Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, 00143 Rome, Italy.
Dipartimento di Scienze e Tecnologie Agrarie, Alimentari, Ambientali e Forestali (DAGRI), Università degli Studi di Firenze, 50144 Firenze, Italy.
Nutrients. 2019 Mar 27;11(4):712. doi: 10.3390/nu11040712.
Patients with non-celiac gluten sensitivity (NCGS) do not have celiac disease, but their symptoms improve after a gluten-free diet (GFD). However, to date, it is uncertain if gluten or other components of wheat are responsible for these symptoms. The aim of this study was to compare the effects of an organic durum wheat variety with those of standard commercial wheat in patients with known NCGS. We performed a double-blind randomized cross-over trial of 42 patients (mean age 45 years, 8 men) with NCGS diagnosed according to the Salerno criteria and adherence to GFD for at least 12 weeks from screening. Enrolled subjects were randomly assigned to one the following groups of treatment: (A) a two-week diet with Senatore Cappelli wheat variety pasta; (B) a two-week diet with standard commercial pasta. Then, after a two-week washout period on gluten-free diet, each patient crossed over to the other treatment group. Symptoms were assessed through a modified version of the Gastrointestinal Symptom Rating Scale (GSRS), tailored on NCGS. Between April 2018 and July 2018, 42 patients with NCGS were enrolled in the study (70.6% females), and 34 patients completed the study. Patients reported lower overall symptoms scores after eating Senatore Cappelli pasta than standard pasta ( = 0.03) and also significantly lower scores in several specific gastrointestinal and extra-intestinal symptoms after eating Senatore Cappelli pasta than standard pasta, specifically, bloating ( = 0.04), abdominal distention ( = 0.004), eructation ( = 0.01), flatus ( = 0.02), feeling of incomplete evacuation ( = 0.001), dermatitis ( = 0.01), and limb numbness ( = 0.03). In our study, patients with NCGS experienced lower gastrointestinal and extra-intestinal symptom scores after eating the Senatore Cappelli wheat variety than a standard commercial wheat. Should our preliminary results be confirmed by further studies, new dietary alternatives may be available to patients with NCGS, with consequent health, economic, and social benefits.
非乳糜泻麸质敏感(NCGS)患者没有乳糜泻,但他们的症状在无麸质饮食(GFD)后会改善。然而,迄今为止,尚不确定是麸质还是小麦的其他成分导致了这些症状。本研究旨在比较有机硬质小麦品种与标准商业小麦在已知 NCGS 患者中的作用。我们对 42 名(平均年龄 45 岁,8 名男性)根据萨勒诺标准诊断为 NCGS 并在筛查后至少遵循 GFD 12 周的患者进行了双盲随机交叉试验。入组患者被随机分配到以下治疗组之一:(A)Senatore Cappelli 小麦品种意大利面的两周饮食;(B)标准商业意大利面的两周饮食。然后,在无麸质饮食的两周洗脱期后,每位患者交叉到另一个治疗组。通过针对 NCGS 定制的胃肠道症状评分量表(GSRS)的改良版评估症状。2018 年 4 月至 7 月期间,共纳入 42 名 NCGS 患者(70.6%为女性),其中 34 名患者完成了研究。与标准意大利面相比,患者食用 Senatore Cappelli 意大利面后总体症状评分较低( = 0.03),并且在食用 Senatore Cappelli 意大利面后,许多特定的胃肠道和肠外症状的评分也显著较低,具体为腹胀( = 0.04)、腹部膨隆( = 0.004)、呃逆( = 0.01)、排气( = 0.02)、排便不尽感( = 0.001)、皮炎( = 0.01)和四肢麻木( = 0.03)。在我们的研究中,NCGS 患者食用 Senatore Cappelli 小麦品种后,胃肠道和肠外症状评分较低。如果我们的初步结果得到进一步研究的证实,那么 NCGS 患者可能会有新的饮食选择,从而带来健康、经济和社会效益。