A Durum Wheat Variety-Based Product Is Effective in Reducing Symptoms in Patients with Non-Celiac Gluten Sensitivity: A Double-Blind Randomized Cross-Over Trial

Abstract

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 (p = 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 (p = 0.04), abdominal distention (p = 0.004), eructation (p = 0.01), flatus (p = 0.02), feeling of incomplete evacuation (p = 0.001), dermatitis (p = 0.01), and limb numbness (p = 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.

Phytochemical Components and Human Health Effects of Old versus Modern Italian Wheat Varieties: The Case of Durum Wheat Senatore Cappelli

“…The interesting issue is that it is not yet clear if gluten or other wheat components are responsible for these symptoms. Ianiro et al [37] studied the effects of Senatore Cappelli durum wheat variety pasta in comparison with a standard commercial wheat pasta obtained by modern wheat varieties in NGCS patients. This double-blind randomized cross-over study has been conducted with a two-week supplementation of both types of pasta with an interval washout period of two weeks.…”

Potential tolerability of ancient grains in non-celiac wheat sensitivity patients: A preliminary evaluation

“…preliminary scientific reports, the most plausible alternative would seem to be a diet that simply replaces "modern" with "ancient" grains (25). However, no studies to date have evaluated the real frequency of ancient wheat variety consumption in NCWS patients diagnosed by the rigorous DBPCC method, or the putative higher tolerability of these wheats in this wheatrelated disease.…”

A Comparative Study of Modern and Heirloom Wheat on Indicators of Gastrointestinal Health

“…This study investigated whether repeated, cyclic breeding of wheat for yielding ability, as represented by the widely grown modern variety Gallagher, induces gastrointestinal inflammation when consumed within the context of a typical WD. The majority of research done comparing heirloom and modern wheat cultivars has been performed within a clinical disease state (e.g., type 2 diabetes, NCGS) or animal models of oxidative stress (i.e., doxorubicin injection), leaving questions as to whether inherent properties of wheat drive reported changes or if these effects are only observed within pre-existing pathologies. ,,− Additionally, these studies largely utilize crossover designs and/or lack a negative control, making it difficult to know if modern wheat has negative properties or if heirloom wheat has beneficial properties. Also, the health effects of modern compared to heirloom wheat are not well characterized in a model more representative of the general population.…”

“…Thus far, the majority of work comparing heirloom and modern wheat has been performed by an Italian research group studying wheat in the context of chronic diseases (e.g., type 2 diabetes, nonalcoholic fatty liver disease). These studies suggest that heirloom wheat has anti-inflammatory properties and improves gastrointestinal symptoms compared to modern wheat. − Similarly, Wistar rats fed heirloom wheat displayed improved indicators of gut health (i.e., duodenal villi height, lymphocyte infiltration) relative to modern wheat when subjected to oxidative stress . Despite this evidence that heirloom wheat has beneficial properties relative to modern wheat in disease states, it is not known whether similar effects are observed in an otherwise healthy population consuming the WD.…”