Non-celiac wheat sensitivity?

I’ve long suspected that everyone has some degree of sensitivity to gluten, even if they’ve never been formally diagnosed and even if they don’t notice any overt symptoms after eating it. Now we have concrete evidence that non-celiac gluten sensitivity actually exists. My own story was that of a lifetime grain-eater who defended my “right” to eat grains until I was 47 – until the evidence was just too overwhelming to ignore. Once I gave them up as part of a 30-day experiment, lo and behold, my arthritis cleared up, my lifelong IBS went away, and my occasional GERD disappeared. Ditching grains, especially wheat, changed my life for forever and made me understand how easy it is for so many people to overlook this possible problem.

A recent study … confirmed the existence of non-celiac wheat sensitivity. Subjects without the atrophied villi (tiny projects that line the intestines and help absorb nutrients) characteristic of celiac and without positive tests for various markers that indicate celiac experienced gluten-related symptoms after a blinded wheat challenge. It doesn’t give us much of a clue as to the prevalence of sensitivity, but it establishes that such a thing might exist among the general population.

It’s not even the only study. It’s just the latest of many to establish and/or hint that non-celiac gluten sensitivity exists:

• “Spectrum of gluten-related disorders: consensus on new nomenclature and classification.” (2012)
• “Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial.” (2011)
• “Is gliadin really safe for non‐coeliac individuals? Production of interleukin 15 in biopsy culture from non‐coeliac individuals challenged with gliadin peptides.” (2007)

While I too suspect that there are more disesaes caused by cereal-grain than celiac disease alone, it seems all a bit murky still what other adverse health effects grains have – and especially what the mechanisms are.

We'll see. But it is always nice to see that Mark has gathered together some studies for the topic.

The occurrence of Celiac Disease has increased in the US

Natural history of celiac disease autoimmunity in a USA cohort followed since 1974.
…
During a 15-year period CD prevalence increased 2-fold in the CLUE cohort and 5-fold overall in the US since 1974. The CLUE study demonstrated that this increase was due to an increasing number of subjects that lost the immunological tolerance to gluten in their adulthood.

Key Differences Between Celiac Disease and Gluten Sensitivity

Key Differences Between CD and Gluten Sensitivity

Study from University of Maryland Center for Celiac Research Places Gluten Sensitivity on Center Stage of Spectrum of Gluten-Related Disorders

Baltimore, MD – March 10, 2011. Scientists at the University of Maryland School of Medicine’s Center for Celiac Research have proven that gluten sensitivity is different from celiac disease at the molecular level and in the response it elicits from the immune system. The research, published online in BMC Medicine, provides the first scientific evidence of a different mechanism leading to gluten sensitivity. It also demonstrates that gluten sensitivity and celiac disease are part of a spectrum of gluten-related disorders.

"We found differences in levels of intestinal permeability and expression of genes regulating the immune response in the gut mucosa," says lead investigator Alessio Fasano, M.D., professor of pediatrics, medicine and physiology at the University of Maryland School of Medicine and director of the Center for Celiac Research. The research documents the genes and the pathways—a sequence of reactions in the small intestine—possibly associated with gluten sensitivity. "Identifying and isolating specific 'biomarkers' in the immune response of people with gluten sensitivity could lead to diagnostic tools for the condition," says Dr. Fasano, who also directs the University of Maryland School of Medicine Mucosal Biology Research Center.

…

Subclinical celiac disease and gluten sensitivity

Jamie Scott has some interesting things about subclinical celiac disease and gluten sensitivity:

Treat the symptoms - not the test.  If you suspect any issue with gluten anywhere on the spectrum of possibility, take it out for a period of time and see how you feel.  I really see little point in someone feeling better being gluten free but being given the green light to eat the stuff because they threw a negative tTg test...  And parts of this review also call into question the common instruction given by doctors and dietitians to not exclude gluten from the diet as this makes it harder to diagnose via biopsy.

Make sure to read the study extracts he posted.

And related to this: Is a gluten free diet the sport person’s secret weapon?