Review · Nutrients · 2021Conflicts declared

Gluten-free diet for celiac disease and other conditions

What it found

A gluten-free diet is the main treatment for celiac disease and helps some other conditions, but it can be costly and lead to nutrient gaps.

The evidence for mental and brain disorders is still limited.

What they found

Studies in people

Celiac disease treatment

A strict gluten-free diet is the treatment for celiac disease. It can restore the small bowel in 95% of children within two years, while 34% and 66% of adults see mucosal recovery after two and five years.

Other conditions

The diet is also used for gluten ataxia, dermatitis herpetiformis, and some cases of irritable bowel syndrome and inflammatory bowel disease. For dermatitis herpetiformis, 93% of patients on a gluten-free diet could reduce their dapsone dose.

Gut bacteria changes

In a study of 10 healthy people, a gluten-free diet for one month reduced beneficial gut bacteria. Another study found that celiac patients on the diet had an imbalance in gut bacteria.

Nutritional gaps

The diet may lead to low levels of vitamin D, iron, calcium, and fiber. For example, women with celiac disease took in only 46%, 44%, and 31% of their daily fiber, iron, and calcium needs.

Cost and social impact

Gluten-free products can be 205% to 267% more expensive than regular ones. Some people report social isolation and difficulty eating out.

Studies in people and animals

Mental and brain disorders

Some studies show a link between gluten and neurological or mental illnesses like autism and schizophrenia, but results are conflicting. More data is needed to know if the diet helps these conditions.

What the authors conclude

“More data is needed to assess the effectiveness of the diet in managing mental and cognitive disorders and to establish a connection between the brain and gluten.”
Aljada B, Zohni A, El-Matary W, 2021

Also in their conclusions

  • They recommend close follow-up with patients following the diet.
  • They call for more data to assess the effectiveness of the diet in managing mental and cognitive disorders and to establish a connection between the brain and gluten.

How it was done

The gluten-free diet has become popular beyond its main medical use for gluten-related disorders, so the authors wanted to review its proven benefits and downsides.

They reviewed studies on the gluten-free diet in people with celiac disease and other conditions, including how well it works and what problems it can cause.

What it can’t tell you

  • Many studies in this review are observational, so they can show links but not prove that gluten or a gluten-free diet causes a specific outcome.
  • Some findings come from small studies or lack control groups, so the results may not apply to everyone.
  • The long-term effects of a gluten-free diet in people without celiac disease are not well known.

The paper

Title
The Gluten-Free Diet for Celiac Disease and Beyond
Type
ReviewThe authors read earlier studies and describe what they found. It isn’t a new study.
Evidence
Studies in people · animals · lab
Summarised from
Full text
Cite
Aljada B, Zohni A, El-Matary W (2021). The Gluten-Free Diet for Celiac Disease and Beyond. Nutrients. doi:10.3390/nu13113993Free full textPubMed 34836247DOI

Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error