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Eating gluten doesn’t cause symptoms in those without celiac disease or NCGS, study finds

Photo by Fiona Smallwood on Unsplash
Most people who believe they are sensitive to gluten are not.

Gluten-free diets continue to be popular with millions of Americans, despite the fact that there’s no evidence that such a diet is any healthier for most people than one that contains gluten.

The exceptions are people who have inherited the autoimmune disease known as celiac disease. For those individuals, eating gluten — a protein found in wheat and related grains, such as rye, barley and spelt — can damage the small intestine and lead to serious health complications.

People with celiac disease must follow a gluten-free diet. But they are a relatively small group — about 1 percent of the population.

Some other people have “gluten intolerance” or “gluten sensitivity,” which is sometimes referred to in the medical literature as nonceliac gluten sensitivity, or NCGS. Although the symptoms can mimic those of celiac disease — diarrhea, bloating and gas, abdominal pain, constipation, nausea and fatigue — NCGS does not cause damage to the tissue of the small intestines.

Most people who believe they are sensitive to gluten are not. A 2015 study found, for example, that more than 80 percent of people who reported gluten-related symptoms did not have celiac disease, NCGS or a wheat allergy.

Yet the fact that so many people falsely claim that they are gluten-intolerant has very real consequences for individuals with celiac disease or NCGS. It has meant that they face strong skepticism by family, friends and restaurants when they make dietary requests that are necessary for them to stay healthy.

A ‘gold standard’ study

It was for that reason that a group of British researchers decided to conduct what they say is the first double-blinded randomized controlled trial (considered the gold standard of medical research) on the effects of gluten on healthy people.

They recruited 28 healthy men and women, aged 19 to 63. The participants underwent a blood test to determine if they had celiac disease (none did) and filled out questionnaires to measure various symptoms associated with gluten intolerance, such as abdominal pain, indigestion, diarrhea, constipation and fatigue.

They were then put on a strict gluten-free diet for two weeks. At the end of that period, they were told to continue with the diet for another two weeks, but to also mix into their food each day a packet containing 14 grams of flour. Half of the participants were randomly assigned to receive gluten-containing flour, while the other half received gluten-free flour. Neither the participants nor the researchers knew which participants received which flour.

At the end of the two weeks, the participants filled out another detailed questionnaire. The study, which was published in the journal Gastroenterologyfound that the people in the gluten-flour group were not more likely to report gastrointestinal symptoms or fatigue at the end of the study than those in the “placebo-flour” group.

“Our results support the view that gluten does not appear to cause symptoms in individuals who do not have a physiological susceptibility to it (ie, most of the population),” the study’s authors write.

Limitations and implications

This was a small study, and lasted for a relatively short time, although as its authors point out, other randomized controlled trials involving people with diagnosed NCGS have shown that symptoms of glucose intolerance can begin after just one week of eating gluten.

Despite those limitations, the researchers believe their findings suggest that people should be actively discouraged from starting on a gluten-free diet if they have not been diagnosed with either celiac disease or NCGS.

Fad diets are difficult to counter with facts, however, as an editorial that accompanies the study points out.

“Scientifically valid findings have to date had little influence on beliefs about gluten,” write the editorial’s authors, Emma Halmos and Peter Gibson, who are gastroenterology researchers at Monash University in Melbourne, Australia. “The psychology around a contested health phenomenon such as gluten avoidance involves active disenchantment with science and conventional medicine.”

One of those facts is that gluten-free diets are not always benign. It’s true that adopting a gluten-free diet can be healthy — if it leads people to reduce their consumption of processed foods and eat more whole foods, especially fruits and vegetables. It’s also true, however, that many gluten-free packaged foods are far from nutritional, for they are often high in fat, sodium and sugar and low in fiber.

“The big question is whether these findings will dampen enthusiasm for the use of a [gluten-free diet] among the general community,” say Halmos and Gibson.

Right not, they don’t seem very optimistic about that happening. Although the new study “has filled a gap in the gluten story,” they write, “it may do little to sway opinion regarding the notion that a [gluten-free diet] is a diet good for health.”

FMI: You’ll find abstracts of the study and the editorial on Gastroenterology’s website.

Comments (8)

  1. Submitted by Pat Terry on 08/28/2019 - 10:02 am.

    Shout this from the rooftops.

  2. Submitted by George Moore on 08/28/2019 - 02:27 pm.

    I have recently discovered that not eating US grown wheat, or other similar grains, greatly reduces the pain from the arthritis in my hands.
    However, I have eaten pasta made with European wheat without problem. It appears many others have had similar experiences.
    Virtually all US wheat is made from GMO seed. But GMO seeds are not allowed in Europe. Since the study you reference was done in Britain, I assume it was done with non-GMO wheat and therefor would not be expected to affect those with gluten “sensitivity”.
    Thank You

    • Submitted by Greg Smith on 09/04/2019 - 07:17 am.

      Interesting point. Other than the fact there is no GMO wheat available in the market, never has been marketed, approved or commercially grown , not has any THO what’s been used in flour production.
      I’m short, your symptoms are from some other cause.

  3. Submitted by GEORGE Ferch on 08/28/2019 - 04:38 pm.

    The focus group was too small. I’m sure British flour doesn’t have as much gmo glyphosate in it as the USA. And this study doesn’t have enough time to cause a chronic condition. I do agree that fad diets are lame but there could be something else in our food causing problems and avoiding flour makes us feel better.

  4. Submitted by Rachel Kahler on 08/29/2019 - 08:19 am.

    It appears that certain scenarios can make you sensitive to gluten (or something else in foods containing gluten), even if you’re not celiac. I know of two people who were rendered extremely sensitive to gluten (their problems were very real, not imagined).

    The first went on a gluten free diet for several weeks so that she could look good for a vacation in Spain. She discovered that she could not eat gluten containing foods (most obvious was bread) on her vacation after the diet, and had severe symptoms. I don’t know if she has been able to eat gluten containing foods without symptoms since.

    In the second case, the individual was put on a strong antibiotic. The antibiotic itself caused gastrointestinal problems, which is common. After the antibiotic regimen was over, she was also extremely sensitive to gluten containing foods. She has since been able to “work her way back” to eating gluten containing foods–over a couple of years.

    While anecdotal, these cases suggest that the gut microbiome can affect how the body reacts to certain proteins, such as gluten. And all those people who go gluten free for no good reason might be unwittingly making themselves intolerant to normal, healthy foods at the same time they’re making people skeptical of those who really do have a sensitivity to gluten.

  5. Submitted by Kathie Noga on 08/29/2019 - 02:26 pm.

    I would like to comment on this because I have personal experience with this situation. My niece had bad headaches and she was actually taken to the Mayo Clinic and they could not find the cause of it. Then one day my sister-in-law saw a program by Dr. Oz on gluten intolerance. A light went on in her head because my niece was eating gluten every day. They took it out of her diet and her headaches seized. I do know people who do have symptoms from eating gluten similar to hers. Some people simply can’t handle the foods. I personally do not care what the cause of it is. In her case she had a sensitivity which the Mayo Clinic should have discovered and did not. Kudos to Dr. Oz for helping my niece when the Mayo Clinic did not!

    • Submitted by Autumn Detert on 08/29/2019 - 11:51 pm.

      I had the same type of situation. For 16 years I suffered with migraines multiple times a week, horrible bloating, intentional problems, and always felt so tired. I went to many doctors and none of them could tell me what was wrong. Finally I went to a more natural doctor and she suggested cutting gluten out of my diet and it’s been a life changer. I never thought I could feel so good, everything that I was dealing with for years and years finally went away and it was all because I have NCGS.

  6. Submitted by Joy Cooper on 12/13/2019 - 12:53 am.

    I’m gluten free because this past January I found out gluten was the cause of my joint inflammation and pain; cutting it out of my diet has climates the pain and made me (20) not feel as though I was in my 70s!

    I have to disagree with the researchers on saying those who don’t need to shouldn’t eat gluten free. I do try to avoid the processed/package gluten free products since they aren’t the healthiest, but in terms of restaurant options and general accommodation, I would love for more people to ask for gluten free options so more places offer them in greater variety!

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