Gluten exerts null effect on youth with gastrointestinal symptoms

The addition of gluten to the diet is detrimental to neither the gastrointestinal (GI) symptoms in young people nor their mental health, according to a study.

Researchers looked at 273 youths with at least four different GI symptoms to examine whether gluten induced GI symptoms, measured by self-reported questionnaires, as well as mental health symptoms.

The study involved two phases. Phase one (n=54) was a run-in phase where the participants lived gluten-free for 2 weeks. If their symptoms improved, the participants continued to phase 2 (n=33; median age 20 years, 32 female) where they were randomized to start with 7 days of gluten, eating two granola bars containing 10 g of gluten, or to 7 days on placebo, eating two granola bars without gluten. Afterwards, the two groups received the alternative intervention, separated by a 7-day washout period.

At the beginning of phase 1, the median average visual analogue scale (VAS) score (symptom assessed on a 100-mm, where 100 represented the worst symptoms ever experienced) was 55. After 2 weeks of a gluten-free diet, the median average VAS significantly dropped to 21 (p<0.0000). The SF-36 mental component score (mcs; 0–100, with the highest being the best) was 47.0 (SD 11.2).

The three most dominating symptoms at baseline were flatulence (median VAS 27), borborygmi (median VAS 26), and the feeling of incomplete evacuation after toilet visits (median VAS 23). With regard to HLA status, 55 percent of the participants (18/33) were positive for HLA DQ2 and/or HLA DQ8.

Compared with a placebo, gluten did not induce GI symptoms (average VAS difference, −0.01, 95 percent confidence interval, −2.07 to 2.05). Likewise, there was no difference in mental health outcomes.