Abstract
Wheat products make a substantial contribution to the dietary intake of many people worldwide. Despite the many beneficial aspects of consuming wheat products, it is also responsible for several diseases such as celiac disease (CD), wheat allergy, and nonceliac gluten sensitivity (NCGS). CD and irritable bowel syndrome (IBS) patients have similar gastrointestinal symptoms, which can result in CD patients being misdiagnosed as having IBS. Therefore, CD should be excluded in IBS patients. A considerable proportion of CD patients suffer from IBS symptoms despite adherence to a gluten-free diet (GFD). The inflammation caused by gluten intake may not completely subside in some CD patients. It is not clear that gluten triggers the symptoms in NCGS, but there is compelling evidence that carbohydrates (fructans and galactans) in wheat does. It is likely that NCGS patients are a group of self-diagnosed IBS patients who self-treat by adhering to a GFD.
Highlights
The three most important food grains worldwide are wheat, maize, and rice [1]
In a recent randomized, double-blind, placebo-controlled, cross-over study on adults without celiac disease (CD) or wheat allergy (WA) who believe that they suffer from nonceliac gluten sensitivity (NCGS) showed that intake of small amounts of gluten increase the intestinal and extraintestinal symptoms significantly [108]. Together these results indicate that it is not clear that gluten is responsible for triggering NCGS symptoms; instead, it appears that it is the carbohydrate content in the wheat that triggers these symptoms
CD patients experience gastrointestinal symptoms similar to those seen in irritable bowel syndrome (IBS) patients, and are at risk of being misdiagnosed as having IBS
Summary
The three most important food grains worldwide are wheat, maize, and rice [1]. The ability to produce high yields of wheat under a broad range of conditions, so that it can be cultivated successfully at global latitudes from 67° N in Scandinavia to 45° S in Argentina, renders it useful as a food source [1]. The nutritional needs following the two world wars and the exponential growth of the world population resulted in the global production and consumption of wheat expanding hugely by the end of the twentieth century [1,2,3]. The high consumption of wheat is attributed to its adaptability and potential for high yields, and to its viscoelasticity, which allows it to be processed into several food items such as bread, baked products, and pastas [1]. Wheat and wheat-based products make substantial contributions to the dietary intake of protein, dietary
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