Impact of Acute and Sub-Acute Gluten Exposure on Gastrointestinal Symptoms and Psychological Responses in Non-Coeliac Gluten Sensitivity: A Randomised Crossover Study
Background
Non-coeliac gluten sensitivity (NCGS) is characterised by symptom improvement with gluten exclusion in the absence of coeliac disease 📝
But is there a biological basis behind its presence? 🧐
Study Details
This new study recruited 20 healthy adults and 16 individuals with NCGS who were exposed 4 eating conditions 🍽️
Acute Exposure 🥣
1️⃣ 16 g gluten or 2️⃣ whey in yoghurt
Sub-Acute Exposure 🗓️
1️⃣ gluten-containing (16 g) or 2️⃣ gluten-free muffins per day for 5 days
Key Findings
Here is what they found ⬇️
The NCGS group had a higher subjective experience of negative emotional states 🧠
Participants experienced higher “tension” after gluten, regardless of group 🤷♂️
After both acute intakes…
😮💨 Fatigue scores
…increased in NCGS compared to healthy adults regardless of nutrient intake (gluten and gluten-free) 🔍
After both sub-acute intakes…
😖 Abdominal pain
💨 Bloating
…increased in NCGS compared to healthy adults regardless of nutrient intake (gluten and gluten-free) 🔍
There were no differences between groups for biological markers (incl. intestinal permeability, cortisol)🔬
Conclusion
These findings suggest that non-coeliac gluten sensitivity is characterised by greater negative emotions rather than any biological basis ‼️
These outcomes are not specific to gluten ❌
This can be explained by the nocebo effect (“expectancy of negative outcomes”) and may require re-evaluation of NCGS 🚫