Gluten: do only celiac patients benefit from its removal from the diet?

• Published in: Food reviews international Vol. 39; no. 7; pp. 4388 - 4418
• Main Authors: de Sousa Franckilin, Laryssa Rosa, Dos Santos, Anna Clara Paiva Menezes, Freitas, Flávio Eduardo Dias Araújo, Vieira, Isabela Garbazza, de Freitas Jorge, Carlos Eduardo, Neri, Daniela Godoy, de Abreu, Maria Vitória Cota, Fonseca, Janaina Koenen, Loffi, Renato Guimarães, Foureaux, Giselle
• Format: Journal Article
• Language: English
• Published: Philadelphia Taylor & Francis 25.08.2023; Taylor & Francis Ltd
• Subjects: Allergies; Autism; Autoimmune diseases; Celiac disease; Diet; Food processing; Gluten; gluten free diet; Immunoglobulin A; Immunology; Intestinal microflora; Mental disorders; Microbiomes; non-celiac gluten sensitivity; Processed foods; Schizophrenia; Special diets; Vegetable oils; Wheat; wheat allergy
• ISSN: 8755-9129; 1525-6103
• DOI: 10.1080/87559129.2021.2024566

Gluten is the most common protein in wheat and is related to different pathogeneses. There are three main gluten-related disorders: celiac disease (CD), wheat allergy (WA), and non-celiac gluten sensitivity (NCGS). Clinical manifestations are strictly related in all of them, such as abdominal pain and distention, however the development pathways may differ. The diagnosis criteria are also different, in CD features immunological markers such as IgA, while WA presents IgE markers, and NCGS does not have any specific immunological marker. The consumption of wheat, and consequently gluten-related products, is historical and it has grown over human evolution, which leads us to question what role this component plays in other diseases, and the consequence of a gluten-free diet (GFD). GFD is the treatment with major efficacy in CD and, likewise, is related with improvements in neuropathologies (autism spectrum disorder, anxiety, depression and schizophrenia), obesity, and the gut microbiome. Further investigation is required. GFD studies in people who do not present CD seem to be safe, especially when products containing gluten are not replaced by processed gluten-free products but by minimally processed foods, and also when the food strategy is accompanied by a qualified professional.