無麩質飲食
無麩質飲食（英語：Gluten-free diet，縮寫GFD）是指沒有麩質的飲食方式。麩質是一種在小麥、大麥及裸麥中含有的蛋白質成份[1][2]，這些物類及其雜交種（如斯佩耳特小麥[1]、卡姆麥及小黑麥[1][2]）也都算在內。但無麩質飲食是否要將燕麥列入，此部份仍有爭議，燕麥中的燕麥蛋白（Avenin）對乳糜瀉患者是有毒的[2]，毒性視栽培品種而定[3]。此外，燕麥也常會被含麩質的穀物交叉污染[2]。也有健康民眾進行無麩質飲食，用以避免攝取基因改造的小麥，但不攝取基因改造的小麥有益處此一論點目前沒有科學證據。
概論
[編輯]麩質造成的健康問題為麩質相關疾病，包括了乳糜瀉、非乳糜瀉麩質敏感、麩質失調、疱疹樣皮炎及小麥過敏[4]。若有這些疾病，改用無麩質飲食是醫師建議且有效的治療方式[5][6][7]。[8]，不過在部份案例中，無麩質飲食可以改善一些疾病的消化道症狀或是整體症狀，這些疾病包括大腸激躁症、類風濕性關節炎、多發性硬化症或HIV腸病等[9]。
麩質蛋白質的營養成份及生物學價值較低，而含有麩質的穀類也不是人類飲食中所必需的[10]。不過若食物攝取不均衡，或是不正確的選用無麩質替代飲食，可能會造成營養不良。營養方面的問題可以透過正確的飲食教育預防[2]。
無麩質飲食應該主要以天然的無麩質食物為基礎，而且在微量元素及營養素之間有好的平衡。肉類、魚類、蛋、豆類、堅果、馬鈴薯、米及玉米都很合適，若使用商業販售的無麩質替代飲食，建議選用富有維生素及礦物質的飲食[2]。此外像藜、莧和蕎麥等準穀物及其他雜糧也是很好的代替品[2][10]。
提供
[編輯]雖然無麩質飲食法2010年代在歐美掀起新風潮，乃至美國食品藥品監督管理局（FDA）自2014年針對無麩質食品頒佈新標準，一些連鎖餐廳也開始為顧客提供無麩質菜餚，但是有不少餐廳表示，無法保證和承諾這些餐點完全不含麩質；一些顧客抱怨稱餐點含有麩質，並表示食用後腸胃不適。根據統計，全美國約有兩三百萬民眾患有乳糜瀉消化性疾病，他們食用麩質後會出現腸胃不適。另根據全美乳糜瀉覺醒基金會（National Foundation for Celiac Awareness）估計，還有1800萬美國人對麥麩過敏，他們聲稱食用麩質食品後會發生腹瀉、貧血及其他類似乳糜瀉疾病的症狀。2013年市場調查機構NPD Group的一份報告顯示，近3成美國民眾表示會避開含麩質的食品，高於3年前的25.5%[11][12]。
很多航空公司為旅客提供特殊航空餐食選項，其中也包含無麩質餐[13]（英語：Gluten Free Meal，縮寫GFML；也稱無麥麩餐[14]、無麵筋餐[15]）的預定，旅客一般需在航班起飛的24小時之前告知航空公司。
參看
[編輯]- 地中海飲食 - 以不飽和脂肪酸與纖維的高量為重點之飲食法，穀物類略少，肉類脂肪尤其紅肉類大幅壓低。
- 植物性飲食 - 只吃素食的飲食方式
- 生酮飲食 - 以脂肪和油類當主食取代醣類，用以治療特定疾病，亦有研究其養生功能但有許多爭議。
相關條目
[編輯]參考文獻
[編輯]- ^ 1.0 1.1 1.2 Tovoli F, Masi C, Guidetti E, Negrini G, Paterini P, Bolondi L. Clinical and diagnostic aspects of gluten related disorders. World J Clin Cases. Mar 16, 2015, 3 (3): 275–84. PMC 4360499
. PMID 25789300. doi:10.12998/wjcc.v3.i3.275.
- ^ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Penagini F, Dilillo D, Meneghin F, Mameli C, Fabiano V, Zuccotti GV. Gluten-free diet in children: an approach to a nutritionally adequate and balanced diet. Nutrients. Nov 18, 2013, 5 (11): 4553–65. PMC 3847748 . PMID 24253052. doi:10.3390/nu5114553.
For CD patients on GFD, the nutritional complications are likely to be caused by the poor nutritional quality of the GFPs mentioned above and by the incorrect alimentary choices of CD patients. (...) the limited choice of food products in the diet of children with CD induces a high consumption of packaged GFPs, such as snacks and biscuits. (..) It has been shown that some commercially available GFPs have a lower content of folates, iron and B vitamins or are not consistently enriched/fortified compared to their gluten containing counterparts. (...) The first step towards a balanced diet starts from early education on CD and GFD, possibly provided by a skilled dietitian and/or by a physician with expert knowledge in CD. (...) It is advisable to prefer consumption of naturally GF foods, since it has been shown that they are more balanced and complete under both the macro- and micro-nutrient point of view. In fact, these foods are considered to have a higher nutritional value in terms of energy provision, lipid composition and vitamin content as opposed to the commercially purified GF products. Within the range of naturally GF foods, it is preferable to consume those rich in iron and folic acid, such as leafy vegetables, legumes, fish and meat. During explanation of naturally GF foods to patients, it is a good approach for healthcare professionals to bear in mind the local food habits and recipes of each country. This may provide tailored dietary advice, improving acceptance and compliance to GFD. Furthermore, increasing awareness on the availability of the local naturally GF foods may help promote their consumption, resulting in a more balanced and economically advantageous diet. Indeed, these aspects should always be addressed during dietary counseling. With regards to the commercially purified GFPs, it is recommended to pay special attention to the labeling and chemical composition. (...) Increasing awareness on the possible nutritional deficiencies associated with GFD may help healthcare professionals and families tackle the issue by starting from early education on GFD and clear dietary advice on how to choose the most appropriate gluten-free foods.
- ^ Comino I, Moreno Mde L, Sousa C. Role of oats in celiac disease. World J Gastroenterol. Nov 7, 2015, 21 (41): 11825–31. PMC 4631980 . PMID 26557006. doi:10.3748/wjg.v21.i41.11825.
- ^ Ludvigsson JF, Leffler DA, Bai JC, Biagi F, Fasano A, Green PH, Hadjivassiliou M, Kaukinen K, Kelly CP, Leonard JN, Lundin KE, Murray JA, Sanders DS, Walker MM, Zingone F, Ciacci C. The Oslo definitions for coeliac disease and related terms. Gut. January 2013, 62 (1): 43–52. PMC 3440559 . PMID 22345659. doi:10.1136/gutjnl-2011-301346.
- ^ Mulder CJ, van Wanrooij RL, Bakker SF, Wierdsma N, Bouma G. Gluten-free diet in gluten-related disorders. Dig Dis. (Review). 2013, 31 (1): 57–62. PMID 23797124. doi:10.1159/000347180.
The only treatment for CD, dermatitis herpetiformis (DH) and gluten ataxia is lifelong adherence to a GFD.
- ^ Hischenhuber C, Crevel R, Jarry B, Mäki M, Moneret-Vautrin DA, Romano A, Troncone R, Ward R. Review article: safe amounts of gluten for patients with wheat allergy or coeliac disease. Aliment Pharmacol Ther. Mar 1, 2006, 23 (5): 559–75. PMID 16480395. doi:10.1111/j.1365-2036.2006.02768.x.
For both wheat allergy and coeliac disease the dietary avoidance of wheat and other gluten-containing cereals is the only effective treatment.
- ^ Volta U, Caio G, De Giorgio R, Henriksen C, Skodje G, Lundin KE. Non-celiac gluten sensitivity: a work-in-progress entity in the spectrum of wheat-related disorders. Best Pract Res Clin Gastroenterol. Jun 2015, 29 (3): 477–91. PMID 26060112. doi:10.1016/j.bpg.2015.04.006.
A recently proposed approach to NCGS diagnosis is an objective improvement of gastrointestinal symptoms and extra-intestinal manifestations assessed through a rating scale before and after GFD. Although a standardized symptom rating scale is not yet applied worldwide, a recent study indicated that a decrease of the global symptom score higher than 50% after GFD can be regarded as confirmatory of NCGS (Table 1) [53]. (…) After the confirmation of NCGS diagnosis, according to the previously mentioned work-up, patients are advized to start with a GFD [49].
- ^ 無麩質飲食 真相探索. [2016-05-09]. （原始內容存檔於2020-02-01）.
- ^ El-Chammas K, Danner E. Gluten-free diet in nonceliac disease. Nutr Clin Pract (Review). Jun 2011, 26 (3): 294–9. PMID 21586414. doi:10.1177/0884533611405538.
The prescription of a GFD has been recommended for patients with IBS-like symptoms without histologic evidence of CD and who have positive IgA tTG antibodies or have the at-risk haplotypes DQ2 or DQ8.46 (…) Historically, a GFD was occasionally used in the management of multiple sclerosis (MS), because anecdotal reports indicated a positive effect (reversal of symptoms) of a GFD in MS patients. (…) what has been demonstrated so far is that a glutenfree vegan diet for 1 year significantly reduced disease activity and levels of antibodies to β-lactoglobulin and gliadin in patients with RA. (...) The beneficial effect of a GFD on diarrhea and weight gain in patients with HIV enteropathy has been demonstrated in a few case series. Treatment with a GFD has been observed to decrease the frequency of diarrhea and thus allow weight gain.84 (IBS=irritable bowel syndrome; RA=rheumatoid arthritis; GFD=gluten-free diet)
- ^ 10.0 10.1 Lamacchia C, Camarca A, Picascia S, Di Luccia A, Gianfrani C. Cereal-based gluten-free food: how to reconcile nutritional and technological properties of wheat proteins with safety for celiac disease patients. Nutrients (Review). 2014, 6 (2): 575–90. PMC 3942718 . PMID 24481131. doi:10.3390/nu6020575.
- ^ 蕭麗君. 就是要无麸质食品. 工商時報 (中時電子報). [2013-12-29]. （原始內容存檔於2020-02-01） （中文（臺灣））.
- ^ At Restaurants, Gluten-Free Is a Tough Recipe - WSJ. [2019-05-17]. （原始內容存檔於2020-02-01）.
- ^ 国航机上服务：餐食服务之保健餐膳_新浪旅游_新浪网. [2019-05-17]. （原始內容存檔於2019-05-17）.
- ^ 特殊餐食种类 | China Eastern Airlines. [2019-05-17]. （原始內容存檔於2019-05-18）.
- ^ 特殊餐食,川航官网. [2019-05-17]. （原始內容存檔於2019-05-17）.
