Should you eat a low-gluten diet?

In an intervention study of healthy Danish adults, reported today in Nature Communications, an international team of scientists shows that a low-gluten but fibre-rich diet changes the community of gut bacteria and decreases gastrointestinal discomfort such as bloating and is linked to a modest weight loss. The changes in intestinal comfort and body weight relate to changes in gut bacteria composition and function.

"We demonstrate that, in comparison with a high-gluten diet, a low-gluten, fibre-rich diet induces changes in the structure and function of the complex intestinal ecosystem of bacteria, reduces hydrogen exhalation, and leads to improvements in self-reported bloating. Moreover, we observed a modest weight loss, likely due to increased body combustion triggered by the altered gut bacterial functions," explains the leading principal investigator of the trial, Professor Oluf Pedersen, Novo Nordisk Foundation Center for Basic Metabolic Research at University of Copenhagen.

Change in dietary fibre composition seems to be the cause

The researchers undertook a randomised, controlled, cross-over trial involving 60 middle-aged healthy Danish adults with two eight week interventions comparing a low-gluten diet (2 g gluten per day) and a high-gluten diet (18 g gluten per day), separated by a washout period of at least six weeks with habitual diet (12 g gluten per day).

The two diets were balanced in number of calories and nutrients including the same amount of dietary fibres. However, the composition of fibres differed markedly between the two diets.

Based on their observations of altered food fermentation patterns of the gut bacteria, the researchers conclude that the effects of low-gluten dieting in healthy people may not be primarily due to reduced intake of gluten itself but rather to a change in dietary fibre composition by reducing fibres from wheat and rye and replacing them with fibres from vegetables, brown rice, corn, oat and quinoa.

No basis for change of diet recommendation yet

A low-gluten diet has previously been proposed to diminish gastrointestinal symptoms in patients with inflammatory bowel diseases and irritable bowel syndrome, disorders which occur in up to 20 percent of the general Western population.

The present study suggests that even some healthy individuals may prefer a low-gluten diet to combat intestinal discomfort or excess body weight.

"More long-term studies are definitely needed before any public health advice can be given to the general population. Especially, because we find dietary fibres -- not the absence of gluten alone -- to be the primary cause of the changes in intestinal discomfort and body weight. By now we think that our study is a wake-up call to the food industry. Gluten-free may not necessarily be the healthy choice many people think it is. Most gluten-free food items available on the market today are massively deprived of dietary fibers and natural nutritional ingredients. Therefore, there is an obvious need for availability of fibre-enriched, nutritionally high-quality gluten-free food items which are fresh or minimally processed to consumers who prefer a low-gluten diet. Such initiatives may turn out to be key for alleviating gastro-intestinal discomfort and in addition to help facilitating weight control in the general population via modification of the gut microbiota," concludes senior lead investigator, Professor Oluf Pedersen.