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DOI: 10.1055/a-0759-7474
Glutenfrei = Problemfrei?
Gefahr einer gesteigerten Schwermetallaufnahme durch glutenfreie ErnährungFree from Gluten – Free from Problems?Risk of Increased Uptake of Heavy Metals Following a Gluten Free DietPublikationsverlauf
Publikationsdatum:
10. Dezember 2018 (online)
Zusammenfassung
Immer mehr Menschen, die nicht an Zöliakie erkrankt sind, ernähren sich glutenfrei. Neben ungeklärten abdominellen Symptomen sind auch andere Beschwerden (z. B. Müdigkeit, Hautveränderungen, Gelenkbeschwerden) Gründe für eine gluten- bzw. weizenfreie Ernährung. Aber auch gesunde Personen erhoffen sich vom Glutenverzicht im Rahmen des „frei-von“-Trends einen gesundheitlichen Nutzen. Inzwischen weisen Studien auf eine mögliche Schwermetallbelastung durch eine glutenfreien Diät hin, die sich u. a. in erhöhten Arsenurinkonzentrationen und Quecksilberblutspiegeln manifestiert. Ursache hierfür ist vor allem der hohe Anteil an belastetem Reis und Reismehl in vielen glutenfreien Produkten. Als weitere negative Effekte einer glutenfreien Diät werden ein erhöhtes Herz-Kreislauf- und Typ-2-Diabetes-Risiko durch eine verringerte Ballaststoffzufuhr diskutiert.
Zum jetzigen Zeitpunkt gibt es außer bei einer Zöliakiediagnose keine weitere eindeutige Indikation für eine glutenfreie Ernährung.
Abstract
More and more people without celiac disease follow a gluten-free diet. In addition to unexplained abdominal symptoms, other complaints (such as tiredness, skin changes, joint problems) are reasons for a gluten- or wheat-free diet. But an increasing number of people not affected by these diseases expect positive health effects of a gluten-free diet. According to a recent study, negative effects of a gluten-free diet are elevated heavy metal concentrations e. g. higher urinary arsenic levels and mercury blood levels in people following a gluten-free diet compared to people who not following a gluten-free diet. Reason for that could be the high intake of rice and rice flour in processed gluten-free foods often consumed by these groups. Other risks that are associated with a gluten-free lifestyle are coronary heart diseases and type 2 diabetes. For this reason, a gluten-free diet is not recommended for individuals without celiac disease, if a medical advice does not exist.
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Literatur
- 1 Ludvigsson JF, Leffler DA, Bai JC. et al. The Oslo definitions for coeliac disease and related terms. Gut 2013; 62: 43-52
- 2 Handelsblatt. Ernährung: Jeder vierte Deutsche vermeidet Gluten oder Laktose. http://www.handelsblatt.com/technik/medizin/ernaehrung-jeder-vierte-deutsche-vermeidet-gluten-oder-laktose/12126150.html (Aktualisierungsdatum: 2017-05-06 – Überprüfungsdatum 2017-05-07)
- 3 Mintel Group Ltd.. Half of Americans think gluten-free diets are a fad while 25% eat gluten-free foods. http://www.mintel.com/press-centre/food-and-drink/half-of-americans-think-gluten-free-diets-are-a-fad-while-25-eat-gluten-free-foods (Aktualisierungsdatum: 2015 – Überprüfungsdatum 2017-05-07)
- 4 Di Sabatino A, Volta U, Salvatore C. et al. Small Amounts of Gluten in Subjects With Suspected Nonceliac Gluten Sensitivity: A Randomized, Double-Blind, Placebo-Controlled, Cross-Over Trial. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 2015; 13: 1604-1612.e3
- 5 Fasano A, Sapone A, Zevallos V. et al. Nonceliac gluten sensitivity. Gastroenterology 2015; 148: 1195-1204
- 6 Davis W. Wheat belly: Lose the wheat, lose the weight, and find your path back to health. Emmaus Pa.: Rodale; 2011
- 7 salto.btz. Trentiner BeSchärung. https://www.salto.bz/de/article/28042016/trentiner-bescharung (Aktualisierungsdatum: 2016 – Überprüfungsdatum 2017-05-06)
- 8 Raehsler SL, Choung Rok Seon M, Eric V. et al. Accumulation of Heavy Metals in People on a Gluten-Free Diet. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 2017; 2018: 244-251
- 9 Bulka CM, Davis MA, Karagas MR. et al. The Unintended Consequences of a Gluten-free Diet. Epidemiology (Cambridge, Mass.) 2017; 28: e24-e25
- 10 Umweltbundesamt. Stoffmonographie Arsen – Referenzwert für Urin: Stellungnahme der Kommission „Human-Biomonitoring“ des Umweltbundesamtes. https://link.springer.com/article/10.1007/s00103-003-0710-6?view=classic#page-2 (Überprüfungsdatum 2017-06-30)
- 11 TheSpruce.com. Arsenic in Rice and Gluten-Free Diets. https://www.thespruce.com/arsenic-in-rice-and-gluten-free-diets-1451154 (Überprüfungsdatum 2017-06-11)
- 12 Lanphear BP, Rauch S, Auinger P. et al. Low-level lead exposure and mortality in US adults: a population-based cohort study. Lancet Public Health 2018; 3: e177-184
- 13 World Health Organization. Arsenic: Fact sheet. http://www.who.int/mediacentre/factsheets/fs372/en/ (Aktualisierungsdatum: 2017-05-15 – Überprüfungsdatum 2017-05-15)
- 14 Wang JP, Wang SL, Lin Q. et al. Association of arsenic and kidney dysfunction in people with diabetes and validation of its effects in rats. Environment international 2009; 35: 507-511
- 15 EFSA. Scientific Opinion on Arsenic in Food. EFSA Journal 2009; 7: 1351
- 16 Joint FAO WHO Expert Committee on Food Additives. Safety evaluation of certain contaminants in food. Geneva: World Health Organization; 2011. (FAO JECFA monographs 8)
- 17 Meharg AA, Sun G, Williams PN. et al. Inorganic arsenic levels in baby rice are of concern. Environmental pollution (Barking, Essex: 1987) 2008; 152: 746-749
- 18 Signes-Pastor AJ, Woodside JV, McMullan P. et al. Levels of infants’ urinary arsenic metabolites related to formula feeding and weaning with rice products exceeding the EU inorganic arsenic standard. PloS one 2017; 12: e0176923
- 19 Sohn E. Contamination: The toxic side of rice. Nature 2014; 514: S62-S63
- 20 Carey M, Jiujin X, Gomes Farias J. et al. Rethinking Rice Preparation for Highly Efficient Removal of Inorganic Arsenic Using Percolating Cooking Water. PloS one 2015; 10: e0131608
- 21 EFSA. Scientific Opinion on the risk for public health related to the presence of mercury and methylmercury in food. EFSA Journal 2012; 10: 2985
- 22 Zhang H, Feng X, Larssen T. et al. In inland China, rice, rather than fish, is the major pathway for methylmercury exposure. Environmental health perspectives 2010; 118: 1183-1188
- 23 Li R, Wu H, Ding J. et al. Mercury pollution in vegetables, grains and soils from areas surrounding coal-fired power plants. Scientific reports 2017; 7: 46545
- 24 Miranda J, Lasa A, Bustamante MA. et al. Nutritional differences between a gluten-free diet and a diet containing equivalent products with gluten. Plant foods for human nutrition (Dordrecht, Netherlands) 2014; 69: 182-187
- 25 Segura MEM, Rosell CM. Chemical composition and starch digestibility of different gluten-free breads. Plant foods for human nutrition (Dordrecht, Netherlands) 2011; 66: 224-230
- 26 Stevens L, Rashid M. Gluten-free and regular foods: a cost comparison. Canadian journal of dietetic practice and research: a publication of Dietitians of Canada = Revue canadienne de la pratique et de la recherche en dietetique: une publication des Dietetistes du Canada 2008; 69: 147-150
- 27 Lebwohl B, Cao Y, Zong G. et al. Long-term gluten consumption in adults without celiac disease and risk of coronary heart disease: prospective cohort study. BMJ (Clinical research ed.) 2017; 357: j1892
- 28 American Heart Association, Inc.. Abstract 11: Associations of Gluten Intake With Type 2 Diabetes Risk and Weight Gain in Three Large Prospective Cohort Studies of US Men and Women. http://circ.ahajournals.org/content/135/Suppl_1/A11 (Aktualisierungsdatum: 2017-03-07 – Überprüfungsdatum 2017-06-09)
- 29 Lancet The. Gluten-free diets: Vital or vogue?. The Lancet 2012; 380: 704
- 30 Leiß O. Reizdarm, Zöliakie, Weizenallergie, Weizensensitivität – die Schwierigkeit, die Spreu vom Weizen zu trennen. Aktuel Ernahrungsmed 2017; 42: 287-303