Diet adherence and gluten exposure in coeliac disease and self-reported non-coeliac gluten sensitivity

Clin Nutr. 2017 Feb;36(1):275-280. doi: 10.1016/j.clnu.2015.11.017. Epub 2015 Dec 10.


Background/objectives: Adherence to gluten-free diet in self reported non-coeliac gluten sensitive subjects is scarcely researched. Objectives of the study were to compare dietary adherence in coeliac disease (CD) subjects and in non-coeliac gluten sensitive (NCGS) subjects, and to estimate gluten exposure based on weighed food records and analysis of gluten content in selected food items.

Subjects/methods: Twenty-three subjects with biopsy verified CD on a gluten-free diet and 34 HLA-DQ2+ NCGS subjects on a self-instituted gluten-free diet were enrolled. The latter group was under investigation of CD. Dietary adherence was assessed by frequency questionnaire and structured forms supplied by weighed food records. For the analyses of food samples, the sandwich R5-ELISA, Ridascreen® Gliadin competitive method was used.

Results: There was no difference in dietary adherence between CD and NCGS subjects (83% vs 68%, p = 0.21). NCGS subjects were mainly self-educated in gluten-free diet compared to CD subjects (91% and 39%, respectively, p < 0.001). In non-adherent subjects, there was no difference in gluten exposure between CD and NCGS (10 vs 138 mg/day, p = 0.83). There was no difference in BMR-factor between CD and NCGS subjects, or between adherent and non-adherent subjects.

Conclusions: Both CD and NCGS subjects were largely adherent, and adherence did not differ between the groups. Gluten exposure varied greatly, and some CD and NCGS subjects reached gluten intake above 500 mg/day, which might have considerable health effects on the individual, especially in case of coeliac disease.

Keywords: Celiac disease; Diet adherence; Gluten contamination; Gluten exposure; Non-celiac gluten sensitivity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Body Mass Index
  • Celiac Disease / diet therapy*
  • Diet, Gluten-Free*
  • Edible Grain / chemistry
  • Female
  • Food Hypersensitivity / diagnosis
  • Food Hypersensitivity / diet therapy
  • Glutens / administration & dosage*
  • HLA-DQ Antigens / genetics
  • Humans
  • Malabsorption Syndromes / diet therapy*
  • Male
  • Middle Aged
  • Nutrition Assessment
  • Patient Compliance*
  • Prolamins / administration & dosage
  • Self Report
  • Young Adult


  • HLA-DQ Antigens
  • HLA-DQ2 antigen
  • HLA-DQ8 antigen
  • Prolamins
  • Glutens