Glutensiz Diyetin Mikrobiyotaya Etkisi

Year 2022, , 548 - 553, 20.09.2022

Nurbanu Büyük , Feride Ayyıldız

https://doi.org/10.33631/sabd.1173946

Abstract

Glutensiz diyet, buğday, arpa, çavdar ve ürünlerini içermeyen beslenme modeli olarak tanımlanmaktadır. Çölyak tanısı alanlar veya gluten intoleransı olan bireylerde yaşam boyu uygulanması gereken terapötik bir yaklaşımdır. Ancak son dönemde sağlıklı bireyler gaz, şişkinlik gibi şikayetlerin azaltılması ve vücut ağırlığı kaybının sağlanması amacıyla sıkça glutensiz diyet uygulayabilmektedir. Bu uygulamanın sağlık üzerine olumlu veya olumsuz etkileri netlik kazanmasa da mikrobiyota üzerine etkileri güncel çalışmalarla incelenmektedir. Bağırsak mikrobiyotası; zararlı veya faydalı metabolitler üreterek insan sağlığını etkileyen ve patojenlere karşı koruyan, bağışıklık sistemine katkısı olan ve gastrointestinal gelişimi düzenleyen bir organ olarak tanımlanmaktadır. Çölyak hastaları gibi glutensiz diyet uygulaması gereken bireylerde glutensiz diyetin, mikrobiyotadaki disbiyoz durumunu kısmen veya tamamen düzelttiği bildirilmiştir. Ayrıca çölyak hastalığında glutensiz diyete ek olarak probiyotik desteğinin bağırsak homeostazının yeniden sağlanmasına yardımcı olduğu belirtilmektedir. Tam tersine sağlıklı bireylerde glutensiz diyet uygulamasının mikrobiyotada disbiyoza neden olduğu rapor edilmiştir. Bu etkinin glutensiz diyetin kompleks karbonhidrat ve bitkisel protein içeriğinin düşük, yağ içeriğinin ise yüksek olmasıyla ilişkili olduğu vurgulanmaktadır. Sonuç olarak glutensiz diyet bağırsak mikrobiyotası üzerinde etkili olup, çölyak hastalığı olanlar ve sağlıklı bireyler üzerine etkisi farklı olabilmektedir. Özellikle sağlıklı bireylerde yapılan çalışmalarda örneklem sayısının az olması ve uygulama sürelerinin kısa olması nedeniyle sınırlılıkları mevcuttur. Glutenin mikrobiyota üzerine etkisinin değerlendirilmesinde net bir mekanizma ve verilere ulaşılması için daha fazla çalışmaya ihtiyaç vardır.

Keywords

Bağırsak mikrobiyotası, glutensiz diyet, çölyak hastalığı, probiyotik

The Impact of Gluten-Free Diet on Microbiota

Abstract

A gluten-free diet is defined as a dietary model that does not include wheat, barley, rye and their products. It is a therapeutic approach that should be applied for life in individuals with a diagnosis of celiac or gluten intolerance. However, recently, healthy individuals can be applied frequently to reduce complaints such as flatulence, bloating and body weight loss. Although the positive or negative effects of this practice are not clear, the effects on the microbiota are being examined. Gut microbiota is defined as an organ that affects human health by producing harmful or beneficial metabolites and protects against pathogens, contributes to the immune system and regulates gastrointestinal development. It has been reported that the gluten-free diet partly or exactly corrects the dysbiosis in the microbiota in individuals who need to follow a gluten-free diet, such as celiac patients. It is also stated that probiotic supplementation in addition to the gluten-free diet in celiac disease helps to restore intestinal homeostasis. On the contrary, it has been reported that gluten-free diet practice causes microbiota dysbiosis in healthy individuals. It is emphasized that this effect is related to the low ingredient of complex carbohydrates and vegetable protein and high fat in gluten-free diet. As a result, gluten-free diet is effective on the intestinal microbiota, and effect on those with celiac disease and healthy individuals may be different. Especially in studies with healthy individuals, there are limitations due to the small sample size and short practice times. More studies are needed to reach a clear mechanism and data in the evaluation of the effect of gluten on the microbiota.

Keywords

Gut microbiota, gluten-free diet, celiac disease, probiotic

References

• Oxentenko AS, Rubio-Tapia A. Celiac Disease. Mayo Clin Proc. 2019; 94(12): 2556-71.
• Melini V, Melini F. Gluten-Free Diet: Gaps and Needs for a Healthier Diet. Nutrients. 2019; 11(1): 170.
• Taetzsch A, Das S, Brown C, Krauss A, Silver R, Roberts S. Are gluten-free diets more nutritious? An evaluation of self-selected and recommended gluten-free and gluten-containing dietary patterns. Nutrients. 2018; 10(12): 1881.
• Ulusoy HG, Rakıcıoğlu N. Glutensiz diyetin sağlık üzerine etkileri. Beslenme ve Diyet Derg. 2019; 47(2): 87-92.
• Zopf Y, Reljic D, Dieterich W. Dietary effects on microbiota-New trends with gluten-free or paleo diet. Med Sci. 2018; 6(4): 92-105.
• De Palma G, Nadal I, Collado MC, Sanz Y. Effects of a gluten-free diet on gut microbiota and immune function in healthy adult human subjects. Br J Nutr. 2009; 102(8): 1154-60.
• Hansen LBS, Roager HM, Søndertoft NB, Gøbel RJ, Kristensen M, Vallès-Colomer M, et al. A low-gluten diet induces changes in the intestinal microbiome of healthy Danish adults. Nat Commun. 2018; 9(1): 4630.
• Bonder MJ, Tigchelaar EF, Cai X, Trynka G, Cenit MC, Hrdlickova B, et al. The influence of a short-term gluten-free diet on the human gut microbiome. Genome Med. 2016; 8(1): 45.
• De Angelis M, Garruti G, Minervini F, Bonfrate L, Portincasa P, Gobbetti M. The food-gut human axis: The effects of diet on gut microbiota and metabolome. Curr Med Chem. 2019; 26(19): 3567-83.
• Drago L, Panelli S, Bandi C, Zuccotti G, Perini M, D’Auria E. What Pediatricians Should Know Before Studying Gut Microbiota. J Clin Med. 2019; 8(8): 1206.
• Moszak M, Szulińska M, Bogdański P. You are what you eat-The relationship between diet, microbiota, and metabolic disorders. Nutrients. 2020; 12(4): 1096-206.
• Ramos S, Martín MÁ. Impact of diet on gut microbiota. Curr Opin Food Sci. 2021; 37: 83-90.
• Sonnenburg JL, Bäckhed F. Diet–microbiota interactions as moderators of human metabolism. Nature. 2016; 535: 56-64.
• Sender R, Fuchs S, Milo R. Revised estimates for the number of human and bacteria cells in the body. Public Libr Sci Biol. 2016; 14(8): 1-14.
• Rinninella E, Cintoni M, Raoul P, Lopetuso LR, Scaldaferri F, Pulcini G, et al. Food components and dietary habits: Keys for a healthy gut microbiota composition. Nutrients. 2019; 11(10): 2393.
• Reddel S, Putignani L, Del Chierico F. The impact of low-FODMAPs, gluten-free, and ketogenic diets on gut microbiota modulation in pathological conditions. Nutrients. 2019; 11(2): 373-89.
• Song Q, Wang Y, Huang L, Shen M, Yu Y, Yu Q, et al. Review of the relationships among polysaccharides, gut microbiota, and human health. Food Res Int. 2021; 140: 1-10.
• Parada Venegas D, De la Fuente MK, Landskron G, González MJ, Quera R, Dijkstra G, et al. Corrigendum: Short chain fatty acids (SCFAs)-Mediated gut epithelial and immune regulation and its relevance for inflammatory bowel diseases. Front Immunol. 2019; 10: 1486.
• Zhang LS, Davies SS. Microbial metabolism of dietary components to bioactive metabolites: opportunities for new therapeutic interventions. Genome Med. 2016; 8(46): 1-18.
• Seo YS, Lee H-B, Kim Y, Park H-Y. Dietary carbohydrate constituents related to gut dysbiosis and health. Microorganisms. 2020; 8(3): 427.
• Yang Q, Liang Q, Balakrishnan B, Belobrajdic DP, Feng Q-J, Zhang W. Role of dietary nutrients in the modulation of gut microbiota: a narrative review. Nutrients. 2020; 12(2): 381.
• Singh RK, Chang H-W, Yan D, Lee KM, Ucmak D, Wong K, et al. Influence of diet on the gut microbiome and implications for human health. J Transl Med. 2017; 15(1): 73.
• Charoenngam N, Shirvani A, Kalajian TA, Song A, Holick MF. The effect of various doses of oral vitamin D3 supplementation on gut microbiota in healthy adults: a randomized, doubleblinded, dose-response study. Anticanser Res. 2020; 40(1): 551-6.
• Simonyté Sjödin K, Domellöf M, Lagerqvist C, Hernell O, Lönnerdal B, Szymlek-Gay EA, et al. Administration of ferrous sulfate drops has significant effects on the gut microbiota of iron-sufficient infants: a randomised controlled study. Gut. 2019; 68(11): 2095-7.
• Caminero A, Nistal E, Herran AR, Perez-Andres J, Vaquero L, Vivas S, et al. Gluten metabolism in humans. In: Watson RR, Preedy VR, Zibadi S, editors. Wheat and rice in disease prevention and health. Cambridge: Academic Press; 2014. p. 157-70.
• Seri̇n Y, Akbulut G. Çölyak hastalığı ve glutensiz diyet tedavisine güncel yaklaşım. Turk Klin J Health Sci. 2017; 2(3): 192-200.
• Dennis M, Lee AR, McCarthy T. Nutritional considerations of the gluten-free diet. Gastroenterol Clin North Am. 2019; 48(1): 53-72.
• Subhan FB, Chan CB. Review of dietary practices of the 21st century: Facts and fallacies. Can J Diabetes. 2016; 40(4): 348-54.
• Polo A, Arora K, Ameur H, Di Cagno R, De Angelis M, Gobbetti M. Gluten-free diet and gut microbiome. J Cereal Sci. 2020; 95: 1-10.
• Collado MC, Donat E, Ribes-Koninckx C, Calabuig M, Sanz Y. Imbalances in faecal and duodenal Bifidobacterium species composition in active and non-active coeliac disease. BMC Microbiol. 2008; 8(1): 232.
• Di Cagno R, Rizzello CG, Gagliardi F, Ricciuti P, Ndagijimana M, Francavilla R, et al. Different fecal microbiotas and volatile organic compounds in treated and untreated children with celiac disease. Appl Environ Microbiol. 2009; 75(12): 3963-71.
• Sanz Y, Sánchez E, Marzotto M, Calabuig M, Torriani S, Dellaglio F. Differences in faecal bacterial communities in coeliac and healthy children as detected by PCR and denaturing gradient gel electrophoresis: Bacterial communities in coeliac and healthy children. FEMS Immunol Med Microbiol. 2007; 51(3): 562-8.
• Primec M, Klemenak M, Aloisio I, Gorenjak M, Gioia DD, Micetic-Turk D, et al. Faecal Concentrations of Short-chain Fatty Acids and Selected Bacteria in Healthy and Celiac Children. Int J Celiac Dis. 2016; 4(3): 95-101.
• Sanchez E, De Palma G, Capilla A, Nova E, Pozo T, Castillejo G, et al. Influence of environmental and genetic factors linked to celiac disease risk on infant gut colonization by bacteroides species. Appl Environ Microbiol. 2011; 77(15): 5316-23.
• Wacklin P, Kaukinen K, Tuovinen E, Collin P, Lindfors K, Partanen J, et al. The duodenal microbiota composition of adult celiac disease patients is associated with the clinical manifestation of the disease. Inflamm Bowel Dis. 2013; 19(5): 934-41.
• Nylund L, Kaukinen K, Lindfors K. The microbiota as a component of the celiac disease and non-celiac gluten sensitivity. Clin Nutr Exp. 2016; 6: 17-24.
• Nistal E, Caminero A, Vivas S, Ruiz de Morales JM, Sáenz de Miera LE, Rodríguez-Aparicio LB, et al. Differences in faecal bacteria populations and faecal bacteria metabolism in healthy adults and celiac disease patients. Biochimie. 2012; 94(8): 1724-9.
• Di Cagno R, De Angelis M, De Pasquale I, Ndagijimana M, Vernocchi P, Ricciuti P, et al. Duodenal and faecal microbiota of celiac children: molecular, phenotype and metabolome characterization. BMC Microbiol. 2011; 11(1): 219.
• National Institutes of Health (NIH), Probiotics: What You Need To Know [Internet]. United States; 2019 August. [Cited: 2021 Nov 26]. Available from: https://www.nccih.nih.gov/health/probiotics-what-you-need-to-know .
• Olivares M, Castillejo G, Varea V, Sanz Y. Double-blind, randomised, placebo-controlled intervention trial to evaluate the effects of Bifidobacterium longum CECT 7347 in children with newly diagnosed coeliac disease. Br J Nutr. 2014; 112(1): 30-40.
• Primec M, Klemenak M, Di Gioia D, Aloisio I, Bozzi Cionci N, Quagliariello A, et al. Clinical intervention using Bifidobacterium strains in celiac disease children reveals novel microbial modulators of TNF-α and short-chain fatty acids. Clin Nutr. 2019; 38(3): 1373-81.
• Smecuol E, Hwang HJ, Sugai E, Corso L, Cherñavsky AC, Bellavite FP, et al. Exploratory, Randomized, Double-blind, Placebo-controlled Study on the Effects of Bifidobacterium infantis Natren Life Start Strain Super Strain in Active Celiac Disease. J Clin Gastroenterol. 2013; 47(2): 139-47.
• Caminero A, Nistal E, Arias L, Vivas S, Comino I, Real A, et al. A gluten metabolism study in healthy individuals shows the presence of faecal glutenasic activity. Eur J Nutr. 2012; 51(3): 293-9.
• Bernardo D, Garrote JA, Nadal I, Leon AJ, Calvo C, Fernandez-Salazar L, et al. Is it true that coeliacs do not digest gliadin. Degradation pattern of gliadin in coeliac disease small intestinal mucosa. Gut. 2009; 58(6): 886-7.
• Shang Q, Jiang H, Cai C, Hao J, Li G, Yu, G. Gut microbiota fermentation of marine polysaccharides and its effects on intestinal ecology: An overview. Carbohydr Polym. 2018; 179: 173-85.