Ljiljana Bjelaković, Milovan Bratić, Saša Pantelić, Nebojša Ranđelović, Ana Lilić, Danica Piršl

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The aim of this paper is to present the latest scientific data related to a gluten-free diet, the justification of the introduction of a diet, the advantages and disadvantages of this dietary approach in the population of athletes. Non-celiac gluten sensitivity, previously defined as gluten sensitivity, is a relatively new clinical entity first defined in 2011. This disorder is characterized by intestinal symptoms (abdominal pain, bloating, diarrhea, and constipation) and extra intestinal symptoms such as headache, chronic fatigue, impaired concentration or “brain fog”, numbness and muscle or bone pain are frequently reported. Since most of the symptoms are subjective without accompanying clinical signs, and since no specific biomarker for diagnostics exists in clinical practice, there is always a dilemma whether this is really a health problem. A gluten-free diet has become popular among athletes due to the opinion that it has ergogenic effects. It should also be borne in mind that the introduction of a gluten-free diet has its drawbacks. Several studies suggest that a gluten-free diet is deficient in whole grains, dietary fiber, micronutrients and minerals. The data collected from the National Health and Nutrition Examination Survey study indicate the existence of higher concentrations of heavy metals in urine and blood samples taken from people following a gluten-free diet as a result of narrowed food choices. These data remind us to keep in mind the justification of the introduction of a gluten-free diet and the potential damage to health when observed adherence to this pattern of nutrition in the long run.


Gluten-Free Diet, Athletes, Non-Celiac Gluten Sensitivity, Effects

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Biesiekierski, J.R., Newnham, E.D., Irving, P.M., Barrett, J.S., Haines, M., Doecke, J.D., et al. (2011). Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial. The American Journal of Gastroenterology, 106(3), 508-514.

Capili, B., Chang, M., & Anastasi, J.K. (2014). A clinical update: Nonceliac gluten sensitivity-Is it really the gluten? The Journal for Nurse Practitioners, 10(9), 666–673.

Catassi, C., Elli, L., Bonaz, B., Bouma, G., Carroccio, A., Castillejo, G., et al. (2015). Diagnosis of non-celiac gluten sensitivity (NCGS): The Salerno experts’ criteria. Nutrients, 7(6), 4966-4977.

De Palma, G., Nadal, I., Collado, M.C., & Sanz, Y. (2009). Effects of a gluten-free diet on gut microbiota and immune function in healthy adult human subjects. British Journal of Nutrition, 102(8), 1154-1177.

Di Sabatino, A., & Corazza, G. R. (2012). Nonceliac gluten sensitivity: sense or sensibility? Annals of Internal Medicine, 156(4), 309-311.

Di Sabatino, A., Volta, U., Salvatore, C., Biancheri, P., Caio, G., De Giorgio, R., et al. (2015). Small amounts of gluten in subjects with suspected nonceliac gluten sensitivity: a randomized, double-blind, placebo-controlled, cross-over trial. Clinical Gastroenterology and Hepatology, 13(9), 1604-1612.

Elli, L., Tomba, C., Branchi, F., Roncoroni, L., Lombardo, V., Bardella, M., et al. (2016). Evidence for the presence of non-celiac gluten sensitivity in patients with functional gastrointestinal symptoms: Results from a multicenter randomized double-blind placebo-controlled gluten challenge. Nutrients, 8(2), 84-97.

Francavilla, R., Cristofori, F., Verzillo, L., Gentile, A., Castellaneta, S., Polloni, C., et al. (2018). Randomized double-blind placebo-controlled crossover trial for the diagnosis of non-celiac gluten sensitivity in children. The American Journal of Gastroenterology, 113(3), 421-430.

Gómez, L., Martin, E., Hernández, D., Sánchez-Monge, R., Barber, D., del Pozo, V., et al. (1990). Members of the α-amylase inhibitors family from wheat endosperm are major allergens associated with baker’s asthma. FEBS Letters, 261(1), 85-88.

Junker, Y., Zeissig, S., Kim, S.J., Barisani, D., Wieser, H., Leffler, D.A., et al. (2012). Wheat amylase trypsin inhibitors drive intestinal inflammation via activation of toll-like receptor 4. The Journal of Experimental Medicine, 209(13), 2395-2408.

Lebwohl, B., Cao, Y., Zong, G., Hu, F.B., Green, P.H.R., Neugut, A.I., et al. (2017). Long term gluten consumption in adults without celiac disease and risk of coronary heart disease: prospective cohort study. British Medical Journal, doi:10.1136/bmj.j1892

Lis, D.M., Stellingwerff, T., Kitic, C.M., Ahuja, K.D.K., & Fell, J.W. (2015a). No effects of a short-term gluten-free diet on performance in nonceliac athletes. Medicine and Science in Sports and Exercise. doi:10.1249/MSS.0000000000000699.

Lis, D.M., Stellingwerff, T., Shing, C.M., Ahuja, K.D.K., & Fell, J.W. (2015b). Exploring the popularity, experiences, and beliefs surrounding gluten-free diets in nonceliac athletes. International Journal of Sport Nutrition and Exercise Metabolism, 25(1), 37-45.

Ludvigsson, J.F., Lebwohl, B., Chen, Q., Bröms, G., Wolf, R.L., Green, P.H.R., et al. (2018). Anxiety after coeliac disease diagnosis predicts mucosal healing: a population-based study. Alimentary Pharmacology and Therapeutics. doi:10.1111/apt.14991

Ludvigsson, J.F., Leffler, D.A., Bai, J.C., Biagi, F., Fasano, A., Green, P.H.R., et al. (2013). The Oslo definitions for coeliac disease and related terms. Gut, 62(1), 43-52.

Marković, D., Bjelaković, B., Jović, M., Ilić, D., & Popović, D. (2019). Necelijačna glutenska senzitivnost-dijagnostički i terapijski izazov (Non celiac gluten sensivity-Diagnostic and therapeutic challenges). Preventivna pedijatrija, 6(1-2), 14-18. In Serbian

Martin, J., Geisel, T., Maresch, C., Krieger, K., & Stein, J. (2013). Inadequate nutrient intake in patients with celiac disease: Results from a German dietary survey. Digestion, 87(4), 240-246.

Raehsler, S., Choung, R.S., Marietta, E.V., & Murray, J.A. (2018). Accumulation of heavy metals in people on a gluten-free diet. Clinical Gastroenterology and Hepatology, 16(2), 244-251.

Sapone, A., Bai, J.C., Ciacci, C., Dolinsek, J., Green, P.H.R., Hadjivassiliou, M., et al. (2012). Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Medicine, 10(1), 1-12.

Skodje, G.I., Sarna, V.K., Minelle, I.H., Rolfsen, K.L., Muir, J.G., Gibson, P.R., et al. (2018). Fructan, rather than gluten, induces symptoms in patients with self-reported non-celiac gluten sensitivity. Gastroenterology, 154(3), 529-539.

Vici, G., Belli, L., Biondi, M., & Polzonetti, V. (2016). Gluten free diet and nutrient deficiencies: a review. Clinical Nutrition, 35(6), 1236-1241.

Zanini, B., Baschè, R., Ferraresi, A., Ricci, C., Lanzarotto, F., Marullo, M., et al. (2015). Randomised clinical study: Gluten challenge induces symptom recurrence in only a minority of patients who meet clinical criteria for non-coeliac gluten sensitivity. Alimentary Pharmacology and Therapeutics, 42(8), 968-976.

Zevallos, V.F., Raker, V., Tenzer, S., Jimenez-Calvente, C., Ashfaq-Khan, M., Rüssel, N., et al. (2017). Nutritional wheat amylase-trypsin inhibitors promote intestinal inflammation via activation of myeloid cells. Gastroenterology, 152(5), 1100-1113.

Zong, G., Lebwohl, B., Hu, F.B., Sampson, L., Dougherty, L.W., Willett, W.C., et al. (2018). Gluten intake and risk of type 2 diabetes in three large prospective cohort studies of US men and women. Diabetologia, 61(10), 2164-2173.



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