What’s the big deal with gluten? - William D. Chey

翻译人员: Yunxi Shi 校对人员: Chenlu Wang

Maybe you've recently seen the phrase "gluten-free" on food packaging,

也许你最近常在食品包装袋

or take-out menus, shampoo bottles, apartment listings, the tag of your shirt,

外卖菜单，香波瓶子，公寓列表或者体恤衫上

on a hammer, as a lower back tattoo, or in your friend's resume.

在铁锤上，在后背下部的纹身，或在你朋友的简历上看到“无谷蛋白“的字样。

Next time someone starts telling you about their newfound freedom from gluten,

下次如果有人告诉你关于他们避免摄入谷蛋白以后有多么舒服自在

here are some questions you can ask,

你可以问问待会我告诉你的几个问题

and the well-informed answers that your friend,

你一定会从你这个保持理性

being a reasonable individual making educated dietary choices,

选择最佳饮食方案

and by no means just following the latest diet craze, will tell you.

无论看似多疯狂也要遵从健康饮食的朋友身上获得一个信息量丰富的答案。

What is gluten?

什么是谷蛋白？

Gluten is an insoluble protein composite

谷蛋白是一种不能溶解的蛋白质组成

made up of two proteins named gliadin and glutenin.

由醇溶朊和麦谷蛋白两种蛋白质组成。

Where might you encounter gluten?

你在哪儿可以见到谷蛋白？

Gluten is found in certain grains, particularly wheat, rye and barley.

谷蛋白可以在某些特定的谷物中被发现，尤其是小麦、黑麦和大麦

What has gluten been doing for the previous entirety of human history,

谷蛋白在之前的整个人类历史中起到了什么作用？

and why do you suddenly care about it?

为什么我们突然之间对它如此感兴趣？

Gluten is responsible for the elastic consistency of dough

谷蛋白可以保持生面团的弹性和粘稠度

and the chewiness of foods made from wheat flour,

以及由小麦粉做成的食物的咀嚼性

like bread and pasta.

比如面包和意大利面

For some people, these foods cause problems,

对于某些人来说，这些食物可能会带来麻烦

namely wheat allergy, celiac disease, and non-celiac gluten sensitivity.

即小麦过敏，脂泻病和非腹腔谷蛋白敏感性

Wheat allergy is an uncommon condition

小麦过敏是一种不常见的情况

that occurs when a person's immune system

人们的免疫系统

mounts an allergic response to wheat proteins,

对小麦蛋白产生过敏反应

leading to mild problems, and in rare cases,

导致出现轻微的不良反应，极少数情况下

a potential dangerous reaction called anaphylaxis.

也会出现严重的蛋白质过敏反应，这种过敏反应叫做刺激性接触性皮肤炎

Celiac disease is an inherited disease,

脂泻病是一种遗传病

in which eating foods with gluten

当吃进去的食物中含有谷蛋白的时候

leads to inflammation and damage of the lining of the small intestine.

会导致发炎和小肠内壁损伤

This impairs intestinal function,

这会导致肠道功能损伤

leading to problems like belly pain, bloating, gas, diarrhea,

引发诸如腹痛、腹胀、多屁、腹泻

weight loss, skin rash, bone problems like osteoporosis,

体重下降、皮肤过敏、骨头问题比如骨质疏松症

iron deficiency, small stature, infertility, fatigue and depression.

贫血、身材矮小、不孕、疲劳、压力等一系列疾病

Untreated, celiac disease increases the risk

不进行治疗的脂泻病会增加

of developing certain types of cancer.

患某些癌症的风险

Celiac disease is present in one in every 100 to 200 persons in the U.S.

在美国，每100-200人中就有1人患有脂泻病

When blood tests suggest the possibility of celiac,

当血液检测显示出潜在的腹腔疾病可能性时

the diagnosis is confirmed with a biopsy.

会利用腹腔活组织切片检查加以诊断。

The most effective treatment is a gluten-free diet,

最有效的治疗方法就是不含谷蛋白的饮食

which helps heal intestinal damage and improve symptoms.

这种方法可以帮助治愈肠道损伤以及缓解病症

Some people don't have celiac disease or a wheat allergy,

一些人没有脂泻病或者不会对小麦过敏

but still experience symptoms when they eat foods with gluten.

但是吃了含有谷蛋白的食物的时候仍然有病症

These people have non-celiac gluten sensitivity.

这些人患有非腹腔谷蛋白敏感性疾病

They experience painful gut symptoms

他们经历着极度痛苦的胆炎症

and suffer from fatigue, brain fog, joint pain or skin rash.

承受着疲劳、头脑发晕、关节疼痛或者皮肤过敏

A gluten-free diet typically helps with these symptoms.

不含谷蛋白的饮食基本上可以帮助缓解以上症状

So how many people actually have this gluten sensitivity you speak of?

所以到底多少人患有这种我们所说的非腹腔谷蛋白敏感性疾病？

Gluten sensitivity's occurrence in the general population is unclear,

谷蛋白敏感性在总人口中的发病率现在还是未知数

but likely much more common than wheat allergy or celiac disease.

但是很有可能比小麦过敏和脂泻病更常见

Diagnosis is based on the development of symptoms,

这种病的诊断基本上靠症状的发展

the absence of wheat allergy and celiac disease,

排除小麦过敏和脂泻病

and subsequent improvement on a gluten-free diet.

以及食用不含谷蛋白的饮食以后身体的恢复来诊断

There's no reliable blood or tissue test,

现在还没有可靠地血液和组织检测

partly because gluten sensitivity isn't a single disease,

一部分原因是因为非腹腔谷蛋白敏感性疾病不是一个单一的疾病

and has a number of different possible causes.

它可能有一系列不同的发病原因

For example, it may be the case

比如，很有可能是这种情况

that gluten can activate the immune system in the small intestine,

谷蛋白可以在小肠中激发免疫系统的反应

or cause it to become leaky.

或者让它变得有漏洞

But sometimes, people claiming gluten sensitivity

但是有些时候，人们声称谷蛋白敏感性

are actually sensitive not to wheat proteins,

实际上敏感的对象不是小麦蛋白

but sugars found in wheat and other foods, called fructans.

而是在小麦和其他食物中发现的一种糖，叫果聚糖

The human intestine can't break down or absorb fructans,

人类的小肠不能分解或者吸收果聚糖

so they make their way to the large intestine or colon,

所以它们直接到达了大肠或者结肠

where they're fermented by bacteria,

在那里它们被细菌发酵

producing short-chain fatty acids and gases.

产生了短链脂肪酸和气体

This leads to unpleasant symptoms in some people with bowel problems.

这使得某些人的肠部出现了令人不愉快的症状

Another possible explanation behind gluten sensitivity is the nocebo effect.

另一个对谷蛋白敏感性的可能的解释就是反安慰剂效应

This occurs when a person believes something will cause problems,

当一个人相信某事会导致某些问题的时候这个效应就会出现

and because of that belief, it does.

并且因为他们相信，身体就真的做出了相应的动作

It's the opposite of the more well-known and much more fortuitous placebo effect.

上述效应和更广为人知、更有效的"安慰剂效应"正好相反

Given how much bad press gluten is getting in the media,

由于谷蛋白的媒体形象每况愈下，在这种情况下

the nocebo response may play a role

反安慰剂效应也许会影响到

for some people who think they're sensitive to gluten.

那些他们自认为对谷蛋白敏感的人们

For all these reasons,

以上这些原因

it's clear that the problems people develop

清楚地显示人们食用小麦等谷物时，遇到的种种问题

when they eat wheat and other grains aren't exclusively due to gluten.

不能完全归咎于谷蛋白

给"非腹腔谷蛋白敏感性"更恰当的名字，可能是

So a better name than non-celiac gluten sensitivty

might be wheat intolerance.

小麦不耐症