Fave si, ma non per tutti

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Quando arriva questa stagione la mia casa si riempie di fave fresche considerate in famiglia una leccornia da gustare assieme ad un bel pezzetto di formaggio, un gustoso pecorino stagionato, un buon bicchiere di vino e perché no una fettina di buon salame (o sopressata per chi come me ha origini calabresi).

Avendo da sempre vissuto in una terra che è quella pugliese, però, le fave sono un alimento che amo consumare anche nel periodo invernale sotto forma di purè di fave, uno dei piatti poveri della tradizione, che si consuma accompagnandolo a deliziose cicorie selvatiche.

Perché le fave, come tutte le altre leguminose, possono consumarsi sia fresche che essiccate. In quest’ultimo caso previo ammollo e quasi sempre cotte.

Coltivata già in epoca biblica dagli Ebrei la fava, la leguminosa del genere Vicia faba, vede la sua cultura diffondersi presso gli egizi e i romani, ma anche presso i greci i quali utilizzavano tale frutto secco per votare, convinti che le anime dei defunti potessero reincarnarsi in esse.

Considerato, per secoli, il cibo dei poveri e per giunta tossico (sia nella sua versione fresca che secca), il consumo delle fave non è legato esclusivamente ad una questione di gusto, ma al fatto che alcuni soggetti, al di là del piacere o meno, non hanno proprio la possibilità di poterlo consumare.

Questo frutto, infatti, risulta molto dannoso per quei soggetti predisposti o affetti da una malattia molto grave detta favismo o anemia emolitica, una enzimopatia umana (la più comune), causata dal deficit genetico dell’enzima glucosio-6-fosfato-deidrogenasi, che serve a proteggere i globuli rossi dallo stress ossidativo.

Nel 2012 il Comitato Nazionale per la Sicurezza Alimentare aveva rilasciato un parere su alcune problemtiche relative al favismo (riprendendo quanto detto in una nota del 2008 dal CUDN- Commissione unica per la dietetica e la nutrizione) a seguito di una richiesta giunta alla Direzione generale per l’igiene e la sicurezza degli alimenti e la nutrizione con la quale si era chiesto di “verificare se negli ultimi anni (successivi al 2008 e successivi pertanto al parere del CUDN) fossero intervenuti elementi a carattere medico-scientifico tali da dimostrare che anche le inalazioni di pollini di fave e piselli potessero essere considerati fattori scatenanti di crisi emolitiche”.

Già le indicazioni del CUDN avevano messo in evidenza come l’ingestione di piselli e fagiolini, o l’inalazione dei loro pollini, non potessero essere considerate fattore scatenante di crisi emolitiche, quali quelle riconducibili al favismo e nonostante l’inalazione di polline nei campi di fave in fiore, potesse provocare malessere nei soggetti esposti, affetti da deficit di G6PD, non erano state trovate prove scientifiche sufficienti a correlare l’inalazione di polline con lo scatenamento delle crisi emolitiche.

Il parere rilasciato nel 2012 secondo il quale dagli  studi condotti nel 1979, nel 1983 e nel 2009 si evinceva che “Le rare segnalazioni esistenti non sono tuttavia sufficienti per poter ragionevolmente correlare lo scatenamento di una crisi emolitica all’inalazione di pollini di fave” non ha fatto altro che confermare nuovamente la nota precedente.

Favismo o G6PD deficit : facciamo il punto

I soggetti colpiti dal favismo (400 milioni di persone al mondo, circa 400.000 in Italia con maggiore incidenza in Sardegna, nel Delta del Po e nella zona ex-paludosa del Veneto orientale) presentano una malattia genetica ereditaria causata da una carenza dell’enzima glucosio-6-fosfato deidrogenasi normalmente presente nei globuli rossi, da qui il nome di deficit G6PD (anche detto G6PDH), sintetizzato da un gene localizzato sul cromosoma X ed essenziale per la vitalità degli eritrociti e in particolare per i processi ossidativi che in essi si svolgono.  Il deficit, pertanto, si trasmette con un’ereditarietà legata al sesso, con interessamento prevalente dei maschi emizigoti e delle femmine omozigoti.

Di solito nei maschi il deficit enzimatico è decisamente marcato, mentre le femmine possono essere sia portatrici che affette.

Nei soggetti portatori della patologia non si riesce a mantenere un adeguato livello di glutatione ridotto negli eritrociti (globuli rossi) che per tale motivo vanno incontro a crisi emolitiche scatenate da reazioni ossidative a loro volte legate a ingestione di fave,  assunzione di alcuni farmaci quali sulfamidici, salicilici, chinidina, ecc., o a causa di infezioni.

Nel caso specifico delle fave è l’ingestione di alcune sostanze in esse presenti, la vicina e la convicina (beta-glucosidi della pirimidina presenti nei cotiledoni del frutto, ma non nei fiori, con funzioni protettive contro i numerosi patogeni che attaccano la pianta) a poter scatenare, dopo circa 12-48 ore, manifestazioni cliniche di entità variabile con crisi emolitiche (e distruzione degli interi globuli rossi), conseguente ittero per accumulo di bilirubina, respiro frequente, difficoltoso e, nei casi più gravi, insufficienza renale acuta.

Secondo vari studi non tutti i soggetti affetti da deficit di G6PD manifestano episodi emolitici conclamati, infatti,  i bambini sembrano essere più soggetti a crisi faviche, probabilmente per la relativa maggiore esposizione correlata alla minore superficie corporea. Come del resto la gravità della sintomatologia può dipendere da una concomitanza di diversi fattori, quali ad esempio, il livello di attività enzimatica, le caratteristiche metaboliche individuali, lo stato di salute generale, la quantità di fave ingerite o gli eventuali trattamenti ai quali le stesse possono essere sottoposte.

Proprio in virtù di quanto appena detto, si è riscontrato, infatti, che le fave fresche risultino maggiormente dannose rispetto a quelle trattate (ad esempio rispetto alle fave sottoposte a cottura), o che le fave “giovani” siano più rischiose per la presenza in esse di una percentuale maggiore dei glucosidi vicina e convicina rispetto alle fave più mature dove il loro quantitativo tende a ridursi progressivamente.

Conclusioni

Come indicato nelle Linee guida al Deficit di G6PD dell’Associazione Italiana Favismo, in molti ospedali,  per questa malattia è stato ormai introdotto lo screening neonatale. E comunque la diagnosi per individuare l’eventuale carenza enzimatica nei globuli rossi viene fatta attraverso un semplice prelievo del sangue.

Esistono più di 200 varianti di questo deficit in continua evoluzione, la cui reazione può risultare imprevedibile in quanto accentuata dallo stato psicofisico generale del soggetto colpito. È importante avere sempre molta cautela nei confronti di questa patologia, poiché una delle caratteristiche del favismo è quella di rendere il soggetto asintomatico fino a quando, lo stesso, non entra in contatto con agenti ossidanti quali gli alimenti e i farmaci su menzionati.

A casa siamo soliti fare sempre un gioco. Chi ne sbuccia di più (di fave), ne mangia di più. Ma è inutile dirlo, io non vinco mai. Perché quando sbuccio i robusti baccelli dalle estremità appuntite di questo frutto la cosa da cui sono più attirata – e soprattutto distratta – è lo strato spugnoso e biancastro, presente al loro interno, capace di ospitare dai 5 ai 10 semi piatti e arrotondati di colore verde, rossastro, brunastro o violaceo (a seconda della varietà), nel quale affondo le dita… quasi fosse un anti stress. Provare per credere!

© Produzione riservata

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Dr.ssa Sabina Rubini

Biologa ed Esperta in Sicurezza degli Alimenti
Consulente Aziendale

Co-founder ISQAlimenti.it

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