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Do People with Non-celiac Gluten Sensitivity Improve on Gluten-free Diets?

Celiac.com 07/25/2014 - People with non-celiac gluten sensitivity (NCGS) do not have celiac disease, but their symptoms improve when they are placed on gluten-free diets.

Photo: Wikimedia CommonsA research team set out to study the specific effects of gluten after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates (fermentable, oligo-, di-, monosaccharides, and polyols [FODMAPs]) in subjects believed to have NCGS. The study team included J.R. Biesiekierski of the Department of Gastroenterology, Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia, and colleagues S.L. Peters, E.D. Newnham, O. Rosella, J.G. Muir, and P.R. Gibson.

They conducted a double-blind cross-over trial on 31 women and 6 men, aged 24-61, with NCGS and irritable bowel syndrome (based on Rome III criteria), but not celiac disease. Researchers randomly assigned participants to groups given a 2-week diet of reduced FODMAPs. Participants were then placed on high-gluten (16 g gluten/d), low-gluten (2 g gluten/d and 14 g whey protein/d), or control (16 g whey protein/d) diets for 1 week, followed by a washout period of at least 2 weeks.

The team measured serum and fecal markers of intestinal inflammation/injury and immune activation, and indices of fatigue. Twenty-two participants were then given either gluten (16 g/d), whey (16 g/d), or control (no additional protein) diets for 3 days. The team evaluated symptoms using visual analogue scales.

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Every patient experienced significant improvement in gastrointestinal symptoms during reduced FODMAP intake. Conversely, every patient experienced significantly worse symptoms when their diets included gluten or whey protein. The team observed gluten-specific effects in just 8% of participants. They saw no diet-specific changes in any biomarker.

During the 3-day re-challenge, participants' symptoms increased by similar levels among groups. Gluten-specific gastrointestinal effects were not reproduced.

The end result for this placebo-controlled, cross-over re-challenge study showed no evidence of specific or dose-dependent effects of gluten in patients with NCGS placed on diets low in FODMAPs. The translation is that the team saw no effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates.

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1 Response:

 
Julie Rohrdanz
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said this on
10 Aug 2014 5:14:40 AM PDT
It is important to understand why people who suffer from non-celiac gluten sensitivity. I do feel that this article though, conveys that non-celiac gluten sensitivity is not real. I'd like the scientific community to really pursue what specifically about a gluten free diet eliminates the symptoms. The critics can say NCGS doesnt exist. In the end, for me, it doesn't matter if it is another protein or a carb in wheat, rye, barley. I know that removing gluten from my diet changed my life, I was very sick. Exposure to gluten foods brings the myriad of symptoms back. Rather than debunking gluten, maybe more research could be done to show why the gluten free diet works (other than gluten).




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