GLUTEN AND MENTAL FUNCTION: ANOTHER MYTH DESTROYED

Gluten is a protein present in wheat, barley, and rye. It is a ubiquitous component of Western diet, with an estimated intake averaging about one to five teaspoons/day. In celiac disease, gluten triggers severe immune responses that cause intestinal damage. In addition to severe gastrointestinal disruption, this immune reaction has been linked to multiple neuropsychiatric symptoms, including cognitive impairment, depression, and anxiety, as suggested in several previous reviews. One study of 11 patients with celiac disease claimed that following a gluten-free diet for a year, not only was intestinal healing noted, but modest improvement in cognitive performance was observed..

Although gluten is not generally believed to cause harm to individuals without celiac disease, gluten-free diets have become increasingly popular in the United States. According to the National Health and Nutrition Examination Survey, the percentage of people without celiac disease that avoided gluten increased from roughly 0.5% in 2009 to a range of 20-23% in 2014, while, during the same period, the prevalence of celiac disease itself remained low (approximately 0.7%). Since the 2013 publication of Grain Brain, a New York Times best-selling book that has been translated into more than 30 languages, the assertion that gluten has a deleterious effect on mental health has become popularized among the general public. However, no systematic study had been undertaken to explore the relationship between gluten intake and cognitive function among individuals without celiac disease or any other type of gluten sensitivity. As a response, a new study, applying sophisticated tools of mental assessment, investigated whether long-term gluten intake might cause cognitive dysfunction. They studied a cohort of women at midlife without celiac disease, relating this to dietary data collected over 2 decades. The study included 13 494 women at midlife, and they found that there was no statistical evidence of any association of long- or short-term gluten intake with cognitive function. Thus these findings established that, in the absence of celiac disease, restriction of dietary gluten to maintain cognitive function is not warranted.

I might also add that there are no other reasons to restrict gluten in normal individuals. Since gluten is an important component of a normal and tasty diet, its restriction may even produce deleterious results by interfering with proper nutrition.

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