Tuesday, 21 April 2015

Jessica Biesiekierski on non-coeliac gluten sensitivity (NCGS)

It's not often that I dedicate a blog post to a specific individual and their views and opinions on a particular topic. Today however, I'm doing just that to provide you with a link to the paper from Jessica Biesiekierski on the topic of non-coeliac gluten sensitivity (NCGS) [1] (open-access).

The reason? Well, aside from being one of the primary protagonists in the research topic of gluten-related ills outside of the autoimmune condition known as coeliac (celiac) disease (itself the topic of some considerable bafflement to me), the work from Dr Biesiekierski and others has also invited quite a bit more inspection of other dietary components ("FODMAPs: Fermentable Oligo-, Di-, and Mono-saccharides And Polyols") as potentially taking the strain off just gluten/wheat when it comes to ideas about health and wellbeing.

The review paper is open-access so no need for any grand discussions from me on the topic. I will however extract a choice quote or two from the paper with some comment. So: "There is some evidence that NCGS may exist, but probably only in a small number of people." I would second that statement particularly in light of recent discussions (see here). I might also direct you to some of the discussions from Brusca [2] too, and the idea that: "About half of NCGS patients are DQ2 positive and have IgG AGA [Anti-gliadin antibodies]."

Also: "Currently, there is no evidence for efficacy of gluten exclusion in mental disorders... therefore care must be given when discussing these early results and awareness given to understanding that a major effect of gluten in NCGS patients may be in the perception of their general well-being." Accepting that the term 'mental disorders' is not one that I would necessarily use and certainly not when using it in the context of referencing the paper from Millward and colleagues [3] and the Cochrane Review of gluten- and casein-free diets for [some] autism, I'd be minded to disagree with such a final statement. As has been mentioned previously on this blog, there is evidence for issues with gluten in some cases of conditions like schizophrenia (see here) and autism (see here). Insofar as 'no evidence of efficacy of gluten exclusion', well, again I'd be minded to suggest there have been hints that there may be more to see in this area (see here for example) albeit with the requirement for further, more experimentally strong research to be conducted. This also includes the notion that there may be best and non-responders to this type of intervention (see here) and that core autism symptoms might not be the primary 'target' of such dietary interventions.

And if you really want yet more reviews of NCGS, then look no further [4] or further [5] or further [6]...

Music: OutKast - Ms. Jackson. Oh, and how would art look without the gluten?

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[1] Biesiekierski JR. Non-coeliac gluten sensitivity: piecing the puzzle together. United European Gastroenterology Journal. 2015; 3: 160-165.

[2] Brusca I. Overview of biomarkers for diagnosis and monitoring of celiac disease. Adv Clin Chem. 2015;68:1-55.

[3] Millward C. et al. Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD003498.

[4] Czaja-Bulsa G. Non coeliac gluten sensitivity – A new disease with gluten intolerance. Clinical Nutrition. 2015; 34: 189-194.

[5] Molina-Infante J. et al. Systematic review: noncoeliac gluten sensitivity. Aliment Pharmacol Ther. 2015 May;41(9):807-20.

[6] Fasano A. et al. Nonceliac Gluten Sensitivity. Gastroenterology. 2015 Jan 9. pii: S0016-5085(15)00029-3.

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ResearchBlogging.org Biesiekierski, J., & Iven, J. (2015). Non-coeliac gluten sensitivity: piecing the puzzle together United European Gastroenterology Journal, 3 (2), 160-165 DOI: 10.1177/2050640615578388