Abstract
Abstract Background: The mechanisms behind non-coeliac gluten sensitivity (NCGS) are not fully understood although clinical symptoms have shown to subside after gluten withdrawal. Self-administration of a gluten-free diet (GFD) without medical supervision is common for NCGS patients, resulting in dietary restrictions that can cause macro- and micronutrient deficiencies. Objectives: The objective of this thesis was to describe nutritional status, clinical symptoms and health-related quality of life (HRQoL) in adults with self-reported NCGS on a GFD. Methods: Baseline characteristics were collected from 66 NCGS patients participating in the study ‘Gluten challenge in patients with non-coeliac gluten sensitivity’ at Oslo University Hospital (OUH) Rikshospitalet. Nutritional status was evaluated through anthropometrics, laboratory data and diet history. Intake of nutrients was estimated by a 7-day food dairy. Symptoms were reported via completion of four symptom specific questionnaires assessing gastrointestinal symptoms, fatigue, depression and subjective health complaints. HRQoL was reported by Short-form 36 (SF-36). The term nutritional assessment encompasses all these factors, and is therefore the overarching method used in this study. Results: Results from nutritional assessment in NCGS patients showed that the average body mass index (BMI) was within upper-normal range (24.8 kg/m2). Nutrient deficiencies were hardly seen. Analysis of the food diaries showed that NCGS patients had a higher total fat intake (43 E %), too high intake of saturated fat (14 E %) together with a lower carbohydrate intake than recommended (39 E %), and a low intake of dietary fibre (19 g). Intakes of micronutrients were lower than recommended for calcium, iodine, iron (females), D vitamin and folic acid. Overall, the NCGS patients had persistent symptoms on a GFD. Extra -intestinal symptoms, in particular fatigue and mild depression, were most arduous. HRQoL was reduced for some aspects, especially for the scale comprising fatigue and loss of energy termed vitality. Conclusion: NCGS patients were found to have good nutritional status regarding BMI and laboratory values. Their high proportion of energy from fat and the sub-optimal intakes of iodine, calcium, iron, D vitamin and folic acid, may put patients at risk of nutrient deficiencies. This highlights the importance of dietary education and nutritional follow up. The reduced diet quality may be linked to unnecessary dietary restrictions. Despite being on a GFD, extra-intestinal and gastrointestinal symptoms were present. Though, patients seemed to perceive their health to be better after adapting to a GFD.