A recent study has found that approximately one in ten people worldwide experience a sensitivity to gluten or wheat, despite not having celiac disease. Researchers from the UK and other countries reviewed multiple studies to determine the prevalence and implications of this condition, known as non-celiac gluten/wheat sensitivity (NCGWS). The findings, published in the journal Gut, suggest that NCGWS is more common than previously understood and is often associated with additional health issues.
Understanding Non-Celiac Gluten Sensitivity
The research team, led by Mohamed Shiha, a gastroenterologist at University Hospitals of Leicester NHS Trust, systematically analyzed 25 studies conducted between 2014 and 2024. These studies involved nearly 50,000 adults across 16 countries. Their analysis revealed that the global rate of self-reported NCGWS stands at 10.3%, but this figure varies significantly across regions. In the UK, the rate is notably higher at 23%, while in Chile, it drops to 0.3%. The United States reports about 5%, although this is based on a single study.
The symptoms associated with NCGWS predominantly include gastrointestinal issues such as bloating, abdominal pain, and diarrhea. Beyond these, individuals also reported experiencing fatigue, joint pain, and headaches. Notably, women are more likely to identify as having NCGWS, which is also more prevalent among individuals suffering from depression, anxiety, and irritable bowel syndrome (IBS).
Challenges in Diagnosis and Treatment
Unlike celiac disease, which can be diagnosed through a simple blood test, NCGWS lacks standardized diagnostic criteria. Shiha emphasizes that this condition is complex, with no single cause identified. He describes NCGWS as an “umbrella term” that encompasses a wide range of individuals who experience symptoms related to gluten or wheat. These symptoms may arise from various underlying mechanisms, such as gut-brain interaction disorders and psychological factors.
In some instances, rising public awareness and media portrayals may influence how individuals interpret their symptoms. Shiha notes that many cases may not be directly linked to gluten or wheat but instead overlap with conditions like IBS. This hypothesis is supported by a recent review published in The Lancet, which posits that many individuals who believe they are sensitive to gluten may actually react to fermentable carbohydrates (FODMAPs) or other components of wheat.
The review also highlights the possibility of a nocebo effect, where the expectation of harm from gluten consumption exacerbates symptoms.
Despite the complexities surrounding NCGWS, the authors advocate for enhanced diagnostic and treatment protocols. They are currently developing clearer, symptom-based criteria to identify the condition and emphasize the importance of managing symptoms without resorting to unnecessarily restrictive diets, which can negatively impact quality of life and nutrition.
This research underscores the need for greater awareness and understanding of non-celiac gluten sensitivity, as well as the importance of tailored approaches to diagnosis and management for those affected.
