虽然无麸质饮食法2010年代在欧美掀起新风潮，乃至美国食品药品监督管理局（FDA）自2014年针对无麸质食品颁布新标准，一些连锁餐厅也开始为顾客提供无麸质菜肴，但是有不少餐厅表示，无法保证和承诺这些餐点完全不含麸质；一些顾客抱怨称餐点含有麸质，并表示食用后肠胃不适。根据统计，全美国约有两三百万民眾患有乳糜泻消化性疾病，他们食用麸质后会出现肠胃不适。另根据全美乳糜泻觉醒基金会（National Foundation for Celiac Awareness）估计，还有1800万美国人对麦麸过敏，他们声称食用麸质食品后会发生腹泻、贫血及其他类似乳糜泻疾病的症状。2013年市场调查机构NPD Group的一份报告显示，近3成美国民眾表示会避开含麸质的食品，高于3年前的25.5%[11][12]。
^ 2.02.12.22.32.42.52.6Penagini F, Dilillo D, Meneghin F, Mameli C, Fabiano V, Zuccotti GV. Gluten-free diet in children: an approach to a nutritionally adequate and balanced diet. Nutrients. Nov 18, 2013, 5 (11): 4553–65. PMC 3847748. PMID 24253052. doi:10.3390/nu5114553. For CD patients on GFD, the nutritional complications are likely to be caused by the poor nutritional quality of the GFPs mentioned above and by the incorrect alimentary choices of CD patients. (...) the limited choice of food products in the diet of children with CD induces a high consumption of packaged GFPs, such as snacks and biscuits. (..) It has been shown that some commercially available GFPs have a lower content of folates, iron and B vitamins or are not consistently enriched/fortified compared to their gluten containing counterparts. (...) The first step towards a balanced diet starts from early education on CD and GFD, possibly provided by a skilled dietitian and/or by a physician with expert knowledge in CD. (...) It is advisable to prefer consumption of naturally GF foods, since it has been shown that they are more balanced and complete under both the macro- and micro-nutrient point of view. In fact, these foods are considered to have a higher nutritional value in terms of energy provision, lipid composition and vitamin content as opposed to the commercially purified GF products. Within the range of naturally GF foods, it is preferable to consume those rich in iron and folic acid, such as leafy vegetables, legumes, fish and meat. During explanation of naturally GF foods to patients, it is a good approach for healthcare professionals to bear in mind the local food habits and recipes of each country. This may provide tailored dietary advice, improving acceptance and compliance to GFD. Furthermore, increasing awareness on the availability of the local naturally GF foods may help promote their consumption, resulting in a more balanced and economically advantageous diet. Indeed, these aspects should always be addressed during dietary counseling. With regards to the commercially purified GFPs, it is recommended to pay special attention to the labeling and chemical composition. (...) Increasing awareness on the possible nutritional deficiencies associated with GFD may help healthcare professionals and families tackle the issue by starting from early education on GFD and clear dietary advice on how to choose the most appropriate gluten-free foods.
^Mulder CJ, van Wanrooij RL, Bakker SF, Wierdsma N, Bouma G. Gluten-free diet in gluten-related disorders. Dig Dis. (Review). 2013, 31 (1): 57–62. PMID 23797124. doi:10.1159/000347180. The only treatment for CD, dermatitis herpetiformis (DH) and gluten ataxia is lifelong adherence to a GFD.
^Hischenhuber C, Crevel R, Jarry B, Mäki M, Moneret-Vautrin DA, Romano A, Troncone R, Ward R. Review article: safe amounts of gluten for patients with wheat allergy or coeliac disease. Aliment Pharmacol Ther. Mar 1, 2006, 23 (5): 559–75. PMID 16480395. doi:10.1111/j.1365-2036.2006.02768.x. For both wheat allergy and coeliac disease the dietary avoidance of wheat and other gluten-containing cereals is the only effective treatment.
^Volta U, Caio G, De Giorgio R, Henriksen C, Skodje G, Lundin KE. Non-celiac gluten sensitivity: a work-in-progress entity in the spectrum of wheat-related disorders. Best Pract Res Clin Gastroenterol. Jun 2015, 29 (3): 477–91. PMID 26060112. doi:10.1016/j.bpg.2015.04.006. A recently proposed approach to NCGS diagnosis is an objective improvement of gastrointestinal symptoms and extra-intestinal manifestations assessed through a rating scale before and after GFD. Although a standardized symptom rating scale is not yet applied worldwide, a recent study indicated that a decrease of the global symptom score higher than 50% after GFD can be regarded as confirmatory of NCGS (Table 1) [53]. (…) After the confirmation of NCGS diagnosis, according to the previously mentioned work-up, patients are advized to start with a GFD [49].
^El-Chammas K, Danner E. Gluten-free diet in nonceliac disease. Nutr Clin Pract (Review). Jun 2011, 26 (3): 294–9. PMID 21586414. doi:10.1177/0884533611405538. The prescription of a GFD has been recommended for patients with IBS-like symptoms without histologic evidence of CD and who have positive IgA tTG antibodies or have the at-risk haplotypes DQ2 or DQ8.46 (…) Historically, a GFD was occasionally used in the management of multiple sclerosis (MS), because anecdotal reports indicated a positive effect (reversal of symptoms) of a GFD in MS patients. (…) what has been demonstrated so far is that a glutenfree vegan diet for 1 year significantly reduced disease activity and levels of antibodies to β-lactoglobulin and gliadin in patients with RA. (...) The beneficial effect of a GFD on diarrhea and weight gain in patients with HIV enteropathy has been demonstrated in a few case series. Treatment with a GFD has been observed to decrease the frequency of diarrhea and thus allow weight gain.84 (IBS=irritable bowel syndrome; RA=rheumatoid arthritis; GFD=gluten-free diet)
