Challenged by my nurse-practioner sister to justify the reasons why those without celiac disease should avoid gluten, I came up empty on my first few tries through google. Does anybody have a study (not a link to somebody's blog, but an actual study) that quantifies the health risks of eating gluten for those who are otherwise not at risk (i.e. Celiac)? Thanks
asked byJason_8 (350)
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on January 21, 2011
at 09:16 PM
Evolvify did a nice writeup on it. http://evolvify.com/the-case-against-gluten-medical-journal-references/
Gluten Causes Gastrointestinal Symptoms in Subjects Without Celiac Disease ??? The American Journal of Gastroenterology http://www.ncbi.nlm.nih.gov/pubmed/21224837
Sensory ganglionopathy due to gluten sensitivity ??? Neurology, 2010 http://www.ncbi.nlm.nih.gov/pubmed/20837968
Gluten sensitivity and the CNS: diagnosis and treatment ??? Lancet Neurology, 2010 http://www.ncbi.nlm.nih.gov/pubmed/20610340
GAD antibody-associated neurological illness and its relationship to gluten sensitivity. ??? Acta Neurologica Scandinavica, 2010 http://www.ncbi.nlm.nih.gov/pubmed/20456245
Genetic and immunological processes in the pathomechanism of gluten-sensitive enteropathy and associated metabolic bone disorders ??? Orvosi Hetelap, 2010 http://www.ncbi.nlm.nih.gov/pubmed/20178968
Gluten sensitivity: from gut to brain ??? Lancet Neurology, 2010 http://www.ncbi.nlm.nih.gov/pubmed/20170845
Gluten sensitivity: an emerging issue behind neurological impairment? ??? Lancet Neurology, 2010 http://www.ncbi.nlm.nih.gov/pubmed/20170835
Gluten-free diet and steroid treatment are effective therapy for most patients with collagenous sprue. ??? Clinical Gastroenterology and Hepatology, 2010 http://www.ncbi.nlm.nih.gov/pubmed/20060071
Gluten sensitivity in multiple sclerosis: experimental myth or clinical truth? ??? Annals of the New York Academy of Sciences, 2010 http://www.ncbi.nlm.nih.gov/pubmed/19758171
Novel immune response to gluten in individuals with schizophrenia. ??? Schizophrenia Research, 2010 http://www.ncbi.nlm.nih.gov/pubmed/19748229
Nervous system in the gluten syndrome: a close relationship. ??? Medical Hypotheses, 2010 http://www.ncbi.nlm.nih.gov/pubmed/19744798
Gluten sensitivity presenting as myoclonic epilepsy with cerebellar syndrome. ??? Movement Disorders, 2009 http://www.ncbi.nlm.nih.gov/pubmed/19705357
Gluten encephalopathy with psychiatric onset ??? Clinical Practice and Epidemiology in Mental Health, 2009 http://www.ncbi.nlm.nih.gov/pubmed/19558661
Gluten sensitivity enteropathy in patients with recurrent aphthous stomatitis. ??? BMC Gastroenterology, 2009 http://www.ncbi.nlm.nih.gov/pubmed/19534771
The gluten syndrome: a neurological disease. ??? Medical Hypotheses, 2009 http://www.ncbi.nlm.nih.gov/pubmed/19406584
Gluten sensitivity in patients with IgA nephropathy. ??? Nephrology, Dialysis, Transplantaiton, 2009 http://www.ncbi.nlm.nih.gov/pubmed/19332868
Schizophrenia, gluten, and low-carbohydrate, ketogenic diets: a case report and review of the literature. ??? Nutrition & Metabolism, 2009 http://www.ncbi.nlm.nih.gov/pubmed/19245705
Hippocampal sclerosis in refractory temporal lobe epilepsy is associated with gluten sensitivity. ??? Journal of Neurology, Neurosurgery, and Psychiatry, 2009 http://www.ncbi.nlm.nih.gov/pubmed/19244266
Relapsing acute pancreatitis associated with gluten enteropathy. ??? Revista Espanola de Enfermedades Digestivas (Spanish Review of Digestive Diseases) http://www.ncbi.nlm.nih.gov/pubmed/19222332
Autoantibodies in gluten ataxia recognize a novel neuronal transglutaminase. ??? Annals of Neurology, 2008 http://www.ncbi.nlm.nih.gov/pubmed/18825674
Gluten ataxia. ??? Cerebellum, 2008 http://www.ncbi.nlm.nih.gov/pubmed/18787912
Neuromyelitis optica in patients with gluten sensitivity associated with antibodies to aquaporin-4. ??? Journal of Neurology, Neurosurgery, and Psychiatry, 2008 http://www.ncbi.nlm.nih.gov/pubmed/18708571
Association of DLG5 variants with gluten-sensitive enteropathy. ??? Gut, 2008 http://www.ncbi.nlm.nih.gov/pubmed/18559397
Theres a start for you, by no means comprehensive, but might drive just a little bit home that its not just some keyboard jockeys internet opinion.
on January 21, 2011
at 09:24 PM
Am J Gastroenterol. 2011 Jan 11. [Epub ahead of print] Gluten Causes Gastrointestinal Symptoms in Subjects Without Celiac Disease: A Double-Blind Randomized Placebo-Controlled Trial. Biesiekierski JR, Newnham ED, Irving PM, Barrett JS, Haines M, Doecke JD, Shepherd SJ, Muir JG, Gibson PR.
Monash University Department of Medicine and Gastroenterology, Box Hill Hospital, Box Hill, Victoria, Australia. Abstract OBJECTIVES: Despite increased prescription of a gluten-free diet for gastrointestinal symptoms in individuals who do not have celiac disease, there is minimal evidence that suggests that gluten is a trigger. The aims of this study were to determine whether gluten ingestion can induce symptoms in non-celiac individuals and to examine the mechanism.
METHODS: A double-blind, randomized, placebo-controlled rechallenge trial was undertaken in patients with irritable bowel syndrome in whom celiac disease was excluded and who were symptomatically controlled on a gluten-free diet. Participants received either gluten or placebo in the form of two bread slices plus one muffin per day with a gluten-free diet for up to 6 weeks. Symptoms were evaluated using a visual analog scale and markers of intestinal inflammation, injury, and immune activation were monitored.
RESULTS: A total of 34 patients (aged 29-59 years, 4 men) completed the study as per protocol. Overall, 56% had human leukocyte antigen (HLA)-DQ2 and/or HLA-DQ8. Adherence to diet and supplements was very high. Of 19 patients (68%) in the gluten group, 13 reported that symptoms were not adequately controlled compared with 6 of 15 (40%) on placebo (P=0.0001; generalized estimating equation). On a visual analog scale, patients were significantly worse with gluten within 1 week for overall symptoms (P=0.047), pain (P=0.016), bloating (P=0.031), satisfaction with stool consistency (P=0.024), and tiredness (P=0.001). Anti-gliadin antibodies were not induced. There were no significant changes in fecal lactoferrin, levels of celiac antibodies, highly sensitive C-reactive protein, or intestinal permeability. There were no differences in any end point in individuals with or without DQ2/DQ8.
CONCLUSIONS: "Non-celiac gluten intolerance" may exist, but no clues to the mechanism were elucidated.Am J Gastroenterol advance online publication, 11 January 2011; doi:10.1038/ajg.2010.487.
PMID: 21224837 [PubMed - as supplied by publisher]
on January 24, 2011
at 07:47 AM
Thanks for linking my article on this, Stephen.
PubMed isn't great for doing searches unless you know exactly what you're looking for, and regular Google is cluttered with so much unhelpful pontificating on gluten that it's hard to get good answers.
Google Scholar is really the way to go for this type of research. Coincidentally I just wrote a post about how to find free scientific studies so that might help.
If you just want a shortcut, here's a pre-built search query for gluten studies in non-celiac individuals on Scholar (7,270 results).
on January 23, 2011
at 07:54 AM
Some more to add to the growing list.
on January 21, 2011
at 08:59 PM
Good timing. Stephan just published a blog post on it today.
Mael??n Fontes Villalba at Lund University recently forwarded me an interesting new paper in the American Journal of Gastroenterology. Dr. Jessica R. Biesiekierski and colleagues recruited 34 IBS patients who did not have celiac disease, but who felt they had benefited from going gluten-free in their daily lives*. All patients continued on their pre-study gluten-free diet, however, half were given two slices of wheat bread and one wheat muffin per day, and the other half were given the same foods made from gluten-free ingredients.
During the six weeks of the intervention, patients receiving the gluten-free food fared considerably better on nearly every symptom of IBS measured. The most striking difference was in tiredness-- the gluten-free group was much less tired on average than the gluten group. Interestingly, they found that a negative reaction to wheat was not necessarily accompanied by the presence of anti-gluten antibodies in the blood, which is a test often used to diagnose gluten sensitivity.
A previous study in 1981 showed that feeding volunteers a large dose of gluten every day for 6 weeks caused adverse gastrointestinal effects, including inflammatory changes, in relatives of people with celiac disease, who did not themselves have celiac (3). Together, these are the most solid evidence that gluten can be damaging in people without celiac disease, a topic that has not received much interest in the biomedical research community.
FWIW, I think Stephan's blog is better than any peer-reviewed journal... but anyway, the article linked in the quote above should get you started.