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A gluten-free diet (GFD) is a diet that strictly excludes gluten, a mixture of proteins found in wheat and related grains, including barley, rye, oat, and all their species and hybrids (such as spelt, kamut, and triticale). The inclusion of oats in a gluten-free diet remains controversial. Oat toxicity in people with gluten-related disorders depends on the oat cultivar consumed because the immunoreactivities of toxic prolamins are different among oat varieties. Furthermore, oats are frequently cross-contaminated with other gluten-containing cereals.
Gluten causes health problems for those with gluten-related disorders, including celiac disease (CD), non-celiac gluten sensitivity (NCGS), gluten ataxia, dermatitis herpetiformis (DH) and wheat allergy. In these patients, the gluten-free diet is demonstrated as an effective treatment, but several studies show that about 79% of the people with coeliac disease have an incomplete recovery of the small bowel, despite a strict gluten-free diet. This is mainly caused by inadvertent ingestion of gluten. People with poor basic education and understanding of gluten-free diet often believe that they are strictly following the diet, but are making regular errors.
In addition, a gluten-free diet may, in at least some cases, improve gastrointestinal and/or systemic symptoms in diseases like irritable bowel syndrome, rheumatoid arthritis, multiple sclerosis or HIV enteropathy, among others. Gluten-free diets have also been promoted as an alternative treatment of people with autism, but the current evidence for their efficacy in treating the symptoms of autism is limited and weak.
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