The gluten-free or gluten-free diet remains today the only valid therapeutic tool in patients suffering from celiac disease.
In recent years the immunogenic characterization of gluten, the identification of intestinal syndromes characterized by an increased sensitivity to gluten and the appearance of new dietary trends, have led to an exponential increase in the number of non-celiac people subjected to gluten-free diets.
In this scenario, many athletes have also experienced the effects of a gluten-free diet on their skin, describing general improvements.
Literature, on the other hand, is still working on the scientific characterization of the possible results obtainable through a gluten-free diet in non-celiac subjects.
Gluten is a macro-protein aggregate present in different cereals, including wheat, made up of over 80% proteins known as glutenins and prolamins.
These proteins, in particular gliadin, due to their particular three-dimensional conformation, are responsible for the adverse immunological reactions typical of the celiac patient. Immune hyperactivation at the intestinal level in fact determines a progressive damage to the mucous membrane of the small intestine, with consequent atrophy of the villi.
The resulting symptomatology, even if multi-faceted, could determine the appearance of recurrent disorders, such as malabsorption, diarrhea, weight loss, cramping abdominal pains and growth deficits in the pediatric population.
The gluten-free diet
As mentioned, the gluten-free diet represents, at the moment, the only valid therapeutic remedy for the celiac patient.
It has been shown that the total elimination of gluten from the diet of a celiac patient can easily lead to an improvement in the histological picture, reducing the inflammation of the intestinal mucosa and promoting a better absorption profile of the micronutrients, as well as a rapid regression of the complained symptomatology .
Considering the presence of gluten in some cereals, in order to achieve a gluten-free diet, it would be sufficient to avoid the consumption of wheat, rye, barley, triticale, kamut, malt, as well as flour and derived products.
Fortunately, already in nature it is possible to find valid substitutes without gluten, such as corn, rice, sorghum, oats, millet, buckwheat, amaranth and quinoa, to which are added a series of products industrial gluten-free, substitutes for pasta, bread and various bakery products.
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No limitation, however, exists in relation to the consumption of fruit, legumes, nuts, oils, vegetables and unprocessed products of animal origin.
For this reason, a nutrition professional could develop, without any problem, nutritionally balanced gluten free diets, even for users with particularly high needs such as athletes.
Benefits of a gluten-free diet in non-celiac patients
If the clinical improvements linked to the elimination of gluten from the diet of celiac patients are clear and well characterized, the potential effects on the healthy population are still little known.
At the moment, a gluten-free diet would seem:
- Improve symptoms such as abdominal bloating, recurrent in patients with irritable bowel syndrome;
- Improve the digestive profile, reducing digestion times;
- Reduce the risk of allergy and related syndromes in predisposed subjects;
- Improve the clinical course in the presence of some psychiatric manifestations.
The evidence concerning the use of the gluten-free diet in sports is even smaller.
If, from a strictly empirical point of view, some athletes describe an improvement in concentration and energy yield, and a general improvement in performance, the currently published studies highlight:
- A lower risk of anaphylaxis induced by physical exercise;
- No benefit on the performance nor on the concentrations of inflammatory markers.
At the moment it is not yet possible to draw certain conclusions regarding the effectiveness of the gluten-free diet in sports.
Indeed, the few published studies seem to contradict the empirical observations made by many athletes.
Therefore we expect further work that can better clarify the usefulness and potential risks of a gluten-free diet in non-celiac subjects.
Gluten-free diet: imprudent dietary advice for the general population?
Gaesser GA, Angadi SS.
J Acad Nutr Diet. 2012 Sep; 112 (9): 1330-3
A novel wheat gliadin as a cause of exercise-induced anaphylaxis.
Palosuo K, Alenius H, Varjonen E, Koivuluhta M, Mikkola J, Keskinen H, Kalkkinen N, Reunala T.
J Allergy Clin Immunol. 1999 May; 103 (5 Pt 1): 912-7
No Effects of a Gluten-free Short-Term Diet on Performance in Nonceliac Athletes.
Lis D, Stellingwerff T, Kitic CM, Ahuja KD, Fell J.
Med Sci Sports Exerc. 2015 May 1
Non coeliac gluten sensitivity - A new disease with gluten intolerance.
Clin Nutr. 2015 Apr; 34 (2): 189-94
Gluten-free diet and quality of life in celiac disease.
Samasca G, Sur G, Lupan I, Deleanu D.
Gastroenterol Hepatol Bed Bench. 2014 Summer; 7 (3): 139-4