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Non-Celiac Gluten Sensitivity? Not So Fast?

Celiac.com 08/11/2014 - A study establishing the existence of non-celiac gluten sensitivity has been turned on its head; by the very scientist who conducted it. In 2011, a small but scientifically rigorous study found that dietary gluten can trigger gastrointestinal distress in people without celiac disease. That study was conducted by Peter Gibson at Monash University in Australia.

Photo: Wikimedia Commons--Jason GulledgeLast year, Gibson published a follow-up study, which indicated that the real culprit might not be gluten, but fermentable, poorly absorbed short-chain carbohydrates known as FODMAPs. Specifically, Gibson’s second study found no effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. That is, once these alleged gluten-sensitive patients reduced their FODMAP intake, their symptoms disappeared, Whether or not they were consuming gluten.

That study looked at 37 self-identified gluten-sensitive patients. Gibson’s team provided all meals for each subject for the duration of the trial. For each meal, the study team eliminated all potential dietary triggers for gastrointestinal symptoms, including lactose (from milk products), preservatives like benzoates, propionate, sulfites, and nitrites, and those fermentable, poorly absorbed short-chain carbohydrates called FODMAPs. They also collected urine and fecal samples from all subjects for the full study period. The team then randomly and secretly cycled test subjects through various high-gluten, low-gluten, and no-gluten (placebo) diets. No test subject had any idea which diet plan they were on at any given time.

In the end, the results showed that test subjects self-identifying as ‘gluten-sensitive’ complained about every single diet — even the non-gluten placebo diet. They complained about pain, bloating, nausea, and gas to a similar degree, whether or not the food contained gluten. Gibson’s latest findings offer the more evidence against non-celiac gluten sensitivity as an actual medical condition. Among them, a full 65% of those who actually met criteria for NCGS showed intolerances to other foods, while 75% of those folks show poor symptoms control despite gluten avoidance.

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So, for now at least, attention remains on FODMAPs as a potential cause for the complaints previously associated with adverse gluten reactions in non-celiac individuals.

So, to sum it up. The latest science argues against the existence of gluten sensitivity in non-celiac individuals, and indicates that the actual culprit behind gastric complaints in these cases might be fermentable, poorly absorbed short-chain carbohydrates called FODMAPs.

Moreover, these results also stress the importance screening for celiac, and testing for other food sensitivities for those people claiming non-celiac gluten-sensitivity.

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9 Responses:

 
sk kelly
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said this on
11 Aug 2014 8:21:24 PM PDT
For this article to have been helpful beyond just reporting the study, an explanation of what foods or additives have FODMAPS should have been included.

 
Jefferson
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said this on
16 Aug 2014 10:45:26 AM PDT
Simply not practical for this article, but a great idea for a future article. Thanks!

 
Dzanda
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said this on
17 Aug 2014 11:16:01 AM PDT
FODMAPs = fermentable, oligo-, di-, monosaccharides, and polyols. (It was in the source citation.)

 
Loren
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said this on
18 Aug 2014 1:48:58 PM PDT
2nd that - this article and the one mentioned above Gastroenterology. 2013 Aug;145(2):320-8.e1-3. do not identify FODMAPS specifics. The article has interest but lacks full disclosure that could have been helpful

 
Janice
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said this on
18 Aug 2014 5:57:43 PM PDT
I just looked at high FODMAPS and interestingly, they include wheat products. So I guess if you're avoiding wheat on a gluten-free diet, you're probably going to feel better regardless.

 
Phil
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said this on
18 Aug 2014 6:54:06 PM PDT
re: FODMAPS, google is your friend. Plenty of in depth coverage by actual scientific sources. It is a big topic though.

 
Greg
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said this on
18 Aug 2014 10:41:25 PM PDT
I believe Monash University is in Australia, not Canada.

 
Jefferson
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said this on
21 Aug 2014 5:11:26 PM PDT
Right you are, Greg. I'll make sure that's corrected.

 
Lynn_M
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said this on
27 Aug 2014 11:48:45 PM PDT
This study barely qualifies as science. It concerned only 37 subjects, looked only at gastrointestinal symptoms, and was sponsored by a baking company. Gastrointestinal symptoms are only a minor aspect of NCGS. Many other researchers have confirmed NCGS as a type of gluten sensitivity, with body-wide impacts, and a distinct entity from celiac disease.

I was diagnosed with NCGS by a genetic test two years ago. I have had joint pain and achiness for 65 years, ever since I was a child. Eliminating gluten sources, but nothing else, has totally eliminated that joint pain, as well as minor issues of bloating and gas. I wish my probably NCGS-related osteoporosis could resolve as quickly.




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