A new study showed no evidence of specific or dose-dependent effects of gluten in patients with non-celiac gluten sensitivity (NCGS) placed on a placebo controlled, specialized diet, according tot he August issue of Gastroenterology. (Gastroenterology, Volume 145, Issue 2, Pages 320-328.e3, August 2013).
Jessica R. Biesiekierski, Ph.D., Monash University in Box Hill, Australia, and colleagues randomly assigned 37 subjects (aged 24 to 61 years; six men) with NCGS and irritable bowel syndrome (based on Rome III criteria), but no celiac disease, to a two-week, low fermentable, oligo-, di-, monosaccharides, and polyols (FODMAP) diet. This was followed by placement on either a 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) diet for one week, followed by a washout period of at least two weeks. Serum and fecal markers of intestinal inflammation/injury and immune activation were assessed, as were indices of fatigue. Subsequently, 22 participants crossed over to groups given gluten (16 g/d), whey (16 g/d), or control (no additional protein) diets for three days.
The researchers found that gastrointestinal symptoms consistently and significantly improved during reduced FODMAP intake, but significantly worsened to a similar degree when their diets included gluten or whey protein. Only 8 percent of participants had gluten-specific effects. No changes in any biomarkers were diet-specific. Participants' symptoms increased by similar levels among groups during the three-day rechallenge, but gluten-specific gastrointestinal effects were not reproduced. The researchers observed an order effect.
"In a placebo-controlled, cross-over rechallenge study, we found no evidence of specific or dose-dependent effects of gluten in patients with NCGS placed [on] diets low in FODMAPs," the authors write.
Patients who do test positive for celiac disease or are sensitive to gluten will have an easier time evaluating foods for their gluten free status according to new definitions for food labeling issued by FDA earlier this month.
Jessica R. Biesiekierski, Ph.D., Monash University in Box Hill, Australia, and colleagues randomly assigned 37 subjects (aged 24 to 61 years; six men) with NCGS and irritable bowel syndrome (based on Rome III criteria), but no celiac disease, to a two-week, low fermentable, oligo-, di-, monosaccharides, and polyols (FODMAP) diet. This was followed by placement on either a 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) diet for one week, followed by a washout period of at least two weeks. Serum and fecal markers of intestinal inflammation/injury and immune activation were assessed, as were indices of fatigue. Subsequently, 22 participants crossed over to groups given gluten (16 g/d), whey (16 g/d), or control (no additional protein) diets for three days.
The researchers found that gastrointestinal symptoms consistently and significantly improved during reduced FODMAP intake, but significantly worsened to a similar degree when their diets included gluten or whey protein. Only 8 percent of participants had gluten-specific effects. No changes in any biomarkers were diet-specific. Participants' symptoms increased by similar levels among groups during the three-day rechallenge, but gluten-specific gastrointestinal effects were not reproduced. The researchers observed an order effect.
"In a placebo-controlled, cross-over rechallenge study, we found no evidence of specific or dose-dependent effects of gluten in patients with NCGS placed [on] diets low in FODMAPs," the authors write.
Patients who do test positive for celiac disease or are sensitive to gluten will have an easier time evaluating foods for their gluten free status according to new definitions for food labeling issued by FDA earlier this month.
