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Frequently asked questions about a gluten-free diet

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Q1: How common is celiac disease in China? Is gluten-sensitive gluten sensitive?

According to a study conducted in Hubei in 2010-2012, 7 out of 395 patients with chronic diarrhea had a positive test for celiac serum (1.77%) ; in 363 healthy controls, 2 patients had serum. The test was positive (0.55%). [1]

Another study collected cases of hospitalized children with chronic diarrhea in Shanghai, Jinan, Wuhan, and Chengdu from January 2005 to December 2008. Of the 118 patients enrolled in the study, 14 (12%) were suspected. Celiac disease, and gluten-free diet treatment is effective. [2]

From January 2000 to December 2014, 17 cases of celiac disease were diagnosed at Peking Union Medical College Hospital . [3]

In addition, the meta-analysis of the frequency of celiac susceptibility genes in Chinese population showed that the HLA-DQ2.5 haplotype and HLA-DQ8 haplotype frequencies in Chinese population were 3.4% and 2.1%, respectively. [4]

The frequency of HLA-DQ2 antigen in Chinese population was 18.4%, and the frequency of DQ2 antigen in northern population was higher than that in southern population; the frequency of HLA-DQ8 antigen was 8.0%. The DQB1*0201 allele frequency is 10.5% and is more common in the northern population.

In the north, especially in the northwestern China, the risk of celiac disease is higher than that of southerners . This is related to the fact that the northern population is mainly wheat and the frequency of HLA gene in celiac disease is higher than that of southerners.

Although there are not many existing studies, we can also find that celiac disease exists in China, and the number of confirmed cases may be only the tip of the iceberg.

According to these studies, the number of celiac cases in China may be around 10 million. Of course, we need a larger epidemiological investigation to make more accurate statistics.

As for the gluten sensitivity of non-Celiac disease, there is no relevant epidemiological data in China, but it is estimated to be more common than celiac disease.


Q2: I was diagnosed with celiac disease. How long does it take for my gluten-free diet to start eating pasta again?

If you are diagnosed with celiac disease, it is necessary to stick to a gluten-free diet.

After avoiding gluten, your intestinal villi can be repaired slowly. And if you eat gluten again, your body will develop an autoimmune reaction and cause the symptoms.

The good news, however, is that after gluten-free, your symptoms usually get noticeably improved in a few weeks. A gluten-free diet based on real foods will also allow you to avoid more junk food, which is good for your long-term health.

Impaired intestinal villi typically take 3-6 months to recover in children and 2-3 years in adults. [5]



Q3: How much gluten is eaten to be gluten-free?

There is no such thing as a "low gluten" diet.

In order to ensure the recovery of the body, it is necessary to avoid gluten as much as possible.

For patients with celiac disease, daily intake of more than 10 mg of gluten may cause damage to the intestinal villi. Non-Celiac gluten-sensitive patients may be better tolerated, but it is also recommended to avoid gluten.



Q4: Can I recover completely without eating gluten?

Everyone is different. Some people can recover well only by avoiding gluten, while others need more intervention.

If patients have been exposed to gluten for a long time and are suffering from persistent digestive problems, they may not only have problems with gluten intolerance; in this population, allergies and intolerances of various foods are common.

Due to long-term food irritation, a variety of chronic inflammatory diseases often occur. In addition, some patients have other autoimmune complications. These need to communicate with a professional doctor to see if proper drug intervention is needed.

In addition, additional nutritional supplements are necessary for patients with malnutrition due to long-term dyspepsia.


Q5: Can X eat?

If you eat according to the " gluten-free diet 2.0 food list" , you can not only avoid gluten-free foods, but also avoid other problematic foods.

For gluten-free foods, see: "The gluten-free foods you need to avoid."

If you don't know the ingredients of a food, don't eat!



Q6: May I ask Musen, is oatmeal gluten-free?

Oatmeal itself is gluten-free, but because oats and wheat often share mills, oats are easily contaminated with gluten.

If you need to eat oatmeal, you can choose a gluten-free oatmeal. But like most cereals, it is recommended to soak the oatmeal for about 6 hours (plus yoghurt or kimchi juice) before eating, which can reduce the anti-nutritional substances such as phytic acid and lectin in the grain.

Similarly, buckwheat is also a gluten-free food, but care should also be taken to avoid gluten contamination. Similarly, only gluten-free barley green juice is safe to drink.



Q7: Can seasonings such as soy sauce and vinegar be eaten?

Most of the domestic seasonings such as soy sauce, vinegar and cooking wine are added with wheat. Therefore, there is no gluten-free seasoning that is not suitable for consumption.

As for soy sauce, there is already a gluten-free soy sauce in China, and related products can be bought on Taobao. In addition, coconut amino acids can be chosen as a substitute for soy sauce.

Vinegar can be replaced with apple cider vinegar or coconut vinegar.

Seasonings use natural ingredients such as ginger, turmeric, garlic, cinnamon, onions, and fennel.



Q8: What can be used as a substitute for flour?

Although both soy flour and whole grain flour are gluten-free, it is not recommended for large-scale consumption (unless it is used to make fermented bread) due to the presence of phytic acid and lectins.

Suitable flour substitutes include:

  • rice flour

  • Potato flour

  • Too white powder

  • Sweet potato powder

  • Tapioca flour

  • coconut powder

  • Almond powder

  • Plantain powder



Q9: What if I want to eat out?

Avoid eating out as much as possible. Because even if the restaurant offers gluten-free food, there may be cross-contamination problems.

If you really need to eat out, ask about the ingredients and avoid dishes that contain wheat, barley and rye.

In addition, explain the reasons with the waiter, and ask for more requirements - for example, do not put soy sauce, do not check and so on.

Health is your own, so don't be bothered.

In addition, supplementation with gluten-digesting enzymes may have some effect.

But gluten digestive enzymes can't be used as a shield for your gluten intake.

On the one hand, these digestive enzymes have not been clinically tested, and the specific effects are unclear; on the other hand, not only gluten, but also a-amylase inhibitors in wheat, wheat germ agglutinin Both can cause symptoms. [6]


Q10: What are the similarities and differences between the gluten-free diet 2.0, the original diet and the ketogenic diet?

The gluten-free diet 2.0 and the original diet focus on the choice of food, not on the proportion of carbon water.

That is to say, when you are doing these two kinds of diets, you can use sweet potato and yam as the main food – carbohydrate as the main energy source; you can also eat meat as the main food, and then add extra oil – use fat as the main energy. source.

Both diets need to avoid over-processed foods, added sugar, refined vegetable oil, alcohol, and gluten. Simply put, it is to eat real food.

In addition, gluten-free diet 2.0 and the original diet focus on the intake of fermented vegetables and bone soup .

In contrast, the ketogenic diet is more concerned with strictly limiting carbohydrates. This dietary stressed: strictly limit carbohydrate intake and add enough fat, the body can produce enough to ketone bodies for energy.

The ketogenic diet does not care about the choice of food, as long as the body can maintain a high blood ketone content.

It does not emphasize the intake of potentially harmful foods such as gluten, artificial sugar, vegetable oil, processed foods.

Of course, you can have a gluten-free diet 2.0 or a raw diet version of the ketogenic diet, which can improve the health benefits of the ketogenic diet.

Compared to the gluten-free diet 2.0, the original diet is banned from all grains, beans and dairy products.

Gluten-free diet 2.0

  • Grains and beans that allow for long periods of soaking, germination or fermentation;

  • Allowing no added fermented dairy products, bovine colostrum and whey protein;

  • Allow the intake of white rice;

In addition, the gluten-free diet focuses on the intake of resistant starch (from green bananas, yam, cooked and then cooled potatoes, cooked and then cooled rice, etc.) to nourish the intestinal flora.



references:

[1] Wang, H., Zhou, G., Luo, L., Crusius, JBA, Yuan, A., Kou, J., ... & Morré, SA (2015). Serological screening for celiac disease in adult Chinese patients with diarrhea predominant irritable bowel syndrome. Medicine, 94(42).

[2] Wang Yuqiong, Liu Wei, Xu Junjie, Mei Hong, Peng Hanming, & Plateau et al. (2010). The incidence of celiac disease in children with chronic diarrhea in China. Chinese Journal of Pediatrics, 48(4), 244-248 .

[3] Li Rongrong, & Yu Kang. (2015). Whole-course nutrition management improves the outcome of patients with celiac disease. Concord Medical Journal (4), 255-259.

[4]Yuan, J., Gao, J., Li, X., Liu, F., Wijmenga, C., Chen, H., & Gilissen, LJ (2013). The tip of the “celiac iceberg” in China: a systematic review and meta-analysis. PLoS One, 8(12), e81151.

[5] Nihgov (2016) Nihgov Retrieved July 4, 2016, from... nlm.nih.gov/medlineplus

[6] Aziz, I., Hadjivassiliou, M., & Sanders, DS (2015). The spectrum of noncoeliac gluten sensitivity. Nature Reviews Gastroenterology & Hematology.



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