Going Against the Grains: Gluten-Free Diets in Patients Without Celiac Disease-Worthwhile or Not?
Study Goal
The researchers aimed to evaluate the evidence for the use of a gluten-free diet (GFD) in non-celiac conditions, including non-celiac gluten sensitivity, athletic performance, autism, rheumatoid arthritis, and psychiatric disorders.
Results Summary
The study found that evidence supporting the use of GFDs for conditions other than celiac disease is poor, with many patients having alternative diagnoses after investigation. The abstract also highlights potential physical and psychological harms of unnecessary gluten avoidance.
Population
Individuals without celiac disease who self-report intestinal or extraintestinal symptoms, as well as those seeking athletic enhancement or treatment for autism, rheumatoid arthritis, or psychiatric disorders.
Effective Dosage
Not Assessed
Duration
Not Assessed
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
gluten-free diet | decrease | celiac disease | patients with celiac disease | - | is the only known effective therapy | #1 |
gluten-free diet | increase | health conditions, many extraintestinal, other than celiac disease | people without celiac disease | - | has beneficial effects | #2 |
gluten-free diet | no change | conditions other than celiac disease | patients without celiac disease | - | evidence for use is poor | #3 |
gluten-free diet | no change | physical/athletic enhancement | people seeking physical/athletic enhancement | - | should not be encouraged | #4 |
While the gluten-free diet (GFD) is the only known effective therapy for celiac disease, in recent years it has become increasingly popular in the USA and worldwide, with many believing it to be more "healthful" and others claiming that it has beneficial effects for health conditions, many extraintestinal, other than celiac disease. This review examines the evidence for use of the GFD in patients without celiac disease who self-report intestinal and/or extraintestinal symptoms (non-celiac gluten sensitivity), as well as for enhancement of athletic performance and treatment of autism, rheumatoid arthritis, and psychiatric disorders. Overall, the evidence for use of GFDs in conditions other than celiac disease is poor. Though non-celiac gluten sensitivity may ultimately emerge as a biomarker-defined condition, a large proportion of patients with apparent non-celiac gluten sensitivity have, after careful investigation, an alternative diagnosis. In light of this, and coupled with the potential physical and psychological harms associated with the avoidance of gluten, initiating a GFD should not be encouraged for people who have these other conditions or are seeking physical/athletic enhancement.