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Gluten-free diet benefits asymptomatic patients with serologic markers of celiac disease

A study in the latest Gastroenterology examines the benefits of a gluten-free diet on asymptomatic patients with serologic markers of celiac disease.

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Dr Kaukinen and colleagues investigated whether screen-detected and apparently asymptomatic adults with endomysial antibodies benefit from a gluten-free diet.

The researchers performed a prospective trial of 3031 individuals at risk for celiac disease based on screens for endomysial antibodies.

Of 148 seropositive individuals, 40 fulfilled inclusion criteria and were assigned randomly to groups placed on a gluten-free diet or gluten-containing diets.

The research team evaluated ratios of small-bowel mucosal villous height:crypt depth, serology and laboratory test results, gastrointestinal symptom scores, physiologic well-being, perception of health by a visual analog scale, bone mineral density, and body composition at baseline and after 1 year.

Thereafter, the group on the gluten-containing diet started a gluten-free diet, and was evaluated a third time, subjects in the gluten-free diet group remained on this diet.

Only social function scores improved more in the gluten-containing diet group
Gastroenterology

After 1 year on the gluten-free diet, the mean mucosal villous height:crypt depth values increased, levels of celiac-associated antibodies decreased, and gastrointestinal symptoms improved to a greater extent than in patients on gluten-containing diets.

The gluten-free diet group also had reduced indigestion, reflux, and anxiety, and better health, based on the visual analog scale, than the gluten-containing diet group.

The team noted that only social function scores improved more in the gluten-containing diet group than in the gluten-free diet group.

The researchers found no differences between groups in laboratory test results, bone mineral density, or body composition.

Most measured parameters improved when patients in the gluten-containing diet group were placed on gluten-free diets.

The researchers observed no subjects considered their experience to be negative, and most expected to remain on gluten-free diets.

Dr Kaukinen's team concludes, "Gluten-free diets benefit asymptomatic endomysial antibodies-positive patients."

"The results support active screening of patients at risk for celiac disease."

Gastroenterology 2014: 147(3): 610–617.e1
29 August 2014

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