Monday, August 19, 2013

Study Fails To Find Gluten Sensitivity In People Who Claim Gluten Sensitivity

This was a very controlled study:

No Effects of Gluten in Patients With Self-Reported Non-Celiac Gluten Sensitivity After Dietary Reduction of Fermentable, Poorly Absorbed, Short-Chain Carbohydrates, Gastroenterology, August 2013
In conclusion, these consecutive double-blind, randomized, placebo-controlled, cross-over rechallenge studies showed no evidence of specific or dose-dependent effects of gluten in patients with NCGS [non-celiac gluten sensitivity] placed on a low FODMAP [fermentable, oligo-, di-, monosaccharides, and polyols] diet.

A high nocebo* response was found regardless of known background dietary triggers being controlled and reproducibility of symptom induction to a specific protein was poor.

These data suggest that [gluten sensitivity], as currently defined, might not be a discrete entity or that this entity might be confounded by FODMAP restriction, and that, at least in this highly selected cohort, gluten might be not be a specific trigger of functional gut symptoms once dietary FODMAPs are reduced.
It points to dietary patterns! Food combinations seem to matter more than the effect of single nutrients. In this case, participants had a sensitivity to gluten, or at least a perceived sensitivity ("nocebo"), when the rest of their diet included FODMAPs.

FODMAPs are carbohydrates that are known to produce GI upset. You could probably name them ... beans, dairy (lactose), the cabbages (broccoli, cauliflower), onions and garlic, and fructose, especially beverages that are sweetened with unnaturally high amounts of fructose.

* A nocebo response is essentially a placebo response except the expectation is undesirable instead of desirable.


Anonymous said...

Kind of a weird study. Wheat is one of the things that is not eaten on a low FODMAP diet.

Anonymous said...

Finally science weighs in. I've been saying this for years!!