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Coeliac disease

Effect of expectation of gluten intake on non-coeliac gluten sensitivity

Nature Reviews Gastroenterology & Hepatology volume 21, page 71 (2024)Cite this article

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People with non-coeliac gluten sensitivity (NCGS) report gastrointestinal symptoms after gluten consumption in the absence of coeliac disease or wheat allergy. However, the mechanism by which gluten can induce gastrointestinal symptoms in individuals with NCGS is unclear. In a new study published in The Lancet Gastroenterology & Hepatology, researchers conducted a randomized, double-blind study that assessed whether gluten-induced gastrointestinal symptoms were influenced by expectancy — that is, whether participants expected to consume gluten or not.

301 individuals were pre-screened and 165 individuals were fully screened for eligibility, and 84 adults with NCGS (n = 83 in the per-protocol analysis) were randomly assigned to one of four groups based on those who expected (E+) or did not expect (E−) to consume gluten, and those who consumed (G+) or did not consume (G−) gluten as part of the study. Thus, the study groups were E+G+, E+G−, E−G+, and E−G−. Participants, who were not aware of the expectancy aspect of the study, consumed gluten-free or gluten-containing oat bread for breakfast and lunch.

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Original article

  • de Graaf, M. C. G. et al. The effect of expectancy versus actual gluten intake on gastrointestinal and extra-intestinal symptoms in non-coeliac gluten sensitivity: a randomised, double-blind, placebo-controlled, international, multicentre study. Lancet Gastroenterol. Hepatol. https://doi.org/10.1016/S2468-1253(23)00317-5 (2024)

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  1. Nature Reviews Gastroenterology & Hepatology http://www.nature.com/nrgastro/

    Jordan Hindson

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  1. Jordan Hindson
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Correspondence to Jordan Hindson.

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Hindson, J. Effect of expectation of gluten intake on non-coeliac gluten sensitivity. Nat Rev Gastroenterol Hepatol 21, 71 (2024). https://doi.org/10.1038/s41575-024-00894-4

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  • DOI: https://doi.org/10.1038/s41575-024-00894-4

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