Low Gluten Diet Research Articles

Characteristics of dietary patterns, and serum metabolites during the low-gluten diet among Chinese young adults

The number of gluten-restricted dieters is growing, yet its impact on healthy diets and serum profiles is unclear. This study investigated the effects of a 2-week low-gluten diet (LGD) on the dietary patterns, serum metabolic profiles, and health status of 61 young individuals from a university in southeastern China. Data on food intake, serum metabolomics, blood biochemistry, and fecal SCFA were collected. This population was divided into four dietary patterns by k-means method:1 Processed food group (PB, n = 17), 2 Rice group (RB, n = 10), 3 Fish/shrimp-based group (SB, n = 4), and 4 Vegetable group (VB, n = 30). Serum metabolites and fecal SCFA were measured using HPLC-MS and GC-MS, respectively. After 2-week of LGD, the SB group had the highest diet diversity. There were remarked differences in nutrient intake among the four dietary patterns, but no differences in health indices or fecal SCFA. WGCNA method revealed the differences in metabolite metabolite modules 4 and 5, and 3-hydroxybutyric acid, hydrolyzed fumonisin（HFB1）, and palmitoleic acid were the different metabolites among clusters. Following a 2-week LGD, different dietary patterns lead to different nutrient intakes and serum metabolite profiles.

Effects of gluten on dyspeptic symptoms: a systematic review and meta-analysis of clinical trials.

Research on the effects of gluten on dyspeptic symptoms has shown conflicting results. The aim of this systematic review and meta-analysis of clinical trials was to assess the effects of gluten on dyspeptic symptoms. A systematic search of the PubMed, ISI Web of Science, Scopus, Cochrane, and Embase online databases was performed up to May 2022. Randomized controlled trials (RCTs) and non-RCTs that examined the impact of a gluten-free diet, a low-gluten diet, or a gluten challenge on dyspeptic symptoms, including early satiety, epigastric pain, bloating, and nausea, were selected independently by 2 authors. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework was used to assess the certainty of the evidence. Results were pooled using a random-effects model and expressed as weighted mean differences (WMDs) and 95%CIs. Of the 7641 citations retrieved, 27 articles (18 RCTs and 9 non-RCTs) were included in the systematic review. Of those, 5 RCTs were eligible for the meta-analysis. The pooled results indicated that gluten challenge significantly increased the severity of bloating (WMD = 0.67; 95%CI, 0.37-0.97; I2 = 81.8%; n = 6), early satiety (WMD = 0.91; 95%CI, 0.58-1.23; I2 = 27.2%; n = 5), and epigastric pain (WMD = 0.46; 95%CI, 0.17-0.75; I2 = 65.8%; n = 6). However, the effect of gluten challenge on the severity of nausea (WMD = 0.13; 95%CI, -0.17 to 0.43; I2 = 0.0%, n = 5) was nonsignificant. Gluten challenge significantly worsened dyspeptic symptoms, including bloating, early satiety, and epigastric pain, but did not affect nausea. These findings suggest that gluten restriction could be efficient in reducing dyspeptic symptoms. Well-designed large RCTs recruiting homogenous groups of patients with functional dyspepsia are needed to clarify the effectiveness of gluten restriction on dyspeptic symptoms.

Plant-based milk Developed from Soy (Glycine max) Milk and Foxtail Millet (Setaria italica)

The presence of lactose and casein content can exacerbate clinical symptoms in people with autism and lactose intolerance. Apart from casein, a low gluten diet can be given to people with autism and celiac disease. Thus, not everyone able to digest and consume dairy milk well. This study aimed to develop plant-based milk products based on soybean milk with the addition of foxtail millet. There were four beverage formulations, F0 (100% soy milk, 0% millet), F1 (90% soy milk, 10% millet), F2 (80% soy milk, 20% millet), and F3 (70% soy milk, 30% millet). A total of 25 semi-trained panelists were involved in this study. Plant-based milk of soy milk with the addition of 10% millet tended to have better hedonic and hedonic quality values than pure soy milk products and soy milk with 20% and 30% millet. The 100% soy milk product (F0) had a viscosity value of 1.07 ± 0.03 and increased along with more millet added, about 1.27 ± 0.02 - 1.58 ± 0.01 cp. Based on the statistical test, the addition of foxtail millet significantly affected the protein, fat, and ash content at α = 0.05. However, it did not significantly affect the carbohydrate, water, and energy content (p> 0.05). In addition, the calcium content might be improved in line with the addition of millet to soy milk. Plant-based milk formulated with soy milk and millet can be an alternative to dairy milk which contains better nutrients than whole soy milk.

Non-Celiac Gluten Sensitivity in the Context of Functional Gastrointestinal Disorders.

Gluten-free diets are increasingly chosen in the Western world, even in the absence of a diagnosis of celiac disease. Around 10% of people worldwide self-report gluten-related complaints, including intestinal and extra-intestinal symptoms. In most cases, these subjects would be labeled as patients suffering from irritable bowel syndrome (IBS) who place themselves on a gluten-free diet even in the absence of celiac disease. In some instances, patients report a clear benefit by avoiding gluten from their diet and/or symptom worsening upon gluten reintroduction. This clinical entity has been termed non-celiac gluten sensitivity (NCGS). The symptoms referred by these patients are both intestinal and extra-intestinal, suggesting that similarly to functional gastrointestinal disorders, NCGS is a disorder of gut–brain interaction. It remains unclear if gluten is the only wheat component involved in NCGS. The mechanisms underlying symptom generation in NCGS remain to be fully clarified, although in the past few years, the research has significantly moved forward with new data linking NCGS to changes in gut motility, permeability and innate immunity. The diagnosis is largely based on the self-reported reaction to gluten by the patient, as there are no available biomarkers, and confirmatory double-blind challenge protocols are unfeasible in daily clinical practice. Some studies suggest that a small proportion of patients with IBS have an intolerance to gluten. However, the benefits of gluten-free or low-gluten diets in non-celiac disease-related conditions are limited, and the long-term consequences of this practice may include nutritional and gut microbiota unbalance. Here, we summarize the role of gluten in the clinical features, pathophysiology, and management of NCGS and disorders of gut–brain interaction.

A Low Gluten Diet Suppresses Disease Activity of Rheumatoid Arthritis

Background: This study aimed to evaluate the efficacy of a low gluten diet in the disease activity of Rheumatoid Arthritis (RA). Methods: Among 109 patients with RA enrolled in this study, 98 patients who completed 16 weeks on a low gluten diet regimen were included in the study. At baseline, we gave the patients the information about gluten-free and gluten-contained foods, and asked them to refrain from the daily gluten consumption during the experimental period. Results: The low gluten diet significantly improved DAS28-CRP and CDAI scores after 16 weeks. The percentages of patients achieving DAS28-CRP and CDAI-defined remission or LDA were significantly increased after 16 weeks. There was a significant increase in the percentage of the responders in EULAR treatment response after 16 weeks. Rheumatoid Factor (RF) but not C-reactive protein was significantly decreased after 16 weeks. When the self-reported level about adherence to the low gluten diet was divided into three categories, a significant decrease in DAS28-CRP, CDAI and RF was detected in the patients with the strict adherence to the low gluten diet. Conclusion: This study demonstrates that the strict adherence to a low gluten diet results in the decreased disease activity of RA.

Definitions, regulations, and new frontiers for dietary fiber and whole grains

The aim of this article is to review the definitions and regulations for dietary fiber and whole grains worldwide and to discuss barriers to meeting recommended intake levels. Plant foods, such as whole grains, that are rich in dietary fiber are universally recommended in dietary guidance. Foods rich in dietary fiber are recommended for all, but dietary recommendations for whole grains and dietary fiber depend on definitions and regulations. Official recommendations for dietary fiber in the United States and Canada are denoted by dietary reference intakes (DRIs), which are developed by the Institute of Medicine. An adequate intake (AI) for dietary fiber was based on prospective cohort studies of dietary fiber intake and cardiovascular disease risk that found 14 grams of dietary fiber per 1000 kilocalories protected against cardiovascular disease (CVD). This value was used to set AIs for dietary fiber across the life cycle based on recommended calorie intakes. Actual intakes of dietary fiber are generally about half of the recommended levels. Recommendations for whole grain intake are equally challenging, as definitions for whole grain foods are needed to set recommendations. The 2005 Dietary Guidelines for Americans recommended that half of all grain servings be whole grains, but usual intakes are generally less than 1 serving per day, rather than the recommended 3 servings per day. Scientific support for whole grain recommendations is based on the same prospective cohort studies and links to CVD protection used to inform dietary fiber guidance. Thus, dietary fiber is a recommended nutrient and whole grains are a recommended dietary pattern in dietary guidance in North America and around the world. Challenges for attaining recommended intakes of dietary fiber and whole grains include low-carbohydrate diets, low-gluten diets, and public health recommendations to avoid processed foods.

A low-gluten diet induces changes in the intestinal microbiome of healthy Danish adults

Adherence to a low-gluten diet has become increasingly common in parts of the general population. However, the effects of reducing gluten-rich food items including wheat, barley and rye cereals in healthy adults are unclear. Here, we undertook a randomised, controlled, cross-over trial involving 60 middle-aged Danish adults without known disorders with two 8-week interventions comparing a low-gluten diet (2 g gluten per day) and a high-gluten diet (18 g gluten per day), separated by a washout period of at least six weeks with habitual diet (12 g gluten per day). We find that, in comparison with a high-gluten diet, a low-gluten diet induces moderate changes in the intestinal microbiome, reduces fasting and postprandial hydrogen exhalation, and leads to improvements in self-reported bloating. These observations suggest that most of the effects of a low-gluten diet in non-coeliac adults may be driven by qualitative changes in dietary fibres.

Celiac disease is not more prevalent in patients undergoing in vitro fertilization and does not affect reproductive outcomes with or without treatment: a large prospective cohort study

To study the prevalence of celiac disease in the infertile population undergoing invitro fertilization (IVF) and assess outcomes. Prospective cohort study. A single infertility center from January 2016 to March2017. Women 18-45years of age participating in IVF. Patients had serum tissue transglutaminase (tTG) and endomysial (EMA) IgA testing to screen for celiac disease and completed a 10-question "yes or no" survey to assess their medical history, previous testing, dietary habits, and pertinent symptoms. IVF cycle outcomes were compared between seronegative and seropositive patients. Of 1,000 patients enrolled, 995 completed serologic screening and 968 underwent oocyte retrieval. Eighteen patients screened positive for both tTG and EMA (1.8%) and 10 additional patients (1.0%) screened positive for one of the two antibodies. The number of mature oocytes retrieved, fertilization rates, and blastulation rates were equivalent between seronegative and seropositive patients. There were 987 patients who completed the questionnaire (98.7%), and 84 reported being gluten free (8.5%). Those who reported being gluten free were no more likely to be antibody positive than the general population. Furthermore, a low-gluten diet was not associated with markers of ovarian reserve, oocytes retrieved, fertilization, blastulation, sustained implantation and pregnancy loss rates. The prevalence of seropositive celiac disease was consistent with that of the general population (2.8%). Patients who were seropositive for celiac disease-related antibodies had outcomes equivalent to seronegative patients, and patients with a gluten-free diet did not have improved outcomes.

A randomised, double-blind, cross-over trial to evaluate bread, in which gluten has been pre-digested by prolyl endoprotease treatment, in subjects self-reporting benefits of adopting a gluten-free or low-gluten diet.

The aim of the present study was to determine if the enzyme Aspergillus niger prolyl endoprotease (ANPEP), which degrades the immunogenic proline-rich residues in gluten peptides, can be used in the development of new wheat products, suitable for gluten-sensitive (GS) individuals. We have carried out a double-blind, randomised, cross-over trial with two groups of adults; subjects, self-reporting benefits of adopting a gluten-free or low-gluten diet (GS, n 16) and a control non-GS group (n 12). For the trial, volunteers consumed four wheat breads: normal bread, bread treated with 0·8 or 1 % ANPEP and low-protein bread made from biscuit flour. Compared with controls, GS subjects had a favourable cardiovascular lipid profile - lower LDL (4·0 (sem 0·3) v. 2·8 (sem 0·2) mmol/l; P=0·008) and LDL:HDL ratio (3·2 (sem 0·4) v. 1·8 (sem 0·2); P=0·005) and modified haematological profile. The majority of the GS subjects followed a low-gluten lifestyle, which helps to reduce the gastrointestinal (GI) symptoms severity. The low-gluten lifestyle does not have any effect on the quality of life, fatigue or mental state of this population. Consumption of normal wheat bread increased GI symptoms in GS subjects compared with their habitual diet. ANPEP lowered the immunogenic gluten in the treated bread by approximately 40 %. However, when compared with the control bread for inducing GI symptoms, no treatment effects were apparent. ANPEP can be applied in the production of bread with taste, texture and appearance comparable with standard bread.

Intraepithelial lymphocyte immunophenotype: a useful tool in the diagnosis of celiac disease.

According to new ESPGHAN guidelines, gluten challenge is considered necessary when there is doubt about the initial diagnosis of celiac disease (CD). The main aim of this study was to quantify intraepithelial lymphocyte (IEL) immunophenotype on celiac patients on gluten-containing diet (GCD) compared to those on gluten-free diet (GFD). Another aim was to evaluate the clinical utility of IELs in the CD diagnosis, especially in selected patients on GFD where diagnostic uncertainty remains. IEL immunophenotype (TCRγδ and NK-like IELs) were studied by flow cytometry in 111 children with CD (81 children with CD on GCD and 30 celiac patients on GFD) and a control group (10 children). Duration of GFD was 5.4±1.6years. TCRγδ IELs in celiac patients receiving a GCD or GFD were significantly higher (p<0.001) than in the control group. NK-like IELs in patients receiving a GCD or GFD were significantly lower than in the control group (p<0.001). We observed a permanent decrease of NK-like IELs and an increment of TCRγδ IELs after following an adequate establishment and compliance of a long-term GFD in celiac patients. Recognition of IELs changes in the intestinal mucosa on celiac patients after long-term establishment of a GFD could constitute a useful tool for CD diagnosis in various situations: in which there is doubt about the initial diagnosis and repeat biopsy is necessary (avoiding the need of gluten challenges), and in those patients with symptoms/signs suggestive of CD who maintain a low gluten diet.

Que reste-t-il en 2015 des régimes en hépatogastroentérologie ?

A diet regimen is a therapeutic option often discussed in several gastroenterological diseases. While few are useful, the clinical relevance of others warrants to be documented. A daily intake of 15–20g of fibre in case of delayed colonic transit time, a reduced amount of residues before colonoscopy, a low lipid intake in case of pancreatic insufficiency, a life-long gluten-free diet in celiac disease or a lactose-free diet in case of demonstrated lactose intolerance, are validated options. In addition, several clinical trials have recently provided arguments for a low FODMAP diet to improve symptoms of irritable bowel syndrome (IBS). At variance, the beneficial effect of a low gluten diet in IBS or in case of non-celiac gluten sensitivity remains a matter of debate. Some diet recommendations can be given to cirrhotic patients, according to the severity of the disease and the presence or not of complications of the disease. The evidence for an improvement of gastroparetic symptoms by a diet regimen is not fully established. Any diet regimen has a significant impact on a patient's quality of life. In addition, the benefit-risk ratio needs to be assessed precisely, in taking into account the potential risk of nutritional deficiencies promoted by a too strict diet regimen. For all these reasons, a diet regimen needs to remain a medical advice.

P577 Cost-effectiveness of episodic or maintenance infliximab versus standard treatment in an incidence cohort of Crohn's disease patients with 10-years follow-up

in all study groups (105.8% vs 114.3% RDA in normal controls; 88.7% vs 109.2% RDA in diseased controls, 100.4% vs 87.6% RDA in IBD. Conclusions: In this study IBD patients had a significantly lower Ca intake than healthy controls. In accordance to previous studies, gender and age, more than diagnosis, are relevant factors in determining inadequate Ca intake. The trend is more marked in IBD, especially in postmenopausal women. Selfreported lactose intolerance, leading to dietary restrictions, is the single major determinant of low Ca intake in all pts groups, irrespective to diagnosis, age and gender. Inadequate Ca intake is observed in about one third of IBD pts and represents an easily reversible risk factor for osteoporosis. The observation that celiac patients on low gluten diet have a Ca intake well over RDA, further supports the need for tailored nutrition advice also in ulcerative colitis and Crohn’s disease.

Collagenous sprue diagnosed by double balloon endoscopy

Double balloon endoscopy (DBE) is useful for diagnosing many intestinal diseases and for endoscopic procedures. We report a case of chronic diarrhea in a 58-year-old Japanese man. He was initially suspected to have malabsorption syndrome. DBE showed reduction of folds, scalloping, mucosal nodularity and granularity. Pathological examinations of biopsies from the jejunum showed severe villous atrophy with subepithelial collagen bands. These findings led to the final diagnosis of collagenous sprue (CS). With1 month of total parenteral nutrition followed by a low-gluten diet, his symptoms gradually improved. CS has never been reported before in Japan. DBE is useful for making a diagnosis of CS, and may be considered for patients who are suffering from diarrhea of unknown cause.

Are coeliacs following a gluten-free diet or a low-gluten diet?

An abstract is not available for this content. As you have access to this content, full HTML content is provided on this page. A PDF of this content is also available in through the ‘Save PDF’ action button.

Changes in N-Acetylglutamate Are Involved in Regulating Urea Synthesis in Rats Given a Low Gluten Diet Supplemented with L-Lysine, L-Methinone and L-Threonine

We have shown that urinary urea excretion decreased in rats fed a low gluten diet supplemented with dietary limiting amino acids. The purpose of present study was to determine whether the addition of dietary limiting amino acids to a low gluten diet affected the synthesis and degradation of N-acetylglutamate and regulated urea synthesis. Experiments were done on two groups of rats, given diets containing 10% gluten or 10% gluten+0.5% L-lysine, 0.2% L-threonine and 0.2% L-methionine for 10 d. The urinary excretion of urea, and the liver concentration of N-acetylglutamate, and the liver activity of N-acetylglutamate synthetase decreased with the addition of dietary L-lysine, L-threonine and L-methionine. N-Acetylglutamate concentration in the liver was closely correlated with the N-acetylglutamate synthetase activity in the liver and excretion of urea. The greater degradation of N-acetylglutamate was observed in the group fed the 10% gluten+L-lysine, L-threonine and L-methionine. The hepatic concentration of glutamate and plasma concentration of arginine were not related to the N-acetylglutamate concentration in the liver. These results suggest that the addition of limiting amino acids to the low gluten diet controls the synthesis and degradation of N-acetylglutamate in the liver and lowers urea synthesis.

Effect of adding dietary L-lysine, L-threonine and L-methionine to a low gluten diet on urea synthesis in rats

We have shown that urinary urea excretion increased in rats fed a low quality protein. The purpose of present study was to determine whether an addition of dietary limiting amino acids affected urea synthesis in rats fed a low gluten diet. Experiments were done on three groups of rats given diets containing 10% gluten, 10% gluten +0.5% L-lysine or 10% gluten+0.5% L-lysine, 0.2% L-threonine and 0.2% L-methionine for 10 d. The urinary excretion of urea, and the liver concentrations of serine and ornithine decreased with the addition of dietary L-lysine, L-threonine and L-methionine. The fractional and absolute rates of protein synthesis in tissues increased with the treatment of limiting amino acids. The activities of hepatic urea-cycle enzymes was not related to the urea excretion. These results suggest that the addition of limiting amino acids for the low gluten diet controls the protein synthesis in tissues and hepatic ornithine and decline urea synthesis.

Iron trends in rat serum related to dietary fish oils under protein malnutrition.

The iron trend in the serum of male rats fed a low wheat gluten (5% level) diet containing several fish oils for 2 to 4 wk was investigated. The body weight in every experimental group decreased during the first 3 d and thereafter their body weights dropped gradually until the 4th week. At the end of the experimental period, the weights of the spleens from the rats in the cod liver oil (CLO) and sardine oil (SO) groups were significantly heavier than those of the corn oil (control: CO) group. The iron concentrations in the serum of all dietary groups at the 4th week had a tendency to decrease compared to that of the control (CO) group. Ferritin in serum in the 4th week was significantly increased compared to that of the 2nd week for both the CO and CLO groups. However, that of the SO group remained at a low level similar to that measured in the 2nd week. The unsaturated iron binding capacity (UIBC) of the SO group in the 2nd week was significantly higher than that of the control (CO) group. In the 2nd week, the non-heme iron content in the liver was almost equal to the standard value. In the 4th week, however, the non-heme iron in the liver tissues of all dietary groups was significantly increased compared to those of the corresponding groups in the 2nd week. These findings suggest that iron accumulates in the liver.

Effects of Adding Dietary Lysine to a Low Gluten Diet on the Brain Protein Synthesis Rate in Aged Rats

The purpose of this study was to find whether the addition of dietary lysine affected the rate of brain protein synthesis in aged rats fed on a gluten diet. Experiments were done on two groups of aged rats (30 wk) given the diets containing 5% gluten or 5% gluten + 0.3% lysine for 10 d. The fractional rates of protein synthesis in brain, liver, and kidney increased with an addition of dietary lysine. In brain, liver, and kidney, the RNA activity [g protein synthesized/(g RNA x d)] was significantly correlated with the fractional rate of protein synthesis. The RNA concentration (mg RNA/g protein) was not related to the fractional rate of protein synthesis in any organ. The results suggest that the addition of the limiting amino acid for the low quality protein elevates the rate of protein synthesis in the brain of aged rats, and that RNA activity is at least partly related to the fractional rate of brain protein synthesis.

Cereal Grains: IgE- and Non-IgE-mediated Reactions

In this paper, we study the link between cereal grains and diseases because the clinical consequences are often underestimated. Cereal grains are commonly incriminated when ingested or inhaled. In the first part, we deal with true allergies related to cereal grains such as Baker's asthma and rice allergy, where the purpose of the treatment is to make the symptoms disappear. In the second part, we deal with the most commonly known disease caused by cereal grains, which is coeliac disease (CD). Because many of its clinical features are atypical or non-standard, there are still long delays in the diagnosis of CD which may have serious consequences. In addition, several diseases have been described as being associated with CD. Furthermore, an increased risk of malignancy and mortality has been reported in patients on a normal or even a low gluten diet. Thus, for the sake of patients, a lifelong strict gluten-free diet is mandatory. It has become necessary to make physicians more aware of the problem and to label gluten-containing foods and glutencontaining ingredients in commercial foodstuffs. Health-care professionals, the food industry, government officials and the public should be educated about diseases related to cereal grains. Enlightenment may help to prevent long-term hidden health problems without clinical symptoms.

Therapeutic approaches to autism: research and practice

attendance was predominantly British. A wide-ranging and sometimes rugged variety of treatments are promoted for autism and attract sub stantial amounts of money from parents and local authorities. Each philosophy has its practitioneradvocate who presents a testimony of success with a religious conviction on the basis of their subjective observation of a small number of cases, selected because they have stayed the course. The Nottingham team gave a particularly helpful overview of the field with acomparative study which included several types of special school as well as Waldon and Holding Therapies. The results have yet to be quantified and this will not be easy as many of the children receive a mixture of therapies in a variety of non-residential settings. Other presentations were of an initial evalu ation of Daily Life Therapy from the Boston Higashi School and a Norwegian study of the effectiveness of low casein and gluten diets. These were hampered by their lack of suitable comparisons to control for age-related or spontaneous change. Reviews of other approaches included the Option Method and low social intrusion teaching as well as *A conference held at Durham University,from 3 to 6 April 1991, arranged by the National Autistic Society and Autism Europe. some practical strategies to teach social empathy. As in the blind men's description of an elephant, differ