Nutritional Considerations in Celiac Disease and Non-Celiac Gluten/Wheat Sensitivity

Nutrients. 2023 Mar 19;15(6):1475. doi: 10.3390/nu15061475.

Abstract

A gluten-free diet (GFD) is the only available treatment for celiac disease (CeD), and it may also improve symptoms in non-celiac gluten/wheat sensitivity (NCGWS). In CeD, gluten triggers an immune reaction leading to enteropathy, malabsorption, and symptoms; in NCGWS, the mechanism leading to symptoms is unknown, and neither wheat nor gluten triggers enteropathy or malabsorption. A strict GFD is, therefore, necessary for CeD, but a gluten-restricted diet (GRD) may suffice to achieve symptom control for NCGWS. Regardless of this distinction, the risk of malnutrition and macro- and micronutrient deficiencies is increased by the adoption of a GFD or GRD. Thus, patients with CeD or NCGWS should undergo nutritional assessment and subsequent monitoring, based on evidence-based tools, under the care of a multidisciplinary team involving physicians and dietitians, for the long-term management of their nutrition. This review gives an overview of available nutrition assessment tools and considerations for the nutritional management of CeD and NCGWS populations.

Keywords: celiac disease; gluten; nutrition assessment; wheat sensitivity.

Publication types

  • Review

MeSH terms

  • Celiac Disease* / complications
  • Diet, Gluten-Free
  • Glutens / adverse effects
  • Humans
  • Nutritional Status

Substances

  • Glutens

Grants and funding

MIPS received an AFP Gastroenterology Division and HAHSO AFP Innovation grant Project # HAH-22-002. DA holds the Douglas Family Chair in Nutrition Research.