Concise Commentary: Gluten-Free Diets—You’ve Gotta Believe in Something

Excerpt

Celiac disease (CD) is an autoimmune disease primarily affecting the small intestinal mucosa that mainly manifests as malabsorption and can be accompanied by numerous inflammatory and neoplastic conditions. The observation that the disease regresses with withdrawal of dietary gluten, in addition to data obtained from extensive basic investigations, strongly supports that an immunological reaction to gluten as the primary environmental disease triggers [1]. The actual prevalence of CD in the USA and other Western nations is ~ 1% (i.e., 3 million Americans) [2]. In recent years, a new entity termed non-celiac gluten sensitivity (NCGS) has been introduced, which, although characterized by symptoms that are reported to be related to the ingestion of gluten, is not CD. The prevalence of NCGS according to self-reported gluten avoidance studies is 0.5–13% of the general population [3, 4]. …