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DES INTOLERANCES ALIMENTAIRES

Les aliments contiennent des protéines qui nous sont alien, elles représentent pour le système immunitaire du « non soi » et se retrouvent face à notre frontière digestive.

Soit ces protéines alimentaires sont tolérées, soit elles ne le sont pas et sont même attaquées comme des envahisseurs microbiens.

Nous disposons donc de mécanismes de tolérance immunitaire, mais cette tolérance repose sur des mécanismes qui peuvent facilement se dérègler.

De nombreux autres ingrédients des aliments que les protéines peuvent engendrer des réactions, et ceci, de plus en plus, du fait des traitements multiples par lesquels passent les aliments transformés par l’industrie agro-alimentaire.

Nous pouvons aussi être porteurs d’un héritage génétique qui n’est pas adapté à la consommation de produits contenant par exemple du lactose ou de l’histamine, ce qui mène à des intolérances qui ne mettent pas en jeu le système immunitaire.

Les réactions les plus fréquentes que l’on peut subir suite à la consommation d’aliments sont ces intolérances alimentaires que des experts préfèreraient qu’on appelle « hypersensibilités », mais le terme « intolérance » reste bien ancré.

Les allergies alimentaires restent plus rares – heureusement, car elles peuvent être violentes et même mortelles.

Une épidémie d’intolérances alimentaires ?

La British Allergy Foundation affirme que 45% de la population d’Europe et d’Amérique du Nord en serait atteinte.

D’autres études, cherchant à objectiver les intolérances par des tests trouvent des incidences nettement plus basses.

Mais la réalité est que le nombre d’études sur le sujet reste très insuffisant.

Ce qui est clair est, selon les observateurs, que dans toutes les catégories de la population la fréquence des intolérances alimentaire explose.           

La multiplication des transformations, les additifs et les polluants  dans les aliments industriels sont considérés comme la cause principale de cette explosion.

La fréquence (et les conséquences) des intolérances alimentaires dans les pathologies inflammatoires digestives, de la colopathie à la maladie de Crohn, sont nettement plus importantes que dans le reste de la population.

Quant aux allergies alimentaires, Le Programme National Nutrition Santé (PNNS) en France et l’Association Québécoise des Allergies Alimentaires (AGAA) au Canada considèrent qu’elles concernent

entre 3 et 4% des adultes et 6 à 8% des enfants, ce qui reste un sérieux problème de santé publique étant donné leur gravité.

Ces chiffres sont proches de ceux d’une grande étude sur 33 000 Français réalisée par le Cercle d’Investigations Cliniques et Biologiques en Allergologie Alimentaire (CICBAA) qui observe une prévalence entre 2,1 et 3,8 %.

Certaines allergies s’atténuent ou disparaissent avec l’âge.

Mais selon un rapport des Centers of Disease Control and Prevention d’Altlanta, l’agence gouvernementale américaine chargée de la prévention, la prévalence des allergies alimentaires aurait augmenté de 18 % chez les moins de 18 ans, entre 1997 et 2007.

En France on a observé une augmentation de 28% entre 2001 et 2006. Et les formes graves sont particulièrement concernées par cette augmentation.

Selon les publications d’autres observatoires, le groupe de travail sur les allergènes moléculaires de la société française d’allergologie (SFA), la fréquence des allergies alimentaires a doublé en France ces 5 dernières années.

 

Pour en savoir plus sur la fréquence des intolérances et allergies alimentaires :

DA Moneret-Vautrin, Épidémiologie de l’allergie alimentaire - Epidemiology of food allergy, Revue française d’allergologie et d’immunologie clinique, 2008,  48, 171–178

Dubuisson C et al, Allergies alimentaires : état des lieux et propositions d’orientations, AFSSA, 2002

Dutau G et al. Manifestations cutanées dans l’allergie alimentaire. Résultats préliminaires de l’enquête CICBAA (300 observations) avec référence particulière à la dermatite atopique en pédiatrie, Rev Fr Allergol, 1996, 36 : 233-8

Kanny G et al, Population study of food allergy in France, J Allergy Clin Immunol, 2001, 108 : 133-40

Burney PGJ et al, The prevalence and distribution of food sensitization in European adults, Allergy, 2014, 69 (3), 365-371

Sicherer SH, Epidemiology of food allergy, J Allergy Clin Immunol, 2011, 127 : 594-602

Nelson M et al, An exploration of food intolerance in the primary care setting : the general practitioner's experience, Soc Sci Med, 2008,  67 (6)  : 1038–45

Wüthrich B, Food allergy : definition, diagnosis, epidemiology, clinical aspects, Schweiz Med Wochenschr, 1996, 126 (18) : 770–6

www.allergique.org/article119.html

Qu’est-ce qu’une intolérance alimentaire ?

Une intolérance alimentaire est une réaction à des aliments soit parce qu’ils sont

mal métabolisés, c’est le cas du lactose par manque de lactase
capables d’actions pharmacologiques, comme l’histamine, médiateur de l’allergie classique ou la tyramine
sources d’inflammation du tube digestif, d’altération de la barrière digestive (qui est souvent déjà perturbée par d’autres facteurs comme les déséquilibres de la flore intestinale), comme les additifs ou les polluants.

Les symptômes qui apparaissent entre 1H et 48H après l’ingestion (contrairement à l’allergie qui déclenche une réaction immédiate) concernent en général la peau, les voies respiratoires, le système digestif, ou une combinaison quelconque des trois.

On observe selon chaque personne des manifestations très variées - ce qui rend aussi le diagnostic difficile :

manifestations digestives : aphtes, douleurs abdominales et/ou flatulences,

dyspepsie, nausées, diarrhées, colopathie

manifestations respiratoires : rhinite, augmentation du mucus, asthme 

manifestations cutanées : éruptions, urticaire, angioedème (lèvres, face, mains, pieds gonflés), eczéma

autres manifestations : migraine, conjonctivite, troubles « psychonévrotiques »

L’urticaire et l’angioedème sont des manifestations plus spécifiques des hypersensibilités aux aliments.

L'intolérance alimentaire peut être associée au syndrome du côlon irritable et aux maladies inflammatoires chroniques intestinales

Quels sont les déclencheurs les plus fréquents d’intolérances alimentaires ?

Ce sont :

le lactose
le gluten
l’alcool
des molécules présentes naturellement dans les aliments comme l’histamine, la tyramine, les salicylates (de la même famille que l’aspirine)
des additifs : glutamates, benzoates…
des colorants comme la tartrazine (jaune), le carmin de cochenille…

Ce thème est développé dans le prochain numéro des Dossiers Santé et Nutrition 

www.santenatureinnovation.com/publications/les-dossiers-de-sante-et-nutr...

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Commentaires

 

Merci pour cet article! Tous les aliments ne sont pas forcément bons c'est une évidence! :-)

 

whn

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