisana nokucanuzela kwenhliziyo, ukuhlanza, nokuzwela ukukhanya nomsindo. Ukuquleka kungahlala phakathi kwamahora ama-4 nangama-72 futhi kube nomthelela omkhulu kwikhwalithi yempilo yalabo abaphethwe yikho.
Isixhumanisi esibalulekile sibonwe phakathi kwe-migraine nesifo se-celiac.. Abantu abanesifo se-celiac banamathuba aphindwe kabili okuba ne-migraines. Kwezinye izimo, i-migraine ingenye yezimpawu zokuqala noma ikhula kancane kancane njengoba isifo se-celiac siqhubeka.
Incazelo eyinhloko izungeza impendulo yokuvuvukala kanye nezinguquko ku-intestinal microbiota ezibangela isifo se-celiac. Ukusabela kwamasosha omzimba ku-gluten kubangela ukukhululwa kwama-peptide nama-cytokines angathinta isimiso sezinzwa esiyinhloko, okuholela ekuphathweni kwekhanda nezinye izimpawu zemizwa. Ngaphezu kwalokho, ukuphazamiseka kwe-gut microbiome kungakhuphula amazinga okuvuvukala kwesistimu, kube nomthelela kulezi zinhlobo zokubonakaliswa.
Nokho, akubona bonke ochwepheshe ababheka ubuhlobo njengembangela, njengoba ezinye izifundo zigcizelela lokho I-Migraines ingathuthuka ezigulini ze-celiac ngokulandela ukudla okungenalo i-gluten., kodwa lokhu akusho ukuthi i-gluten iyimbangela eqondile kuzo zonke izimo. Abantu abahlushwa i-migraines ehlala njalo futhi eqhubekayo bayelulekwa ukuthi babonane nodokotela wabo ngaphambi kokuqala ukudla okuqedayo.
Izifo ze-Gluten ne-neurological: ataxia, neuropathies nokunye
I-Gluten ingabangela ukuphazamiseka kwemizwa, ne-gluten ataxia kanye ne-gluten neuropathy okuyizinto ezimbili ezibhalwe kahle.
La i-ataxia ye-gluten Ithinta i-cerebellum, ibangele izinkinga ngokulinganisela nokuxhumanisa kwezimoto. Ngokwengxenye yayo, i i-gluten neuropathy Kuthinta imizwa eseceleni enesibopho sokuzwela namandla emisipha, okubangela ubuthakathaka nokulahlekelwa ukusebenza.
Kuzo zombili izimo, ukwamukela ukudla okungenalo i-gluten kungakhuthaza ukululama futhi kuthuthukise izimpawu. Kodwa-ke, ucwaningo lwesayensi alukaqali ubudlelwano obuqondile phakathi kwe-gluten nezinye izifo zemizwa (ezifana ne-schizophrenia noma i-autism) ngale komongo wesifo se-celiac noma ukuzwela okungeyona i-celiac. Funda kabanzi mayelana nokuthi i-gluten ithinta kanjani impilo yokugaya kanye nempilo yezinzwa..
I-Gluten kanye nokuphazamiseka kwengqondo: i-autism, i-schizophrenia, nezinye izimo
Umthelela we-gluten endaweni yezengqondo uthole ukubaluleka eminyakeni yamuva.. Kuye kwafakwa ukuthi isifo se-celiac kanye ne-NCGS kungase kuhlotshaniswe nengozi eyengeziwe ye-autism spectrum disorders (ASD), i-schizophrenia, i-ADHD, ukukhathazeka, nokucindezeleka.
Endabeni ethize ye i-autismo, ucwaningo lwakamuva kakhulu aluqinisekisi ukuhlobana okucacile kwembangela phakathi kokusetshenziswa kwe-gluten kanye nokuthuthukiswa kwe-ASD, nakuba ama-subgroups athile ezingane ezine-autistic enokwanda okuphezulu kwesifo se-celiac kanye nezimpawu zokugaya ukudla. Dlulela ngokujulile ebuhlotsheni phakathi kwe-gluten nempilo yegilo.
Ezinye izifundo ziphakamisa ukuthi izingane ezine-ASD zinethuba eliphindwe ka-1,4 lokuthuthukisa isifo se-celiac kunabantu abaningi. Ukudla okungenalo i-gluten kuye kwabikwa ukuthi kusiza ukuthuthukisa izimpawu zokuziphatha kanye nesisu ezinganeni ze-autistic ezinesifo se-celiac esiqinisekisiwe. Kodwa-ke, ubufakazi bokuncoma ukudla okungafakwanga ngaphandle kokuxilongwa okuqinile kwezokwelapha kuhlala kunganele.
Eminye imisebenzi ichaze amacala ka Ukuzwela kwe-gluten okungeyona i-celiac ezinganeni ezinezimpawu ze-autistic, lapho ukuhoxiswa kwe-gluten kukhiqize khona ukuthuthuka okuphawulekayo ekuziphatheni kanye nezimpawu zemizwa. Naphezu kwalokhu, umphakathi wezokwelapha uyagcizelela ukuthi ukusetshenziswa kabanzi kwalokhu kudla kungaletha izingozi ezinkulu zokudla okunomsoco uma kungenziwanga ngaphansi kokuqondisa kochwepheshe.
Mayelana ne-schizophrenia, kunenkulumompikiswano ethakazelisayo mayelana nokubandakanyeka okungenzeka kwe-gluten.. Ezinye izifundo zithole ukusabalala okuphezulu kwamasosha omzimba athile ngokumelene nezingxenye ze-gluten ezigulini ze-schizophrenic, okuphakamisa ukuthi amaphesenti abalulekile angazuza ekudleni okungenalo i-gluten, nakuba zingekho izincomo ezisemthethweni kulo mphumela.
IGluten, isifo sikashukela, kanye nezifo ezizimele: ukuxhumana kanye nokucaciswayo
Ubudlelwano phakathi kwesifo se-celiac nesifo sikashukela sohlobo loku-1 baziwa kahle.. Bobabili banesisekelo se-autoimmune esifanayo kanye ne-genetic predisposition, okwenza ukuhlalisana kwawo womabili ama-pathologies ajwayelekile.
Eqinisweni, amalungu omndeni eziguli ze-celiac anengozi enkulu kakhulu yokuba nesifo sikashukela sohlobo loku-1. Ukuhlolwa njalo nokuhlolwa kwesifo se-celiac kunconywa kubantu abanesifo sikashukela sohlobo loku-1, ikakhulukazi ezinganeni.
Ngokuqondene ne Uhlobo 2 sikashukela, ubufakazi bendima ye-gluten abunamandla kangako. Eminye imigqa yocwaningo iphakamisa ukuthi i-gluten ingabangela izimpendulo zokuvuvukala ezishintsha ukusebenza kwe-metabolic, kodwa okwamanje asikho isisekelo esanele sokuncoma ukudla okungenalo i-gluten ezigulini ezinesifo sikashukela esinga-celiac.
Ezinye izimpawu kanye nokubonakaliswa okuhlobene ne-gluten
Uhlu lwezimpawu ezihambisana ne-gluten lukhulu kakhulu futhi ludlulela ngale kwesistimu yokugaya ukudla.. Ukubonakaliswa kwangaphandle kwamathumbu kuhlanganisa:
- Izinguquko ze-Dermatological: ikakhulukazi i-dermatitis herpetiformis, ebonisa izilonda zesikhumba ezilinganayo ngokulinganayo.
- Izinkinga ze-musculoskeletal: njengobuhlungu bamalunga, ubuthakathaka noma ukukhathala okungenasizathu.
- Izimpawu ze-Hematological: I-anemia yokuntuleka kwe-iron eqhubekayo, ngisho nalapho kungekho zimpawu zokugaya ukudla.
- Izinkinga ze-Endocrine kanye ne-metabolic: i-autoimmune hypothyroidism, ukuntuleka kokukhula noma ukuphazamiseka kokuzala.
- Umthelela wokuziphatha kanye nemizwa: ukucasuka, ukubekezelela ukucindezeleka okuncane, ukuphazamiseka kokulala nokuphazamiseka kwesifiso sokudla.
Ukuxilongwa nokuphathwa: nini futhi kanjani uma kusolwa
Izinsolo zomtholampilo yisinyathelo sokuqala ekuxilongeni izifo ezihlobene ne-gluten. Uma izimpawu ziphikelela—kungakhathaliseki ukuthi ukugaya ukudla, imizwa, noma ingqondo—kunconywa ukuthi ubonane nodokotela, ozocabangela ukuhlolwa kwe-serological futhi, uma kunesidingo, izifundo zofuzo kanye ne-histological.
Ukudla okungenalo i-gluten akufanele kuqalwe ngaphandle kokuxilongwa kwezempilo., njengoba lokhu kungenza kube nzima ukuthola imiphumela enokwethenjelwa evela ezivivinyweni nama-biopsies.
La Ukudla kwamahhala kwe-gluten Iwukuphela kwendlela yokwelapha esebenzayo yesifo se-celiac kanye nezimo ezithile zokuzwela okungezona kwe-celiac okuqinisekisiwe. Kumelwe iphelele, ilinganisele, futhi igadwe ithimba lezinhlaka eziningi, lapho uchwepheshe wezokudla edlala indima ebalulekile ekuqinisekiseni ukudla okwanele kwezakhi kanye nokuvimbela ukuntula.
Izici ezingokoqobo: impilo yansuku zonke, ukulebula nezindleko
Ukulandela ukudla okungenagluten kudinga ulwazi oluningiliziwe lokulebula kokudla., njengoba i-gluten ingaba khona ngezindlela ezifihliwe emikhiqizweni eminingi, ngisho naleyo ebhekwa "efanele" ekudleni okukhethekile.
Izindleko zemikhiqizo ethile ye-gluten-free zingaba phezulu, okuyinselele emindenini eminingi. Ngaphezu kwalokho, ukutholakala kwale mikhiqizo kuyehluka ngokwesifunda futhi kuvame ukukhawulelwa ngaphandle kwamadolobha amakhulu.
Eminyakeni yamuva nje, umthetho wokulebula kanye nokwakheka kokudla okungenalo i-gluten uqinisiwe, udinga ukuthi abakhiqizi nezindawo zokudlela badalule ubukhona bezinto ezingezwani nomzimba.
Imigqa emisha yocwaningo nokwelashwa
Njengamanje, ucwaningo nge-gluten nezifo ezihambisana nalo selusebenza ngokugcwele.. Okunye okuhlukile ekudleni okuqinile kuyabhekwa, njengokusetshenziswa kwama-enzyme ehlisa i-gluten, okusanhlamvu okushintshwe izakhi, i-immunotherapy, kanye nemithi yokugoma evimbela inqubo yokuzivikela komzimba ebangelwa ukungena kwe-gluten. .
Nokho, Ukudla okungenagluten kuhlala kuyindinganiso yokunakekelwa, futhi amasu amasha angabhekwa kuphela ngaphansi kokuqondisa kwezokwelapha..
Izincomo zeziguli namalungu omndeni
Kubalulekile ukuthi uhlale usekelwa ochwepheshe bezempilo isikhathi sokwenza izinqumo mayelana nokudla kanye nokuphathwa kwezifo ezihlobene ne-gluten. Ukulandelela okuvamile, ukuqapha ukuntula ukudla okunomsoco okungase kube khona, nokusekelwa ngokomzwelo kusiza ukuthuthukisa izinga lempilo futhi kuvimbele izinkinga zesikhathi eside.
