Original Contribution | Published:

Colon/Small Bowel

Gastrointestinal Effects of Eating Quinoa (Chenopodium quinoa Willd.) in Celiac Patients

The American Journal of Gastroenterology volume 109, pages 270278 (2014) | Download Citation



Celiac disease is an enteropathy triggered by dietary gluten found in wheat, rye, and barley. Treatment involves a strict gluten-free diet (GFD). Quinoa is a highly nutritive plant from the Andes that has been recommended as part of a GFD. However, in-vitro data suggested that quinoa prolamins can stimulate innate and adaptive immune responses in celiac patients. Therefore, we aimed to evaluate the in-vivo effects of eating quinoa in adult celiac patients.


Nineteen treated celiac patients consumed 50 g of quinoa every day for 6 weeks as part of their usual GFD. We evaluated diet, serology, and gastrointestinal parameters. Furthermore, we carried out detail histological assessment of 10 patients before and after eating quinoa.


Gastrointestinal parameters were normal. The ratio of villus height to crypt depth improved from slightly below normal values (2.8:1) to normal levels (3:1), surface-enterocyte cell height improved from 28.76 to 29.77 μm and the number of intra-epithelial lymphocytes per 100 enterocytes decreased from 30.3 to 29.7. Median values for all the blood tests remained within normal ranges, although total cholesterol (n=19) decreased from 4.6 to 4.3 mmol/l, low-density lipoprotein decreased from 2.46 to 2.45 mmol/l, high-density lipoprotein decreased from 1.8 to 1.68 mmol/l and triglycerides decreased from 0.80 to 0.79 mmol/l.


Addition of quinoa to the GFD of celiac patients was well tolerated and did not exacerbate the condition. There was a positive trend toward improved histological and serological parameters, particularly a mild hypocholesterolemic effect. Overall, this is the first clinical data suggesting that daily 50 g of quinoa for 6 weeks can be safely tolerated by celiac patients. However, further studies are needed to determine the long-term effects of quinoa consumption.

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  1. 1.

    , , et al. Wheat amylase trypsin inhibitors drive intestinal inflammation via activation of toll-like receptor 4. J Exp Med 2012;209:2395–2408.

  2. 2.

    , , et al. World gastroenterology organisation global guidelines on celiac disease. J Clin Gastroenterol 2013;47:121–126.

  3. 3.

    Packaged Facts. Gluten-Free Foods and Beverages in the U.S., 4th edn. Packaged Facts: LA, 2012.

  4. 4.

    . Grains in relation to celiac disease. Cereal Foods World 2001;46:209–210.

  5. 5.

    , , et al. A comparison of diets with and without oats in adults with celiac disease. N Engl J Med 1995;333:1033–1037.

  6. 6.

    , , et al. Unkilned and large amounts of oats in the celiac disease diet: a randomized, controlled study. Scand J Gastroenterol 2008;43:1094–1101.

  7. 7.

    , , et al. Oats induced villous atrophy in celiac disease. Gut 2003;52:1649–1652.

  8. 8.

    , , et al. Immunological indicators of celiac disease activity are not altered by long term oats challenge. Clin Exp Immunol 2013;171:313–318.

  9. 9.

    , , et al. Varietal differences of quinoa's tolerance to saline conditions. Plant Soil 2012;357:117–129.

  10. 10.

    , , et al. Immunological evaluation of the alcohol-soluble protein fraction from gluten-free grains in relation to celiac disease. Mol Nutr Food Res 2011;55:1266–1270.

  11. 11.

    , , et al. Variable activation of immune response by quinoa (Chenopodium quinoa Willd.) prolamins in celiac disease. Am J Clin Nutr 2012;96:337–344.

  12. 12.

    , , et al. First case report of anaphylaxis to quinoa, a novel food in France. Allergy 2009;64:819–820.

  13. 13.

    , , et al. Anaphylaxis to quinoa. Ann Allergy Asthma Immunol 2013;110:60–61.

  14. 14.

    , , et al. The effect of substituting alternative grains in the diet on the nutritional profile of the gluten-free diet. J Hum Nutr Diet 2009;22:359–363.

  15. 15.

    , , et al. Jejunal biopsy: criteria and significance. Scand J Gastroenterol 1966;1:57–74.

  16. 16.

    , , et al. Risk assessment and lipid modification for primary and secondary prevention of cardiovascular disease: summary of NICE guidance. BMJ 2008;336:1246–1248.

  17. 17.

    , , et al. Positive serum antigliadin antibodies without celiac disease in the elderly population: does it matter? Scand J Gastroenterol 2010;45:1197–1202.

  18. 18.

    , , et al. Pitfalls in diagnosing celiac disease. J Clin Pathol 1994;47:693–694.

  19. 19.

    , , et al. Adult celiac patients do tolerate large amounts of oats. Eur J Clin Nutr 2003;57:163–169.

  20. 20.

    , , et al. Seroprevalence, correlates, and characteristics of undetected celiac disease in England. Gut 2003;52:960–965.

  21. 21.

    , , et al. Cholesterol profile in people with newly diagnosed celiac disease: a comparison with the general population and changes following treatment. Br J Nutr 2009;102:509–513.

  22. 22.

    , , et al. Change in lipid profile in celiac disease: beneficial effect of gluten-free diet. Am J Med 2006;119:786–790.

  23. 23.

    , , et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 2005;366:1267–1278.

  24. 24.

    , , et al. LDL-cholesterol-lowering effect of a dietary supplement with plant extracts in subjects with moderate hypercholesterolemia. Eur J Nutr 2013;52:547–557.

  25. 25.

    , , et al. Cholesterol lowering effect of the methanol insoluble materials from the quinoa seed pericarp. In: Katsuyoshi N (ed). Hydrocolloids Elsevier Science: Amsterdam, Holland, 2000, pp 417–422.

  26. 26.

    , , et al. Quinoa extract enriched in 20-hydroxyecdysone protects mice from diet-induced obesity and modulates adipokines expression. Obesity 2012;20:270–277.

  27. 27.

    , , . Histologic follow-up of people with celiac disease on a gluten-free diet. Am J Clin Pathol 2002;118:459–463.

  28. 28.

    , , et al. Duodenal histology in patients with celiac disease after treatment with a gluten-free diet. Gastrointest Endosc 2003;57:187–191.

  29. 29.

    , , et al. The normal range of duodenal intraepithelial lymphocytes. Arch Iran Med 2008;11:136–142.

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We are very grateful to all celiac patients participating in the study.

Author information


  1. King's College London, Division of Diabetes and Nutritional Sciences, Department of Gastroenterology, The Rayne Institute (KCL), Gastroenterology Laboratory, London, UK

    • Victor F Zevallos
    • , Suzanne Donnelly
    • , H Julia Ellis
    •  & Paul J Ciclitira
  2. Departamento de Producción Vegetal, Universidad Politécnica de Madrid, Spain

    • L Irene Herencia
  3. Departament of Histopathology, St Thomas’ Hospital, London, UK

    • Fuju Chang


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Competing interests

Guarantors of the article: Victor F. Zevallos, PhD and Paul J. Ciclitira, MD, PhD.

Specific author contributions: V.F.Z., H.J.E., and P.J.C. conceived and designed the experiments. V.F.Z. performed the experiments. V.F.Z. analyzed the data. L.I.H., F.C., and S.D. contributed reagents/materials. V.F.Z. wrote the manuscript. V.F.Z., L.I.H., H.J.E., and P.J.C. made a critical revision of the manuscript.

Financial support: This work was supported by the Food Standards Agency PG1017.

Potential competing interests: None.

Corresponding authors

Correspondence to Victor F Zevallos or Paul J Ciclitira.

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