Do we need to worry about eating wheat?
Do we need to worry about eating wheat?
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DOI：
10.1111/nbu.12186
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发表时间：
2016-03
影响因子：
3.3
通讯作者：
Hey SJ
中科院分区：
文献类型：
--
作者：
Shewry PR;Hey SJ
小麦是温带世界的主食，也是数百万人重要的营养来源。然而，近年来，人们越来越关注小麦对健康的不利影响，特别是在北美和欧洲，越来越多地采用无小麦或无麸质饮食。这涉及两个问题：小麦产品对肥胖和2型糖尿病的增加负有不成比例的责任，小麦麸蛋白会引起一系列不良反应，包括过敏、乳糜泻和“非乳糜泻麸质敏感性”。第一个问题在以前的出版物中已被驳斥，因此我们在这里集中讨论第二个问题。目前的证据表明，对摄入的小麦过敏和乳糜泻（以及相关的不耐受）分别发生在高达1%的人口中。由于诊断的改进和认识的提高，其流行率增加的程度难以量化。然而，与其他免疫介导的食物不良反应相比，两者似乎都没有不成比例地增加。小麦的其他不良反应更难定义，因为它们的机制尚不清楚，因此难以诊断。特别是，据报道，“非乳糜小麦敏感性”发生在美国人口的6%或更多。然而，应用更严格的诊断标准可能会大大降低患病率的估计。因此，通过从饮食中去除小麦或麸质来改善一小部分人的健康是不太可能的。事实上，相反的情况可能会发生，因为小麦是蛋白质、B族维生素、矿物质和生物活性成分的重要来源。
Wheat is a staple food throughout the temperate world and an important source of nutrients for many millions of people. However, the last few years have seen increasing concerns about adverse effects of wheat on health, particularly in North America and Europe, with the increasing adoption of wheat‐free or gluten‐free diets. This relates to two concerns: that wheat products are disproportionally responsible for increases in obesity and type 2 diabetes and that wheat gluten proteins cause a range of adverse reactions, including allergies, coeliac disease and ‘non‐coeliac gluten sensitivity’. The first concern has been refuted in previous publications, and we therefore focus on the second here. Current evidence indicates that allergy to ingested wheat and coeliac disease (and related intolerances) each occur in up to 1% of the population. The extent to which their prevalence has increased is difficult to quantify due to improved diagnosis and increased awareness. However, neither appears to be increasing disproportionally when compared with other immunologically mediated adverse reactions to food. Other adverse reactions to wheat are more difficult to define as their mechanisms are not understood and they are therefore difficult to diagnose. In particular, ‘non‐coeliac wheat sensitivity’ has been reported to occur in 6% or more of the population in the US. However, the application of more rigorous diagnostic criteria is likely to give substantially lower estimates of prevalence. It is therefore unlikely that the health of more than a small proportion of the population will be improved by eliminating wheat or gluten from the diet. In fact, the opposite may occur as wheat is an important source of protein, B vitamins, minerals and bioactive components.