Maybe you've recently seen the phrase "gluten-free" on food packaging, or take-out menus, shampoo bottles, apartment listings,
你最近也许留意到“不含麸质”标志开始出现在食物包装上、或出现在外带菜单、洗发精瓶子、公寓清单、
the tag of your shirt, on a hammer, as a lower back tattoo, or in your friend's resume.
你的衬衫标签、甚至铁锤上，或成为某人腰背纹身字眼，或在朋友简历上。
Next time someone starts telling you about their newfound freedom from gluten, here are some questions you can ask,
下次如果有人跟你讲他们新发现自己不能接触麸质，你可以询问他们以下几个问题，
and the well-informed answers that your friend, being a reasonable individual making educated dietary choices,
如果你的朋友是理性个体，会明智选择饮食，而非盲目追随最新饮食潮流的话，
and by no means just following the latest diet craze, will tell you. What is gluten?
则他们会告诉你如下有见识的答案。什么是麸质？
Gluten is an insoluble protein composite made up of two proteins named gliadin and glutenin.
麸质是一种不可溶解的蛋白质混合物，由两种蛋白质组成：醇溶谷蛋白及谷蛋白。
Where might you encounter gluten?
你在哪里可能会遇到麸质？
Gluten is found in certain grains, particularly wheat, rye and barley.
在一些谷物内可以找到麸质，特别是小麦、黑麦和大麦。
What has gluten been doing for the previous entirety of human history, and why do you suddenly care about it?
在过去整个人类史上，麸质有过什么贡献？为什么你会突然在意麸质？
Gluten is responsible for the elastic consistency of dough and the chewiness of foods made from wheat flour, like bread and pasta.
麸质让面团保持弹性，也让面粉做的食物有嚼劲，譬如面包和意面。
For some people, these foods cause problems, namely wheat allergy, celiac disease, and non-celiac gluten sensitivity.
这些食物给以下一些人带来麻烦：例如患有小麦过敏、乳糜泻、非乳糜泻麸质敏感的人。
Wheat allergy is an uncommon condition that occurs when a person's immune system mounts an allergic response to wheat proteins, leading to mild problems,
小麦过敏并不普遍，其成因为人体免疫系统对小麦蛋白作出过敏反应，导致一些轻度症状。
and in rare cases, a potential dangerous reaction called anaphylaxis.
可是，少数情况下，会出现一种潜在危险的过敏性反应。
Celiac disease is an inherited disease, in which eating foods with gluten leads to inflammation and damage of the lining of the small intestine.
乳糜泻是遗传性疾病，患者在进食麸质食物时，会出现发炎，并损害小肠绒毛。
This impairs intestinal function, leading to problems like belly pain, bloating, gas, diarrhea, weight loss, skin rash,
这会伤害肠道功能，带来一系列症状，例如腹痛、腹胀、腹气、腹泻、体重减轻、皮疹、
bone problems like osteoporosis, iron deficiency, small stature, infertility, fatigue and depression.
骨骼问题譬如骨质疏松症、缺铁、身材矮小、不孕、疲劳和抑郁等。

Untreated, celiac disease increases the risk of developing certain types of cancer.
如不治疗，乳糜泻会增加罹患某些癌症的风险。
Celiac disease is present in one in every 100 to 200 persons in the U.S.
目前在美国，每100至200人中就有一人患乳糜泻。
When blood tests suggest the possibility of celiac, the diagnosis is confirmed with a biopsy.
当血液测试显示可能患乳糜泻时，可通过切片检查来确定诊断。
The most effective treatment is a gluten-free diet, which helps heal intestinal damage and improve symptoms.
最有效的治疗方法是无麸质饮食，这会帮助治愈肠道损伤，改善症状。
Some people don't have celiac disease or a wheat allergy, but still experience symptoms when they eat foods with gluten.
有些人没有乳糜泻或小麦过敏，但他们吃麸质食物时，仍然会出现一些症状。
These people have non-celiac gluten sensitivity.
这类人有非乳糜泻麸质敏感。
They experience painful gut symptoms and suffer from fatigue, brain fog, joint pain or skin rash.
他们会有一些痛苦的肠道症状，出现疲劳、脑雾、关节痛或皮疹。
A gluten-free diet typically helps with these symptoms.
无麸质饮食一般会帮助缓解这些症状。
So how many people actually have this gluten sensitivity you speak of?
那到底有多少人有这种麸质敏感症？
Gluten sensitivity's occurrence in the general population is unclear, but likely much more common than wheat allergy or celiac disease.
麸质敏感症在一般人口中的盛行率并不清楚，但可能比小麦过敏或乳糜泻要广泛得多。
Diagnosis is based on the development of symptoms, the absence of wheat allergy and celiac disease, and subsequent improvement on a gluten-free diet.
麸质敏感的诊断要依据症状如何发展，没有小麦过敏和乳糜泻，以及采用无麸质饮食后的改善状况而定。
There's no reliable blood or tissue test, partly because gluten sensitivity isn't a single disease, and has a number of different possible causes.
现今没有可靠的血液测试或组织测试来确诊，部分原因是麸质敏感不是单一疾病，而可能由一系列不同原因引起。
For example, it may be the case that gluten can activate the immune system in the small intestine, or cause it to become leaky.
譬如，起因可能是麸质可以启动小肠内的免疫系统，或者让小肠变得泻漏。
But sometimes, people claiming gluten sensitivity are actually sensitive not to wheat proteins,
但偶而一些人说自己麸质过敏，其实并非对小麦蛋白过敏，
but sugars found in wheat and other foods, called fructans.
而是对小麦和其他食物内的糖分过敏，这种糖叫果聚醣。
The human intestine can't break down or absorb fructans, so they make their way to the large intestine or colon,
人体肠道无法消化或吸收果聚醣，因此果聚醣会到大肠或结肠，
where they're fermented by bacteria, producing short-chain fatty acids and gases.
然后与那里的细菌发酵，产生短链脂肪酸和气体。
This leads to unpleasant symptoms in some people with bowel problems.
这给一些人带来不快的肠道症状问题。
Another possible explanation behind gluten sensitivity is the nocebo effect.
另一种说法是以为有害的反安慰剂效应引起敏感。
This occurs when a person believes something will cause problems, and because of that belief, it does.
即一个人相信自己对某些东西敏感时，会出现敏感症状，正是这种想法让敏感症状出现。
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、更偶发，以为有利的安慰剂反应刚好相反。
Given how much bad press gluten is getting in the media, the nocebo response may play a role for some people who think they're sensitive to gluten.
由于麸质的媒体形象日益低下，这种情况下，反安慰剂反应也许影响到那些觉得自己对麸质敏感的人。
For all these reasons, it's clear that the problems people develop when they eat wheat and other grains aren't exclusively due to gluten.
上述种种原因，清楚显示人们食用小麦等谷物时遇到的种种问题，不能完全归咎于麸质。
So a better name than non-celiac gluten sensitivity might be wheat intolerance.
给非乳糜泻麸质敏感更恰当的名字，可能是小麦不耐症。