Randomised clinical trial: gluten may cause depression in subjects with non-coeliac gluten sensitivity - an exploratory clinical study

Simone Louise Peters, Jessica Rose Biesiekierski, Gregory Wayne Yelland, Jane Grey Muir, Peter Raymond Gibson

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Abstract

Background Current evidence suggests that many patients with self-reported non-coeliac gluten sensitivity (NCGS) retain gastrointestinal symptoms on a gluten-free diet (GFD) but continue to restrict gluten as they report feeling better . Aim To investigate the notion that a major effect of gluten in those with NCGS is on mental state and not necessarily on gastrointestinal symptoms. Methods Twenty-two subjects (24-62 years, five male) with irritable bowel syndrome who had coeliac disease excluded but were symptomatically controlled on a GFD, undertook a double-blind cross-over study. Participants randomly received one of three dietary challenges for 3 days, followed by a minimum 3-day washout before crossing over to the next diet. Challenge gluten-free food was supplemented with gluten (16 g/day), whey (16 g/day) or not supplemented (placebo). End-points included mental state as assessed by the Spielberger State Trait Personality Inventory (STPI), cortisol secretion and gastrointestinal symptoms. Results Gluten ingestion was associated with higher overall STPI state depression scores compared to placebo [M = 2.03, 95 CI (0.55-3.51), P = 0.010] but not whey [M = 1.48, 95 CI (-0.14 to 3.10), P = 0.07]. No differences were found for other STPI state indices or for any STPI trait measures. No difference in cortisol secretion was identified between challenges. Gastrointestinal symptoms were induced similarly across all dietary challenges. Conclusions Short-term exposure to gluten specifically induced current feelings of depression with no effect on other indices or on emotional disposition. Gluten-specific induction of gastrointestinal symptoms was not identified. Such findings might explain why patients with non-coeliac gluten sensitivity feel better on a gluten-free diet despite the continuation of gastrointestinal symptoms
Original languageEnglish
Pages (from-to)1104 - 1112
Number of pages9
JournalAlimentary Pharmacology and Therapeutics
Volume39
Issue number10
DOIs
Publication statusPublished - 2014

Cite this

@article{fad7c76a8fef4b9a9a385d6b5467b67d,
title = "Randomised clinical trial: gluten may cause depression in subjects with non-coeliac gluten sensitivity - an exploratory clinical study",
abstract = "Background Current evidence suggests that many patients with self-reported non-coeliac gluten sensitivity (NCGS) retain gastrointestinal symptoms on a gluten-free diet (GFD) but continue to restrict gluten as they report feeling better . Aim To investigate the notion that a major effect of gluten in those with NCGS is on mental state and not necessarily on gastrointestinal symptoms. Methods Twenty-two subjects (24-62 years, five male) with irritable bowel syndrome who had coeliac disease excluded but were symptomatically controlled on a GFD, undertook a double-blind cross-over study. Participants randomly received one of three dietary challenges for 3 days, followed by a minimum 3-day washout before crossing over to the next diet. Challenge gluten-free food was supplemented with gluten (16 g/day), whey (16 g/day) or not supplemented (placebo). End-points included mental state as assessed by the Spielberger State Trait Personality Inventory (STPI), cortisol secretion and gastrointestinal symptoms. Results Gluten ingestion was associated with higher overall STPI state depression scores compared to placebo [M = 2.03, 95 CI (0.55-3.51), P = 0.010] but not whey [M = 1.48, 95 CI (-0.14 to 3.10), P = 0.07]. No differences were found for other STPI state indices or for any STPI trait measures. No difference in cortisol secretion was identified between challenges. Gastrointestinal symptoms were induced similarly across all dietary challenges. Conclusions Short-term exposure to gluten specifically induced current feelings of depression with no effect on other indices or on emotional disposition. Gluten-specific induction of gastrointestinal symptoms was not identified. Such findings might explain why patients with non-coeliac gluten sensitivity feel better on a gluten-free diet despite the continuation of gastrointestinal symptoms",
author = "Peters, {Simone Louise} and Biesiekierski, {Jessica Rose} and Yelland, {Gregory Wayne} and Muir, {Jane Grey} and Gibson, {Peter Raymond}",
year = "2014",
doi = "10.1111/apt.12730",
language = "English",
volume = "39",
pages = "1104 -- 1112",
journal = "Alimentary Pharmacology and Therapeutics",
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}

Randomised clinical trial: gluten may cause depression in subjects with non-coeliac gluten sensitivity - an exploratory clinical study. / Peters, Simone Louise; Biesiekierski, Jessica Rose; Yelland, Gregory Wayne; Muir, Jane Grey; Gibson, Peter Raymond.

In: Alimentary Pharmacology and Therapeutics, Vol. 39, No. 10, 2014, p. 1104 - 1112.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Randomised clinical trial: gluten may cause depression in subjects with non-coeliac gluten sensitivity - an exploratory clinical study

AU - Peters, Simone Louise

AU - Biesiekierski, Jessica Rose

AU - Yelland, Gregory Wayne

AU - Muir, Jane Grey

AU - Gibson, Peter Raymond

PY - 2014

Y1 - 2014

N2 - Background Current evidence suggests that many patients with self-reported non-coeliac gluten sensitivity (NCGS) retain gastrointestinal symptoms on a gluten-free diet (GFD) but continue to restrict gluten as they report feeling better . Aim To investigate the notion that a major effect of gluten in those with NCGS is on mental state and not necessarily on gastrointestinal symptoms. Methods Twenty-two subjects (24-62 years, five male) with irritable bowel syndrome who had coeliac disease excluded but were symptomatically controlled on a GFD, undertook a double-blind cross-over study. Participants randomly received one of three dietary challenges for 3 days, followed by a minimum 3-day washout before crossing over to the next diet. Challenge gluten-free food was supplemented with gluten (16 g/day), whey (16 g/day) or not supplemented (placebo). End-points included mental state as assessed by the Spielberger State Trait Personality Inventory (STPI), cortisol secretion and gastrointestinal symptoms. Results Gluten ingestion was associated with higher overall STPI state depression scores compared to placebo [M = 2.03, 95 CI (0.55-3.51), P = 0.010] but not whey [M = 1.48, 95 CI (-0.14 to 3.10), P = 0.07]. No differences were found for other STPI state indices or for any STPI trait measures. No difference in cortisol secretion was identified between challenges. Gastrointestinal symptoms were induced similarly across all dietary challenges. Conclusions Short-term exposure to gluten specifically induced current feelings of depression with no effect on other indices or on emotional disposition. Gluten-specific induction of gastrointestinal symptoms was not identified. Such findings might explain why patients with non-coeliac gluten sensitivity feel better on a gluten-free diet despite the continuation of gastrointestinal symptoms

AB - Background Current evidence suggests that many patients with self-reported non-coeliac gluten sensitivity (NCGS) retain gastrointestinal symptoms on a gluten-free diet (GFD) but continue to restrict gluten as they report feeling better . Aim To investigate the notion that a major effect of gluten in those with NCGS is on mental state and not necessarily on gastrointestinal symptoms. Methods Twenty-two subjects (24-62 years, five male) with irritable bowel syndrome who had coeliac disease excluded but were symptomatically controlled on a GFD, undertook a double-blind cross-over study. Participants randomly received one of three dietary challenges for 3 days, followed by a minimum 3-day washout before crossing over to the next diet. Challenge gluten-free food was supplemented with gluten (16 g/day), whey (16 g/day) or not supplemented (placebo). End-points included mental state as assessed by the Spielberger State Trait Personality Inventory (STPI), cortisol secretion and gastrointestinal symptoms. Results Gluten ingestion was associated with higher overall STPI state depression scores compared to placebo [M = 2.03, 95 CI (0.55-3.51), P = 0.010] but not whey [M = 1.48, 95 CI (-0.14 to 3.10), P = 0.07]. No differences were found for other STPI state indices or for any STPI trait measures. No difference in cortisol secretion was identified between challenges. Gastrointestinal symptoms were induced similarly across all dietary challenges. Conclusions Short-term exposure to gluten specifically induced current feelings of depression with no effect on other indices or on emotional disposition. Gluten-specific induction of gastrointestinal symptoms was not identified. Such findings might explain why patients with non-coeliac gluten sensitivity feel better on a gluten-free diet despite the continuation of gastrointestinal symptoms

UR - http://onlinelibrary.wiley.com/doi/10.1111/apt.12730/pdf

U2 - 10.1111/apt.12730

DO - 10.1111/apt.12730

M3 - Article

VL - 39

SP - 1104

EP - 1112

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

SN - 0269-2813

IS - 10

ER -