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Digestive Diseases and Sciences

, Volume 64, Issue 7, pp 1740–1747 | Cite as

Going Against the Grains: Gluten-Free Diets in Patients Without Celiac Disease—Worthwhile or Not?

  • Benjamin A. Lerner
  • Peter H. R. Green
  • Benjamin LebwohlEmail author
Invited Review

Abstract

While the gluten-free diet (GFD) is the only known effective therapy for celiac disease, in recent years it has become increasingly popular in the USA and worldwide, with many believing it to be more “healthful” and others claiming that it has beneficial effects for health conditions, many extraintestinal, other than celiac disease. This review examines the evidence for use of the GFD in patients without celiac disease who self-report intestinal and/or extraintestinal symptoms (non-celiac gluten sensitivity), as well as for enhancement of athletic performance and treatment of autism, rheumatoid arthritis, and psychiatric disorders. Overall, the evidence for use of GFDs in conditions other than celiac disease is poor. Though non-celiac gluten sensitivity may ultimately emerge as a biomarker-defined condition, a large proportion of patients with apparent non-celiac gluten sensitivity have, after careful investigation, an alternative diagnosis. In light of this, and coupled with the potential physical and psychological harms associated with the avoidance of gluten, initiating a GFD should not be encouraged for people who have these other conditions or are seeking physical/athletic enhancement.

Keywords

Gluten-free diet Gluten Non-celiac gluten sensitivity Rheumatoid arthritis Autism Schizophrenia 

Notes

Compliance with ethical standards

Conflict of interest

Benjamin Lebwohl serves as a consultant for Takeda and serves on the Advisory Board of Innovate Biopharmaceuticals. Peter HR Green serves on the advisory board of ImmusanT, ImmunogenX, and Innovate Biopharmaceuticals. Benjamin Lerner has no disclosures.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Benjamin A. Lerner
    • 1
  • Peter H. R. Green
    • 1
  • Benjamin Lebwohl
    • 1
    • 2
    Email author
  1. 1.Department of Medicine, Celiac Disease CenterColumbia University Medical CenterNew YorkUSA
  2. 2.Department of Epidemiology, Mailman School of Public HealthColumbia University Medical CenterNew YorkUSA

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