Current evidence suggests that many patients with self-reported non-celiac gluten sensitivity retain gastrointestinal symptoms on a gluten-free diet (GFD) but continue to restrict gluten as they report ‘feeling better’.
Dr Peters and colleagues from Australia investigated the notion that a major effect of gluten in those with non-celiac gluten sensitivity is on mental state, and not necessarily on gastrointestinal symptoms.
The team reported that 22 subjects with irritable bowel syndrome who had celiac disease excluded but were symptomatically controlled on a gluten-free diet, undertook a double-blind cross-over study.
Participants randomly received one of three dietary challenges for 3 days, followed by a minimum 3-day washout before crossing over to the next diet.
Challenge gluten-free food was supplemented with gluten (16 g/day), whey (16 g/day) or not supplemented (placebo).
|Gluten ingestion was associated with higher overall STPI state depression scores|
|Alimentary Pharmacology & Therapeutics|
The team's end-points included mental state as assessed by the Spielberger State Trait Personality Inventory (STPI), cortisol secretion and gastrointestinal symptoms.
The researchers found that gluten ingestion was associated with higher overall STPI state depression scores compared to placebo but not whey.
The research team found no differences were found for other STPI state indices or for any STPI trait measures.
No difference in cortisol secretion was identified between challenges.
Gastrointestinal symptoms were induced similarly across all dietary challenges.
Dr Peters' team concludes, "Short-term exposure to gluten specifically induced current feelings of depression with no effect on other indices or on emotional disposition."
"Gluten-specific induction of gastrointestinal symptoms was not identified."
"Such findings might explain why patients with non-celiac gluten sensitivity feel better on a gluten-free diet despite the continuation of gastrointestinal symptoms."