Nonceliac gluten sensitivity may be less prevalent than celiac disease
The national prevalence of nonceliac gluten sensitivity may be lower than initially believed, recent study results suggest.
Researchers evaluated data from 7,762 participants without celiac disease enrolled in the National Health and Nutrition Examination Survey from 2009 to 2010. The cohort underwent physical examination, testing for celiac disease and responded to health questionnaires. Participants who reported adherence to a gluten-free diet were considered to have nonceliac gluten sensitivity.
Gluten-free diet was practiced by 49 participants, indicating a weighted prevalence of 0.548% (95% CI, 0.206 to 0.889), or 1,380,381 people in the United States. Investigators said this estimated prevalence is approximately half that of celiac disease. More females than males reported adherence to a gluten-free diet (0.58% vs. 0.37%; P=.34). Prevalence of the diet did not differ significantly according to race/ethnicity, income or education status.
Participants on a gluten-free diet were older (mean age 46.7 years vs. 40.5 years; P=.005), had a smaller waist circumference (88.2 cm vs. 93.9 cm; P=.03), lower white blood cell count (6,780 cells/mcL vs. 7,080 cells/mcL; P=.03) and a greater HDL cholesterol (63.5 mg/dL vs. 52.9 mg/dL; P=.05) compared with those not on a gluten-free diet.
The researchers said that equating self-reported adherence to a gluten-free diet with nonceliac gluten sensitivity was limited by several variables, including the possibility that patients with self-reported celiac disease who were excluded from analysis may have had nonceliac gluten sensitivity, while others with undiagnosed celiac disease also may have been within the cohort.
“To the degree that self-report gluten-free diet data can be used to approximate nonceliac gluten sensitivity prevalence, the current results suggest the prevalence to be almost half [that of] celiac disease,” the researchers wrote. “This finding is noteworthy, as current clinical inference has suggested that nonceliac gluten sensitivity is far more common than celiac disease. Future studies will be necessary to more completely estimate the prevalence of nonceliac gluten sensitivity and understand whether a gluten-free diet has a causal affect on general health status.”
Disclosure: The researchers report no relevant financial disclosures.