GFD

Gluten-Free Diet Impacts the Human Microbiome:

A gluten-free diet (GFD) is commonly adopted as an effective treatment for celiac disease, and is often followed to alleviate GI complaints. While we know there is an important link between diet and the gut microbiome, how a switch to a GFD affect the human gut microbiome is largely unknown. Twenty one healthy human volunteers followed a GFD for four weeks. Researchers collected stool samples from each at baseline, four during the GFD period, and four when they returned to their habitual diet (HD). They determined microbiome profiles using 16S rRNA sequencing, then processed the samples for taxonomic and imputed functional composition. They also measured six gut health-related biomarkers in all samples. Inter-individual variation in the gut microbiota remained stable during the short term GFD intervention. A number of taxon-specific differences were seen during the GDF: the most striking shift was seen for the family Veillonellaceae (class Clostridia), which was significantly reduced during the intervention. Seven other taxa also showed significant changes; the majority of them known to play a role in starch metabolism. Stronger differences in pathway activities were seen: 21 predicted pathway activity scores showed significant association to the diet change. Strong relation between the predicted activity of pathways and biomarker measurements were observed. Researchers concluded that CFD changes the gut microbiome composition and alters the activity of microbial pathways.

Bonder MJ, et al. The influence of a short-term gluten-free diet on the human gut microbiome. Genome Med. 2016 Apr 21;8(1):45. doi: 10.1186/s13073-016-0295-y.

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How to Diagnose Non-Celiac Gluten Sensitivity

Non-Celiac Gluten Sensitivity (NCGS) is a syndrome characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food, in subjects that are not affected by either celiac disease (CD) or wheat allergy (WA). Although NCGS is triggered by gluten-containing cereals, the offending dietary protein has not been identified yet, and could include other components such as amylase-trypsin inhibitors (ATIs). Indirect evidence suggests that NCGS is more common than CD. Using a self-administered evaluation incorporating a modified Gastrointestinal Symptom Rating Scale, the patient identifies 1 to 3 main symptoms that are quantitatively assessed using a Numerical Rating Scale ranging from 1 to 10. The double-blind placebo-controlled gluten challenge (8 g/day) includes a one-week challenge followed by a one-week washout of strict gluten free diet (GFD) and by the crossover to the second one-week challenge. The vehicle should contain cooked, homogeneously distributed gluten. A variation of 30% of 1 to 3 main symptoms between the gluten and the placebo challenge should be detected to discriminate a positive from a negative result. Note that NCGS may be transient, therefor gluten tolerance needs to be re-assessed in patients with NCGS.

Carlo Catassi, et al. Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts’ Criteria. Nutrients. 2015 June; 7(6): 4966-4977.

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