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Is Gluten the Only Culprit for Non-Celiac Gluten/Wheat Sensitivity?

Nutrients
January 1, 1970
Maria Gloria Mumolo et al. (9 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the appropriateness of a gluten-free diet (GFD) for non-celiac gluten/wheat sensitivity (NCG/WS) and explore other dietary approaches like low-FODMAP diets (LFD).

Results Summary

The study suggests GFD may be suitable for self-reported gluten/wheat-dependent symptoms, but other compounds like FODMAPs, ATIs, WGA, and glyphosate may also contribute to symptoms. A low-FODMAP diet is recommended as a first-line option for FODMAP-related symptoms and second-line for non-responsive GFD cases.

Population

Individuals with non-celiac gluten/wheat sensitivity (NCG/WS) and self-reported gluten/wheat-dependent symptoms.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (3)
InterventionDirectionEndpointPopulationDosageImpactClaim #
gluten-free diet (GFD)
no change
non-celiac gluten/wheat sensitivity (NCG/WS)
patients with self-reported gluten/wheat-dependent symptoms
-
has been suggested for
#1
low-FODMAP diet (LFD)
no change
symptoms more related to FODMAPs than gluten/wheat
patients referring symptoms more related to FODMAPs than gluten/wheat
-
should be the first dietary option for
#2
low-FODMAP diet (LFD)
no change
self-reported gluten/wheat-related symptoms not responding to the GFD
those with self-reported gluten/wheat-related symptoms not responding to the GFD
-
should be the second-line treatment for
#3
Abstract

The gluten-free diet (GFD) has gained increasing popularity in recent years, supported by marketing campaigns, media messages and social networks. Nevertheless, real knowledge of gluten and GF-related implications for health is still poor among the general population. The GFD has also been suggested for non-celiac gluten/wheat sensitivity (NCG/WS), a clinical entity characterized by intestinal and extraintestinal symptoms induced by gluten ingestion in the absence of celiac disease (CD) or wheat allergy (WA). NCG/WS should be regarded as an "umbrella term" including a variety of different conditions where gluten is likely not the only factor responsible for triggering symptoms. Other compounds aside from gluten may be involved in the pathogenesis of NCG/WS. These include fructans, which are part of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs), amylase trypsin inhibitors (ATIs), wheat germ agglutinin (WGA) and glyphosate. The GFD might be an appropriate dietary approach for patients with self-reported gluten/wheat-dependent symptoms. A low-FODMAP diet (LFD) should be the first dietary option for patients referring symptoms more related to FODMAPs than gluten/wheat and the second-line treatment for those with self-reported gluten/wheat-related symptoms not responding to the GFD. A personalized approach, regular follow-up and the help of a skilled dietician are mandatory.

Medical Subject Headings (MeSH)
AmylasesCeliac DiseaseDietDiet, Carbohydrate-RestrictedDiet, Gluten-FreeDisaccharidesFermentationFructansGlutensGlycineHumansMalabsorption SyndromesOligosaccharidesPolymersTrypsin InhibitorsWheat Germ AgglutininsGlyphosate
Study Links
Quality Scores
SafetyNot Assessed
Efficacy70/10
Quality60/10
Citation Metrics
Total Citations23
Citations/Year4.6
Relative Citation Ratio1.94
NIH Percentile73.7%
Research Impact Scores
APT Score0.95
Weight Score0.74
Normalized Score0.60
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