Individuals who self-reported with non-celiac gluten sensitivity did not experience an increase in gastrointestinal or extraintestinal symptoms after a single gluten exposure or five days of continuous gluten intake.
Overview
- What did they test? In this study, researchers tested the effects of a single exposure to 16 grams of gluten and 5 days of exposure to 16 grams of gluten in two doses on gastrointestinal symptoms, fatigue, intestinal permeability, and markers of inflammation in individuals with self-reported non-celiac gluten sensitivity (NCGS) and healthy controls.
- What did they find? Gluten exposure did not contribute to increased gastrointestinal or extraintestinal symptoms in the group with NCGS or the healthy controls after single or repeated exposure. Markers of inflammation and intestinal permeability were also unchanged after gluten exposure. It is important to note that one individual with NCGS dropped out due to increased symptoms when exposed to gluten.
- What does it mean for you? There has been a significant rise in the prevalence of self-reported NCGS in the US population, and many people have chosen to avoid gluten due to perceived symptoms with exposure. This study showed that people who self-identify as having NCGS, on average, don’t experience an increase in digestive or non-digestive symptoms when exposed to gluten either in a single instance or after multiple exposures. These findings suggest that many people who avoid gluten due to self-identifying as having NCGS may be able to eat gluten without symptoms.
What’s The Problem?
Non-celiac gluten sensitivity is a condition where individuals experience improvement on a gluten-free diet despite testing negative for celiac disease 1. There is controversy surrounding NCGS as these symptoms have been difficult to reproduce clinically in response to gluten exposure, and they may be attributable to other components of the wheat, such as amylase tryptase inhibitors or the FODMAP content of the food 2 3.
Previous research on NCGS has failed to demonstrate consistent symptoms for individuals who self-identify as NCGS 4. However, the research design in these studies is highly variable, and there is some evidence that gluten may lead to depressive symptoms that warrants further exploration 5.
There is also a lack of research comparing responses to a gluten challenge among individuals who self-report with NCGS and healthy controls, and examining one-time vs. repeated exposures.
Purpose
The existence of NCGS remains a controversial topic. While it is recognized as a clinical entity, studies that enlist individuals with NCGS and expose them to a gluten challenge have failed to demonstrate an increased symptom profile in most cases, and few studies compare individuals with NCGS to healthy controls
Therefore, the purpose of this study was to examine the effect of both single and repeated exposures to gluten and compare the response in individuals with NCGS vs. healthy controls (HC) on gastrointestinal symptoms, extraintestinal symptoms, and markers of inflammation and intestinal permeability.
Hypothesis
The authors hypothesized that gluten would increase GI and extraintestinal symptom ratings, especially negative emotional state and fatigue, in individuals with NCGS, but not in healthy controls (HC).
