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vector-toc-level-2"> <a class="vector-toc-link" href="#Coeliac_disease"> <div class="vector-toc-text"> 1.1 Coeliac disease </div> </a> <ul id="toc-Coeliac_disease-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Non-coeliac_gluten_sensitivity" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Non-coeliac_gluten_sensitivity"> <div class="vector-toc-text"> 1.2 Non-coeliac gluten sensitivity </div> </a> <ul id="toc-Non-coeliac_gluten_sensitivity-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Wheat_allergy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Wheat_allergy"> <div class="vector-toc-text"> 1.3 Wheat allergy </div> </a> <ul id="toc-Wheat_allergy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Gluten_ataxia" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Gluten_ataxia"> <div class="vector-toc-text"> 1.4 Gluten ataxia </div> </a> <ul id="toc-Gluten_ataxia-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-As_a_popular_diet" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#As_a_popular_diet"> <div class="vector-toc-text"> 1.5 As a popular diet </div> </a> <ul id="toc-As_a_popular_diet-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Research" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Research"> <div class="vector-toc-text"> 1.6 Research </div> </a> <ul id="toc-Research-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Eating_gluten-free" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Eating_gluten-free"> <div class="vector-toc-text"> 2 Eating gluten-free </div> </a> <button aria-controls="toc-Eating_gluten-free-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Eating gluten-free subsection 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the table of contents </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading">Gluten-free diet</h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 19 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-19" aria-hidden="true" > 19 languages </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%86%D8%B8%D8%A7%D9%85_%D8%BA%D8%B0%D8%A7%D8%A6%D9%8A_%D8%AE%D8%A7%D9%84_%D9%85%D9%86_%D8%A7%D9%84%D8%BA%D9%84%D9%88%D8%AA%D9%8A%D9%86" title="نظام غذائي خال من الغلوتين – Arabic" lang="ar" hreflang="ar" data-title="نظام غذائي خال من الغلوتين" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target">العربية</a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Dieta_sense_gluten" title="Dieta sense gluten – Catalan" lang="ca" hreflang="ca" data-title="Dieta sense gluten" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target">Català</a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Bezlepkov%C3%A1_dieta" title="Bezlepková dieta – Czech" lang="cs" hreflang="cs" data-title="Bezlepková dieta" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target">Čeština</a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Dieta_sin_gluten" title="Dieta sin gluten – Spanish" lang="es" hreflang="es" data-title="Dieta sin gluten" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target">Español</a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%B1%DA%98%DB%8C%D9%85_%D8%BA%D8%B0%D8%A7%DB%8C%DB%8C_%D8%A8%D8%AF%D9%88%D9%86_%DA%AF%D9%84%D9%88%D8%AA%D9%86" title="رژیم غذایی بدون گلوتن – Persian" lang="fa" hreflang="fa" data-title="رژیم غذایی بدون گلوتن" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target">فارسی</a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/R%C3%A9gime_sans_gluten" title="Régime sans gluten – French" lang="fr" hreflang="fr" data-title="Régime sans gluten" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target">Français</a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EA%B8%80%EB%A3%A8%ED%85%90_%ED%94%84%EB%A6%AC_%EC%8B%9D%ED%92%88" title="글루텐 프리 식품 – Korean" lang="ko" hreflang="ko" data-title="글루텐 프리 식품" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target">한국어</a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Diet_bebas_gluten" title="Diet bebas gluten – Indonesian" lang="id" hreflang="id" data-title="Diet bebas gluten" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target">Bahasa Indonesia</a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Glutenvrij_dieet" title="Glutenvrij dieet – Dutch" lang="nl" hreflang="nl" data-title="Glutenvrij dieet" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target">Nederlands</a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E3%82%B0%E3%83%AB%E3%83%86%E3%83%B3%E3%83%95%E3%83%AA%E3%83%BC%E3%83%BB%E3%83%80%E3%82%A4%E3%82%A8%E3%83%83%E3%83%88" title="グルテンフリー・ダイエット – Japanese" lang="ja" hreflang="ja" data-title="グルテンフリー・ダイエット" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target">日本語</a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Dieta_bezglutenowa" title="Dieta bezglutenowa – Polish" lang="pl" hreflang="pl" data-title="Dieta bezglutenowa" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target">Polski</a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Dieta_sem_gl%C3%BAten" title="Dieta sem glúten – Portuguese" lang="pt" hreflang="pt" data-title="Dieta sem glúten" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target">Português</a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%91%D0%B5%D0%B7%D0%B3%D0%BB%D1%8E%D1%82%D0%B5%D0%BD%D0%BE%D0%B2%D0%B0%D1%8F_%D0%B4%D0%B8%D0%B5%D1%82%D0%B0" title="Безглютеновая диета – Russian" lang="ru" hreflang="ru" data-title="Безглютеновая диета" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target">Русский</a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Gluten-free_diet" title="Gluten-free diet – Simple English" lang="en-simple" hreflang="en-simple" data-title="Gluten-free diet" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target">Simple English</a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Dijeta_bez_glutena" title="Dijeta bez glutena – Serbian" lang="sr" hreflang="sr" data-title="Dijeta bez glutena" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target">Српски / srpski</a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Gluteeniton_ruokavalio" title="Gluteeniton ruokavalio – Finnish" lang="fi" hreflang="fi" data-title="Gluteeniton ruokavalio" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target">Suomi</a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Glutenfri_kost" title="Glutenfri kost – Swedish" lang="sv" hreflang="sv" data-title="Glutenfri kost" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target">Svenska</a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%91%D0%B5%D0%B7%D0%B3%D0%BB%D1%8E%D1%82%D0%B5%D0%BD%D0%BE%D0%B2%D0%B0_%D0%B4%D1%96%D1%94%D1%82%D0%B0" title="Безглютенова дієта – Ukrainian" lang="uk" hreflang="uk" data-title="Безглютенова дієта" data-language-autonym="Українська" data-language-local-name="Ukrainian" 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free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Diet excluding proteins found in wheat, barley, and rye</div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Triticum_monococcum0.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/59/Triticum_monococcum0.jpg/200px-Triticum_monococcum0.jpg" decoding="async" width="200" height="267" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/59/Triticum_monococcum0.jpg/300px-Triticum_monococcum0.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/59/Triticum_monococcum0.jpg/400px-Triticum_monococcum0.jpg 2x" data-file-width="480" data-file-height="640" /></a><figcaption>Wheat</figcaption></figure> A gluten-free diet (GFD) is a <a href="/wiki/Diet_(nutrition)" title="Diet (nutrition)">nutritional plan</a> that strictly excludes <a href="/wiki/Gluten" title="Gluten">gluten</a>, which is a mixture of <a href="/wiki/Prolamin" title="Prolamin">prolamin</a> <a href="/wiki/Protein" title="Protein">proteins</a> found in <a href="/wiki/Wheat" title="Wheat">wheat</a> (and all of its species and hybrids, such as <a href="/wiki/Spelt" title="Spelt">spelt</a>, <a href="/wiki/Khorasan_wheat" title="Khorasan wheat">kamut</a>, and <a href="/wiki/Triticale" title="Triticale">triticale</a>), as well as <a href="/wiki/Barley" title="Barley">barley</a>, <a href="/wiki/Rye" title="Rye">rye</a>, and <a href="/wiki/Oats" class="mw-redirect" title="Oats">oats</a>.<a href="#cite_note-Biesiekierski2017-1">[1]</a> The inclusion of <a href="/wiki/Oats" class="mw-redirect" title="Oats">oats</a> in a gluten-free diet remains controversial, and may depend on the oat <a href="/wiki/Cultivar" title="Cultivar">cultivar</a> and the frequent cross-contamination with other gluten-containing cereals.<a href="#cite_note-CiacciCiclitira2015-2">[2]</a><a href="#cite_note-CominoMoreno2015-3">[3]</a><a href="#cite_note-PenaginiDilillo-4">[4]</a><a href="#cite_note-DeSouzaDeschenes2016-5">[5]</a> Gluten may cause both <a href="/wiki/Gastrointestinal" class="mw-redirect" title="Gastrointestinal">gastrointestinal</a> and <a href="/wiki/Systemic_disease" title="Systemic disease">systemic</a> symptoms for those with <a href="/wiki/Gluten-related_disorders" title="Gluten-related disorders">gluten-related disorders</a>, including <a href="/wiki/Coeliac_disease" title="Coeliac disease">coeliac disease</a> (CD), <a href="/wiki/Non-celiac_gluten_sensitivity" title="Non-celiac gluten sensitivity">non-coeliac gluten sensitivity</a> (NCGS), <a href="/wiki/Gluten_ataxia" class="mw-redirect" title="Gluten ataxia">gluten ataxia</a>, <a href="/wiki/Dermatitis_herpetiformis" title="Dermatitis herpetiformis">dermatitis herpetiformis</a> (DH), and <a href="/wiki/Wheat_allergy" title="Wheat allergy">wheat allergy</a>.<a href="#cite_note-LudvigssonLeffler-6">[6]</a> In these people, the gluten-free diet is demonstrated as an effective treatment,<a href="#cite_note-MulderWanrooijQuotation-7">[7]</a><a href="#cite_note-HischenhuberCrevelQuotation-8">[8]</a><a href="#cite_note-VoltaCaio2015Quotation-9">[9]</a> 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.<a href="#cite_note-SeeKaukinen2015-10">[10]</a> This is mainly caused by inadvertent ingestion of gluten.<a href="#cite_note-SeeKaukinen2015-10">[10]</a> People with a poor understanding of a gluten-free diet often believe that they are strictly following the diet, but are making regular errors.<a href="#cite_note-SeeKaukinen2015-10">[10]</a><a href="#cite_note-MulderWanrooij-11">[11]</a> In addition, a gluten-free diet may, in at least some cases, improve gastrointestinal or systemic symptoms in diseases like <a href="/wiki/Irritable_bowel_syndrome" title="Irritable bowel syndrome">irritable bowel syndrome</a>, <a href="/wiki/Rheumatoid_arthritis" title="Rheumatoid arthritis">rheumatoid arthritis</a>, or <a href="/wiki/HIV" title="HIV">HIV</a> <a href="/wiki/Enteropathy" title="Enteropathy">enteropathy</a>, among others.<a href="#cite_note-ElChammasDanner2011Quotation-12">[12]</a> There is no good evidence that gluten-free diets are an <a href="/wiki/Complementary_and_alternative_medicine" class="mw-redirect" title="Complementary and alternative medicine">alternative medical treatment</a> for people with <a href="/wiki/Autism" title="Autism">autism</a>.<a href="#cite_note-MariBausetZazpe2014-13">[13]</a><a href="#cite_note-Buie2013-14">[14]</a><a href="#cite_note-Millward2008-15">[15]</a> Gluten proteins have low <a href="/wiki/Nutrition" title="Nutrition">nutritional</a> and biological value and the grains that contain gluten are not essential in the human diet.<a href="#cite_note-LamacchiaCamarca2014-16">[16]</a> However, an unbalanced selection of food and an incorrect choice of gluten-free replacement products may lead to nutritional deficiencies. Replacing flour from wheat or other gluten-containing cereals with gluten-free flours in commercial products may lead to a lower intake of important nutrients, such as <a href="/wiki/Iron" title="Iron">iron</a> and <a href="/wiki/B_vitamins" title="B vitamins">B vitamins</a>. Some gluten-free commercial replacement products are not as enriched or fortified as their gluten-containing counterparts, and often have greater <a href="/wiki/Lipid" title="Lipid">lipid</a>/<a href="/wiki/Carbohydrate" title="Carbohydrate">carbohydrate</a> content. Children especially often over-consume these products, such as snacks and biscuits. Nutritional complications can be prevented by a correct dietary education.<a href="#cite_note-PenaginiDilillo-4">[4]</a> A gluten-free diet may be based on gluten-free foods, such as meat, fish, eggs, milk and dairy products, legumes, nuts, fruits, vegetables, potatoes, rice, and corn.<a href="#cite_note-Saturni-etal-2010-table2-p21-17">[17]</a> Gluten-free <a href="/wiki/Food_processing" title="Food processing">processed foods</a> may be used.<a href="#cite_note-PenaginiDilillo-4">[4]</a> <a href="/wiki/Pseudocereal" title="Pseudocereal">Pseudocereals</a> (<a href="/wiki/Quinoa" title="Quinoa">quinoa</a>, <a href="/wiki/Amaranth" title="Amaranth">amaranth</a>, and <a href="/wiki/Buckwheat" title="Buckwheat">buckwheat</a>) and some minor cereals have been found to be suitable alternative choices that can provide adequate nutrition.<a href="#cite_note-18">[18]</a> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Rationale_behind_adoption_of_the_diet">Rationale behind adoption of the diet</h2>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=1" title="Edit section: Rationale behind adoption of the diet">edit</a>]</div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Amount_of_gluten_that_can_causes_a_reaction.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/75/Amount_of_gluten_that_can_causes_a_reaction.png/200px-Amount_of_gluten_that_can_causes_a_reaction.png" decoding="async" width="200" height="298" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/75/Amount_of_gluten_that_can_causes_a_reaction.png/300px-Amount_of_gluten_that_can_causes_a_reaction.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/75/Amount_of_gluten_that_can_causes_a_reaction.png/400px-Amount_of_gluten_that_can_causes_a_reaction.png 2x" data-file-width="500" data-file-height="745" /></a><figcaption>One <a href="/wiki/Breadcrumb" class="mw-redirect" title="Breadcrumb">breadcrumb</a> of this size contains enough <a href="/wiki/Gluten" title="Gluten">gluten</a> to reactivate the <a href="/wiki/Autoimmunity" title="Autoimmunity">autoimmune response</a> in people with <a href="/wiki/Coeliac_disease" title="Coeliac disease">coeliac disease</a> when they are following a gluten-free diet, although obvious symptoms may not appear.<a href="#cite_note-SeeKaukinen2015-10">[10]</a><a href="#cite_note-Akobeng2008-19">[19]</a><a href="#cite_note-MorenoRodriguezHerrera2017-20">[20]</a> Consuming gluten even in small quantities, which may be the result of inadvertent cross-contamination, impedes recovery in people with <a href="/wiki/Gluten-related_disorders" title="Gluten-related disorders">gluten-related disorders</a>.<a href="#cite_note-MulderWanrooij-11">[11]</a><a href="#cite_note-VoltaCaio2015-21">[21]</a><a href="#cite_note-HadjivassiliouGrünewald2002-22">[22]</a><a href="#cite_note-FrancavillaCristofori2014-23">[23]</a><a href="#cite_note-Antiga_E,_Caproni2015-24">[24]</a></figcaption></figure> <div class="mw-heading mw-heading3"><h3 id="Coeliac_disease">Coeliac disease</h3>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=2" title="Edit section: Coeliac disease">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Coeliac_disease" title="Coeliac disease">Coeliac disease</a></div> <a href="/wiki/Coeliac_disease" title="Coeliac disease">Coeliac disease</a> (<a href="/wiki/American_and_British_English_spelling_differences" title="American and British English spelling differences">American English</a>: celiac) (CD) is a chronic, immune-mediated, and mainly intestinal process, that appears in <a href="/wiki/Genetic_predisposition" title="Genetic predisposition">genetically predisposed</a> people of all ages. It is caused by the ingestion of <a href="/wiki/Gluten" title="Gluten">gluten</a>, which is present in wheat, barley, rye and derivatives. Coeliac disease is not only a gastrointestinal disease, because it may affect several organs and cause an extensive variety of non-gastrointestinal symptoms, and most importantly, it may often be completely asymptomatic. Added difficulties for diagnosis are the fact that serological markers (<a href="/wiki/Anti-transglutaminase_antibodies#Anti-tissue_transglutaminase" title="Anti-transglutaminase antibodies">anti-tissue transglutaminase</a> [TG2]) are not always present,<a href="#cite_note-NEJM2012-25">[25]</a> and many people with coeliac may have minor mucosal lesions, without atrophy of the <a href="/wiki/Intestinal_villi" class="mw-redirect" title="Intestinal villi">intestinal villi</a>.<a href="#cite_note-BoldRostami-26">[26]</a> Coeliac disease affects approximately 1–2% of the general population all over the world<a href="#cite_note-LundinWijmenga2015-27">[27]</a> and is on the increase,<a href="#cite_note-LionettiGatti2015-28">[28]</a> but most cases remain unrecognized, undiagnosed and untreated, exposing patients to the risk of long-term complications.<a href="#cite_note-Fasano2005Pediatric-29">[29]</a><a href="#cite_note-ElliBranchi-30">[30]</a> People may develop severe disease symptoms and be subjected to extensive investigations for many years before a proper diagnosis is achieved.<a href="#cite_note-LudvigssonCard-31">[31]</a> Untreated coeliac disease may cause <a href="/wiki/Malabsorption" title="Malabsorption">malabsorption</a>, reduced <a href="/wiki/Quality_of_life" title="Quality of life">quality of life</a>, <a href="/wiki/Iron_deficiency" title="Iron deficiency">iron deficiency</a>, <a href="/wiki/Osteoporosis" title="Osteoporosis">osteoporosis</a>, obstetric complications (<a href="/wiki/Stillbirth" title="Stillbirth">stillbirth</a>, <a href="/wiki/Intrauterine_growth_restriction" title="Intrauterine growth restriction">intrauterine growth restriction</a>, <a href="/wiki/Preterm_birth" title="Preterm birth">preterm birth</a>, low <a href="/wiki/Birth_weight" title="Birth weight">birthweight</a>, and <a href="/wiki/Small_for_gestational_age" title="Small for gestational age">small for gestational age</a>),<a href="#cite_note-SacconeBerghella2015-32">[32]</a> an increased risk of intestinal <a href="/wiki/Lymphoma" title="Lymphoma">lymphomas</a> and greater mortality.<a href="#cite_note-LebwoholLudvigsson-quotation-33">[33]</a> Coeliac disease is associated with some autoimmune diseases, such as <a href="/wiki/Diabetes_mellitus_type_1" class="mw-redirect" title="Diabetes mellitus type 1">diabetes mellitus type 1</a>, <a href="/wiki/Thyroiditis" title="Thyroiditis">thyroiditis</a>,<a href="#cite_note-LundinWijmenga2015-27">[27]</a> <a href="/wiki/Ataxia" title="Ataxia">gluten ataxia</a>, <a href="/wiki/Psoriasis" title="Psoriasis">psoriasis</a>, <a href="/wiki/Vitiligo" title="Vitiligo">vitiligo</a>, <a href="/wiki/Autoimmune_hepatitis" title="Autoimmune hepatitis">autoimmune hepatitis</a>, <a href="/wiki/Dermatitis_herpetiformis" title="Dermatitis herpetiformis">dermatitis herpetiformis</a>, <a href="/wiki/Primary_sclerosing_cholangitis" title="Primary sclerosing cholangitis">primary sclerosing cholangitis</a>, and more.<a href="#cite_note-LundinWijmenga2015-27">[27]</a> Coeliac disease with "classic symptoms", which include gastrointestinal manifestations such as chronic diarrhea and abdominal distention, malabsorption, loss of appetite, and impaired growth, is currently the least common presentation of the disease and affects predominantly small children generally younger than two years of age.<a href="#cite_note-Fasano2005Pediatric-29">[29]</a><a href="#cite_note-LudvigssonCard-31">[31]</a> Coeliac disease with "non-classic symptoms" is the most common clinical type and occurs in older children (over two years old), adolescents and adults.<a href="#cite_note-LudvigssonCard-31">[31]</a> It is characterized by milder or even absent gastrointestinal symptoms and a wide spectrum of non-intestinal manifestations that can involve any organ of the body, and very frequently may be completely asymptomatic<a href="#cite_note-Fasano2005Pediatric-29">[29]</a> both in children (at least in 43% of the cases<a href="#cite_note-VriezingaSchweizer2015-34">[34]</a>) and adults.<a href="#cite_note-Fasano2005Pediatric-29">[29]</a> Following a lifelong gluten-free diet is the only medically accepted treatment for people with coeliac disease.<a href="#cite_note-LamacchiaCamarca2014-16">[16]</a><a href="#cite_note-De_Palma-35">[35]</a> <div class="mw-heading mw-heading3"><h3 id="Non-coeliac_gluten_sensitivity">Non-coeliac gluten sensitivity</h3>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=3" title="Edit section: Non-coeliac gluten sensitivity">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Non-celiac_gluten_sensitivity" title="Non-celiac gluten sensitivity">Non-celiac gluten sensitivity</a></div> Non-coeliac gluten sensitivity (NCGS) is described as a condition of multiple symptoms that improves when switching to a gluten-free diet, after coeliac disease and wheat allergy are excluded.<a href="#cite_note-36">[36]</a><a href="#cite_note-37">[37]</a> People with NCGS may develop gastrointestinal symptoms, which resemble those of <a href="/wiki/Irritable_bowel_syndrome" title="Irritable bowel syndrome">irritable bowel syndrome</a> (IBS)<a href="#cite_note-ElliRoncorni-38">[38]</a><a href="#cite_note-CatassiBai-39">[39]</a> or a variety of nongastrointestinal symptoms.<a href="#cite_note-VoltaCaio2015-21">[21]</a><a href="#cite_note-FasanoSapone2015-40">[40]</a><a href="#cite_note-CatassiBai2013-41">[41]</a> Gastrointestinal symptoms may include any of the following: <a href="/wiki/Abdominal_pain" title="Abdominal pain">abdominal pain</a>, <a href="/wiki/Bloating" title="Bloating">bloating</a>, bowel habit abnormalities (either <a href="/wiki/Diarrhea" title="Diarrhea">diarrhea</a> or <a href="/wiki/Constipation" title="Constipation">constipation</a>),<a href="#cite_note-VoltaCaio2015-21">[21]</a><a href="#cite_note-CatassiBai2013-41">[41]</a> <a href="/wiki/Nausea" title="Nausea">nausea</a>, <a href="/wiki/Aerophagia" title="Aerophagia">aerophagia</a>, <a href="/wiki/Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">gastroesophageal reflux disease</a>, and <a href="/wiki/Aphthous_stomatitis" title="Aphthous stomatitis">aphthous stomatitis</a>.<a href="#cite_note-FasanoSapone2015-40">[40]</a><a href="#cite_note-CatassiBai2013-41">[41]</a> A range of extra-intestinal symptoms, said to be the only manifestation of NCGS in the absence of gastrointestinal symptoms,<a href="#cite_note-VoltaCaio2015-21">[21]</a><a href="#cite_note-FasanoSapone2015-40">[40]</a><a href="#cite_note-CatassiBai2013-41">[41]</a> have been suggested, but remain controversial.<a href="#cite_note-LebwoholLudvigsson-quotation-33">[33]</a><a href="#cite_note-AzizHadjivassiliou2015-42">[42]</a> These include: <a href="/wiki/Headache" title="Headache">headache</a>, <a href="/wiki/Migraine" title="Migraine">migraine</a>, "<a href="/wiki/Clouding_of_consciousness" title="Clouding of consciousness">brain fog</a>", <a href="/wiki/Fatigue_(medical)" class="mw-redirect" title="Fatigue (medical)">fatigue</a>, <a href="/wiki/Fibromyalgia" title="Fibromyalgia">fibromyalgia</a>,<a href="#cite_note-AzizHadjivassiliou2015-42">[42]</a><a href="#cite_note-RossiDiLollo-43">[43]</a> joint and muscle pain, leg or arm <a href="/wiki/Hypoesthesia" title="Hypoesthesia">numbness</a>, <a href="/wiki/Paresthesia" title="Paresthesia">tingling</a> of the extremities, dermatitis (<a href="/wiki/Dermatitis" title="Dermatitis">eczema</a> or <a href="/wiki/Rash" title="Rash">skin rash</a>), <a href="/wiki/Atopy" title="Atopy">atopic disorders</a> such as <a href="/wiki/Asthma" title="Asthma">asthma</a>, <a href="/wiki/Rhinitis" title="Rhinitis">rhinitis</a>, other <a href="/wiki/Allergy" title="Allergy">allergies</a>, <a href="/wiki/Depression_(mood)" title="Depression (mood)">depression</a>, <a href="/wiki/Anxiety" title="Anxiety">anxiety</a>, <a href="/wiki/Iron-deficiency_anemia" title="Iron-deficiency anemia">iron-deficiency anemia</a>, <a href="/wiki/Folate_deficiency" title="Folate deficiency">folate deficiency</a> or <a href="/wiki/Autoimmune_disease" title="Autoimmune disease">autoimmune diseases</a>.<a href="#cite_note-VoltaCaio2015-21">[21]</a><a href="#cite_note-FasanoSapone2015-40">[40]</a><a href="#cite_note-CatassiBai2013-41">[41]</a><a href="#cite_note-AzizHadjivassiliou2015-42">[42]</a> NCGS has also been controversially implicated in some <a href="/wiki/Neuropsychiatric_disorder" class="mw-redirect" title="Neuropsychiatric disorder">neuropsychiatric disorders</a>, including <a href="/wiki/Schizophrenia" title="Schizophrenia">schizophrenia</a>, <a href="/wiki/Eating_disorder" title="Eating disorder">eating disorders</a>, <a href="/wiki/Autism" title="Autism">autism</a>, <a href="/wiki/Peripheral_neuropathy" title="Peripheral neuropathy">peripheral neuropathy</a>, <a href="/wiki/Ataxia" title="Ataxia">ataxia</a> and <a href="/wiki/Attention_deficit_hyperactivity_disorder" title="Attention deficit hyperactivity disorder">attention deficit hyperactivity disorder</a> (ADHD).<a href="#cite_note-VoltaCaio2015-21">[21]</a><a href="#cite_note-LebwoholLudvigsson-quotation-33">[33]</a><a href="#cite_note-FasanoSapone2015-40">[40]</a><a href="#cite_note-CatassiBai2013-41">[41]</a><a href="#cite_note-AzizHadjivassiliou2015-42">[42]</a> Above 20% of people with NCGS have IgE-mediated allergy to one or more inhalants, foods or metals, among which most common are <a href="/wiki/Mite" title="Mite">mites</a>, <a href="/wiki/Poaceae" title="Poaceae">graminaceae</a>, <a href="/wiki/Parietaria" title="Parietaria">parietaria</a>, cat or dog hair, <a href="/wiki/Shellfish" title="Shellfish">shellfish</a> and <a href="/wiki/Nickel" title="Nickel">nickel</a>.<a href="#cite_note-VoltaCaio2015-21">[21]</a> Approximately, 35% of people with NCGS have other <a href="/wiki/Food_intolerance" title="Food intolerance">food intolerances</a>, mainly <a href="/wiki/Lactose_intolerance" title="Lactose intolerance">lactose intolerance</a>.<a href="#cite_note-AzizHadjivassiliou2015-42">[42]</a> The pathogenesis of NCGS is not yet well understood. For this reason, it is a controversial syndrome<a href="#cite_note-VriezingaSchweizer2015-34">[34]</a> and some authors still question it.<a href="#cite_note-FasanoSapone2015Quotation2-44">[44]</a> There is evidence that not only <a href="/wiki/Gliadin" title="Gliadin">gliadin</a> (the main cytotoxic antigen of gluten), but also other proteins named ATIs which are present in gluten-containing cereals (<a href="/wiki/Wheat" title="Wheat">wheat</a>, <a href="/wiki/Rye" title="Rye">rye</a>, <a href="/wiki/Barley" title="Barley">barley</a>, and their derivatives) may have a role in the development of symptoms. ATIs are potent activators of the <a href="/wiki/Innate_immune_system" title="Innate immune system">innate immune system</a>.<a href="#cite_note-FasanoSapone2015-40">[40]</a><a href="#cite_note-Verbeke2018-45">[45]</a> <a href="/wiki/FODMAP" title="FODMAP">FODMAPs</a>, especially <a href="/wiki/Fructans" class="mw-redirect" title="Fructans">fructans</a>, are present in small amounts in gluten-containing grains and have been identified as a possible cause of some gastrointestinal symptoms in persons with NCGS.<a href="#cite_note-FasanoSapone2015-40">[40]</a><a href="#cite_note-VoltaCaioQuestions-46">[46]</a><a href="#cite_note-Verbeke2018-45">[45]</a><a href="#cite_note-OntiverosHardy-47">[47]</a> As of 2019, reviews have concluded that although FODMAPs may play a role in NCGS, they only explain certain gastrointestinal symptoms, such as <a href="/wiki/Bloating" title="Bloating">bloating</a>, but not the <a href="#Extraintestinal">extra-digestive symptoms</a> that people with NCGS may develop, such as <a href="/wiki/Neurological_disorder" title="Neurological disorder">neurological disorders</a>, <a href="/wiki/Fibromyalgia" title="Fibromyalgia">fibromyalgia</a>, psychological disturbances, and <a href="/wiki/Dermatitis" title="Dermatitis">dermatitis</a>.<a href="#cite_note-Verbeke2018-45">[45]</a><a href="#cite_note-VoltaDeGiorgio2019-48">[48]</a><a href="#cite_note-FasanoSapone2015-40">[40]</a> After exclusion of coeliac disease and wheat allergy,<a href="#cite_note-mansueto-etal-2014-49">[49]</a> the subsequent step for diagnosis and treatment of NCGS is to start a strict gluten-free diet to assess if symptoms improve or resolve completely. This may occur within days to weeks of starting a GFD, but improvement may also be due to a non-specific, placebo response.<a href="#cite_note-GenuisLobo2014-50">[50]</a> Recommendations may resemble those for coeliac disease, for the diet to be strict and maintained, with no transgression.<a href="#cite_note-VoltaCaio2015-21">[21]</a> The degree of gluten <a href="/wiki/Cross_contamination" class="mw-redirect" title="Cross contamination">cross contamination</a> tolerated by people with NCGS is not clear but there is some evidence that they can present with symptoms even after consumption of small amounts.<a href="#cite_note-VoltaCaio2015-21">[21]</a> It is not yet known whether NCGS is a permanent or a transient condition.<a href="#cite_note-VoltaCaio2015-21">[21]</a><a href="#cite_note-VriezingaSchweizer2015-34">[34]</a> A trial of gluten reintroduction to observe any reaction after one–two years of strict gluten-free diet might be performed.<a href="#cite_note-VoltaCaio2015-21">[21]</a> A subgroup of people with NCGS may not improve by eating commercially available gluten-free products, which are usually rich of preservatives and additives, because chemical <a href="/wiki/Food_additive" title="Food additive">additives</a> (such as <a href="/wiki/Sulphite" class="mw-redirect" title="Sulphite">sulphites</a>, <a href="/wiki/Glutamic_acid" title="Glutamic acid">glutamates</a>, <a href="/wiki/Nitrate" title="Nitrate">nitrates</a> and <a href="/wiki/Benzoic_acid" title="Benzoic acid">benzoates</a>) might have a role in evoking functional gastrointestinal symptoms of NCGS. These people may benefit from a diet with a low content of preservatives and additives.<a href="#cite_note-VoltaCaioQuestions-46">[46]</a> NCGS, which is possibly immune-mediated, now appears to be more common than coeliac disease,<a href="#cite_note-Hogg-Collars-2014-51">[51]</a> with prevalence rates between 0.5 and 13% in the general population.<a href="#cite_note-MolinaInfanteSantolaria2015SystematicReview-52">[52]</a> <div class="mw-heading mw-heading3"><h3 id="Wheat_allergy">Wheat allergy</h3>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=4" title="Edit section: Wheat allergy">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Wheat_allergy" title="Wheat allergy">Wheat allergy</a></div> People can also experience adverse effects of wheat as result of a <a href="/wiki/Wheat_allergy" title="Wheat allergy">wheat allergy</a>.<a href="#cite_note-53">[53]</a> Gastrointestinal symptoms of wheat allergy are similar to those of coeliac disease and non-coeliac gluten sensitivity, but there is a different interval between exposure to wheat and onset of symptoms. Other symptoms such as dermal reactions like as rashes or hyperpigmentation may also occur in some people. Wheat allergy has a fast onset (from minutes to hours) after the consumption of food containing wheat and could be <a href="/wiki/Anaphylaxis" title="Anaphylaxis">anaphylaxis</a>.<a href="#cite_note-NEJM2012-25">[25]</a><a href="#cite_note-ScherfBrockowQuotation-54">[54]</a> The management of wheat allergy consists of complete withdrawal of any food containing wheat and other gluten-containing cereals.<a href="#cite_note-HischenhuberCrevelQuotation-8">[8]</a><a href="#cite_note-ScherfBrockowQuotation-54">[54]</a> Nevertheless, some people with wheat allergy can tolerate barley, rye or oats.<a href="#cite_note-Pietzak2012-55">[55]</a> <div class="mw-heading mw-heading3"><h3 id="Gluten_ataxia">Gluten ataxia</h3>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=5" title="Edit section: Gluten ataxia">edit</a>]</div> <figure class="mw-default-size" typeof="mw:File/Thumb"><video id="mwe_player_0" poster="//upload.wikimedia.org/wikipedia/commons/thumb/6/67/Gluten_ataxia_eng.ogv/220px--Gluten_ataxia_eng.ogv.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="220" height="125" data-durationhint="111" data-mwtitle="Gluten_ataxia_eng.ogv" data-mwprovider="wikimediacommons" resource="/wiki/File:Gluten_ataxia_eng.ogv"><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/6/67/Gluten_ataxia_eng.ogv/Gluten_ataxia_eng.ogv.360p.webm" type="video/webm; codecs="vp8, vorbis"" data-transcodekey="360p.webm" data-width="480" data-height="272" /><source src="//upload.wikimedia.org/wikipedia/commons/6/67/Gluten_ataxia_eng.ogv" type="video/ogg; codecs="theora, vorbis"" data-width="480" data-height="272" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/6/67/Gluten_ataxia_eng.ogv/Gluten_ataxia_eng.ogv.144p.mjpeg.mov" type="video/quicktime" data-transcodekey="144p.mjpeg.mov" data-width="254" data-height="144" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/6/67/Gluten_ataxia_eng.ogv/Gluten_ataxia_eng.ogv.240p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="240p.vp9.webm" data-width="424" data-height="240" /></video><figcaption>A male with gluten ataxia: previous situation and evolution after three months of gluten-free diet.</figcaption></figure> <a href="/wiki/Ataxia#Gluten_ataxia" title="Ataxia">Gluten ataxia</a> is an autoimmune disease triggered by the ingestion of gluten.<a href="#cite_note-sapone-etal-2010-b-56">[56]</a> With gluten ataxia, damage takes place in the cerebellum, the balance center of the brain that controls coordination and complex movements like walking, speaking and swallowing, with loss of <a href="/wiki/Purkinje_cell" title="Purkinje cell">Purkinje cells</a>. People with gluten ataxia usually present <a href="/wiki/Gait_abnormality" title="Gait abnormality">gait abnormality</a> or incoordination and tremor of the upper limbs. Gaze-evoked <a href="/wiki/Nystagmus" title="Nystagmus">nystagmus</a> and other ocular signs of cerebellar dysfunction are common. <a href="/wiki/Myoclonus" title="Myoclonus">Myoclonus</a>, palatal tremor, and <a href="/wiki/Opsoclonus_myoclonus_syndrome" title="Opsoclonus myoclonus syndrome">opsoclonus-myoclonus</a> may also appear.<a href="#cite_note-HadjivassiliouSanders2015-57">[57]</a> Early diagnosis and treatment with a gluten-free diet can improve ataxia and prevent its progression. The effectiveness of the treatment depends on the elapsed time from the onset of the ataxia until diagnosis, because the death of <a href="/wiki/Purkinje_cells" class="mw-redirect" title="Purkinje cells">neurons in the cerebellum</a> as a result of gluten exposure is irreversible.<a href="#cite_note-HadjivassiliouSanders2015-57">[57]</a><a href="#cite_note-MitomaAdhikari2016-58">[58]</a> Gluten ataxia accounts for 40% of ataxias of unknown origin and 15% of all ataxias.<a href="#cite_note-HadjivassiliouSanders2015-57">[57]</a><a href="#cite_note-pmid12566288-59">[59]</a> Less than 10% of people with gluten ataxia present any gastrointestinal symptom, yet about 40% have intestinal damage.<a href="#cite_note-HadjivassiliouSanders2015-57">[57]</a> <div class="mw-heading mw-heading3"><h3 id="As_a_popular_diet">As a popular diet</h3>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=6" title="Edit section: As a popular diet">edit</a>]</div> Since the beginning of the 21st century, the gluten-free diet has become the most popular <a href="/wiki/Fad_diet" title="Fad diet">fad diet</a> in the United States and other countries.<a href="#cite_note-FasanoSapone2015-40">[40]</a> Clinicians worldwide have been challenged by an increasing number of people who do not have coeliac disease nor wheat allergy, with digestive or extra-digestive symptoms which improved removing wheat/gluten from the diet. Many of these persons began a gluten-free diet on their own, without having been previously evaluated.<a href="#cite_note-VoltaCaio2017-60">[60]</a><a href="#cite_note-LebwoholLudvigsson-quotation-33">[33]</a> Another reason that contributed to this trend was the publication of several books that demonize gluten and point to it as a cause of type 2 diabetes, weight gain and obesity, and a broad list of diseases ranging from depression and anxiety to arthritis and autism.<a href="#cite_note-NashSlutzky2014-61">[61]</a><a href="#cite_note-ShewryHey2016-62">[62]</a> The book that has had the most impact is Grain Brain: The Surprising Truth About Wheat, Carbs, and Sugar—Your Brain's Silent Killers, by the American neurologist <a href="/wiki/David_Perlmutter" title="David Perlmutter">David Perlmutter</a>, published in September 2013.<a href="#cite_note-NashSlutzky2014-61">[61]</a> Another book that has had great impact is <a href="/wiki/William_Davis_(cardiologist)#Wheat_Belly_in_the_public_forum" title="William Davis (cardiologist)">Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health</a>, by the cardiologist William Davis, which refers to wheat as a "chronic poison" and became a <a href="/wiki/The_New_York_Times_Best_Seller_list" title="The New York Times Best Seller list">New York Times bestseller</a> within a month of publication in 2011.<a href="#cite_note-63">[63]</a> The gluten-free diet has been advocated and followed by many celebrities to lose weight, such as <a href="/wiki/Miley_Cyrus" title="Miley Cyrus">Miley Cyrus</a>, <a href="/wiki/Gwyneth_Paltrow" title="Gwyneth Paltrow">Gwyneth Paltrow</a>, and <a href="/wiki/Kourtney_Kardashian" title="Kourtney Kardashian">Kourtney Kardashian</a>, and are used by some professional athletes, who believe the diet can improve energy and health.<a href="#cite_note-LebwoholLudvigsson-quotation-33">[33]</a><a href="#cite_note-Jones2017-64">[64]</a><a href="#cite_note-USAToday2013-65">[65]</a><a href="#cite_note-66">[66]</a> It became popular in the US, as the popularity of low-carbohydrate diets faded.<a href="#cite_note-:0-67">[67]</a> Estimates suggest that in 2014, 30% of people in the US and Australia were consuming gluten-free foods, with a growing number, calculated from surveys that by 2016 approximately 100 million Americans would consume gluten-free products.<a href="#cite_note-FasanoSapone2015-40">[40]</a><a href="#cite_note-NashSlutzky2014-61">[61]</a><a href="#cite_note-HeraldSun2014-68">[68]</a> Data from a 2015 Nielsen survey of 30,000 adults in 60 countries around the world conclude that 21% of people prefer to buy gluten-free foods, being the highest interest among the younger generations.<a href="#cite_note-Reilly2016-69">[69]</a> In the US, it was estimated that more than half of people who buy foods labeled gluten-free do not have a clear reaction to gluten, and they do so "because they think it will help them lose weight, because they seem to feel better or because they mistakenly believe they are sensitive to gluten."<a href="#cite_note-CBS-70">[70]</a> Although gluten is highly immunologically reactive and humans appear not to have evolved to digest it well, a gluten-free diet is not a healthier option for the general population, other than people with <a href="/wiki/Gluten#Disorders" title="Gluten">gluten-related disorders</a> or other associated conditions which improve with a gluten-free diet in some cases, such as irritable bowel syndrome and certain autoimmune and neurological disorders.<a href="#cite_note-ElChammasDanner2011Quotation-12">[12]</a><a href="#cite_note-Pietzak2012-55">[55]</a><a href="#cite_note-GaesserAngadi2012-71">[71]</a> There is no published experimental evidence to support that the gluten-free diet contributes to weight loss.<a href="#cite_note-GaesserAngadi2012-71">[71]</a> In a review of May 2015 published in <a href="/wiki/Gastroenterology_(journal)" title="Gastroenterology (journal)">Gastroenterology</a>, Fasano et al. conclude that, although there is an evident "fad component" to the recent rise in popularity of the gluten-free diet, there is also growing and unquestionable evidence of the existence of non-coeliac gluten sensitivity.<a href="#cite_note-FasanoSapone2015-quotation-72">[72]</a> In some cases, the popularity of the gluten-free diet may harm people who must eliminate gluten for medical reasons. For example, servers in restaurants may not take dietary requirements seriously, believing them to be merely a preference. This could prevent appropriate precautions in food handling to prevent gluten cross-contamination.<a href="#cite_note-NWF-73">[73]</a> Medical professionals may also confuse medical explanations for gluten intolerance with patient preference.<a href="#cite_note-Pietzak2012-55">[55]</a> On the other hand, the popularity of the gluten-free diet has increased the availability of commercial gluten-free replacement products and <a href="/w/index.php?title=Gluten-free_grains&action=edit&redlink=1" class="new" title="Gluten-free grains (page does not exist)">gluten-free grains</a>.<a href="#cite_note-GaesserAngadi2012-71">[71]</a> Gluten-free commercial replacement products, such as gluten-free cakes, are more expensive than their gluten-containing counterparts, so their purchase adds a financial burden.<a href="#cite_note-LudvigssonCard-31">[31]</a> They are also typically higher in calories, fat, and sugar, and lower in <a href="/wiki/Dietary_fiber" title="Dietary fiber">dietary fibre</a>.<a href="#cite_note-:0-67">[67]</a> In less developed countries, wheat can represent an important source of protein, since it is a substantial part of the diet in the form of bread, noodles, bulgur, couscous, and other products.<a href="#cite_note-LamacchiaCamarca2014-16">[16]</a><a href="#cite_note-74">[74]</a> In the British <a href="/wiki/National_Health_Service" title="National Health Service">National Health Service</a>, gluten-free foods have been supplied on prescription. For many patients, this meant at no cost. When it was proposed to alter this in 2018, the <a href="/wiki/Department_of_Health_and_Social_Care" title="Department of Health and Social Care">Department of Health and Social Care</a> made an assessment of the costs and benefits. The potential annual financial saving to the service was estimated at £5.3 million, taking into account the reduction in cost spending and the loss of income from prescription charges. The proposed scenario was actually that patients could still be prescribed gluten-free breads and mixes but would have to buy any other gluten-free products themselves. The savings would only amount to £700,000 a year. Local initiatives by <a href="/wiki/Clinical_commissioning_group" title="Clinical commissioning group">clinical commissioning groups</a> had already reduced the cost of gluten-free foods to the NHS by 39% between 2015 and 2017.<a href="#cite_note-75">[75]</a> Healthcare professionals recommend against undertaking a gluten-free diet as a form of <a href="/wiki/Self-diagnosis" title="Self-diagnosis">self-diagnosis</a>,<a href="#cite_note-slewis-76">[76]</a> because tests for coeliac disease are reliable only if the person has been consuming gluten recently. There is a consensus in the medical community that people should consult a physician before going on a gluten-free diet, so that a medical professional can accurately test for coeliac disease or any other <a href="/wiki/Gluten-related_disorders" title="Gluten-related disorders">gluten-induced health issues</a>.<a href="#cite_note-ElliBranchi2015-77">[77]</a> Although popularly used as an <a href="/wiki/Complementary_and_alternative_medicine" class="mw-redirect" title="Complementary and alternative medicine">alternative treatment</a> for people with autism, there is no good evidence that a gluten-free diet is of benefit in reducing the symptoms of <a href="/wiki/Autism" title="Autism">autism</a>.<a href="#cite_note-MariBausetZazpe2014-13">[13]</a><a href="#cite_note-Buie2013-14">[14]</a><a href="#cite_note-Millward2008-15">[15]</a> <div class="mw-heading mw-heading3"><h3 id="Research">Research</h3>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=7" title="Edit section: Research">edit</a>]</div> In a 2013 <a href="/wiki/Blind_experiment#Double-blind_trials" class="mw-redirect" title="Blind experiment">double-blind</a>, <a href="/wiki/Placebo-controlled_study" title="Placebo-controlled study">placebo-controlled</a> challenge (DBPC) by Biesiekierski et al. in a few people with <a href="/wiki/Irritable_bowel_syndrome" title="Irritable bowel syndrome">irritable bowel syndrome</a>, the authors found no difference between gluten or placebo groups and the concept of non-celiac gluten sensitivity as a syndrome was questioned. Nevertheless, this study had design errors and an incorrect selection of participants, and probably the reintroduction of both gluten and <a href="/wiki/Whey" title="Whey">whey</a> protein had a <a href="/wiki/Nocebo" title="Nocebo">nocebo</a> effect similar in all people, and this could have masked the true effect of gluten/wheat reintroduction.<a href="#cite_note-ElliBranchi-30">[30]</a><a href="#cite_note-AzizHadjivassiliou2015-42">[42]</a> In a 2015 double-blind placebo cross-over trial, small amounts of purified wheat gluten triggered gastrointestinal symptoms (such as abdominal bloating and pain) and extra-intestinal manifestations (such as foggy mind, depression and aphthous stomatitis) in self-reported non-celiac gluten sensitivity. Nevertheless, it remains elusive whether these findings specifically implicate gluten or other proteins present in gluten-containing cereals.<a href="#cite_note-AzizHadjivassiliou2015-42">[42]</a> In a 2018 double-blind, crossover research study on 59 persons on a gluten-free diet with challenges of <a href="/wiki/Gluten" title="Gluten">gluten</a>, <a href="/wiki/Fructans" class="mw-redirect" title="Fructans">fructans</a> or <a href="/wiki/Placebo" title="Placebo">placebo</a>, intestinal symptoms (specifically <a href="/wiki/Bloating" title="Bloating">bloating</a>) were borderline significantly higher after challenge with fructans, in comparison with gluten proteins (P=0.049).<a href="#cite_note-Verbeke2018-45">[45]</a><a href="#cite_note-VoltaDeGiorgio2019-48">[48]</a> Although the differences between the three interventions was very small, the authors concluded that fructans (the specific type of <a href="/wiki/FODMAP" title="FODMAP">FODMAP</a> found in wheat) are more likely to be the cause of gastrointestinal symptoms of non-celiac gluten sensitivity, rather than gluten.<a href="#cite_note-Verbeke2018-45">[45]</a> For this previous study, experts recommend a low FODMAP diet instead of a gluten free diet for those patients suffering of functional gastrointestinal disorders as <a href="/wiki/Bloating" title="Bloating">bloating</a>.<a href="#cite_note-78">[78]</a> In addition, fructans used in the study were extracted from <a href="/wiki/Chicory_root" class="mw-redirect" title="Chicory root">chicory root</a>, so it remains to be seen whether the wheat fructans produce the same effect.<a href="#cite_note-VoltaDeGiorgio2019-48">[48]</a> <div class="mw-heading mw-heading2"><h2 id="Eating_gluten-free">Eating gluten-free</h2>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=8" title="Edit section: Eating gluten-free">edit</a>]</div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Chenopodium_quinoa0.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f4/Chenopodium_quinoa0.jpg/200px-Chenopodium_quinoa0.jpg" decoding="async" width="200" height="150" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f4/Chenopodium_quinoa0.jpg/300px-Chenopodium_quinoa0.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f4/Chenopodium_quinoa0.jpg/400px-Chenopodium_quinoa0.jpg 2x" data-file-width="640" data-file-height="480" /></a><figcaption><a href="/wiki/Quinoa" title="Quinoa">Quinoa</a> is a <a href="/wiki/Pseudocereal" title="Pseudocereal">pseudocereal</a> that is gluten-free.</figcaption></figure> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Home_made_buckwheat_bread.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b4/Home_made_buckwheat_bread.jpg/200px-Home_made_buckwheat_bread.jpg" decoding="async" width="200" height="112" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b4/Home_made_buckwheat_bread.jpg/300px-Home_made_buckwheat_bread.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/b4/Home_made_buckwheat_bread.jpg/400px-Home_made_buckwheat_bread.jpg 2x" data-file-width="5152" data-file-height="2896" /></a><figcaption>Gluten-free bread made of a mixture of flours like buckwheat flour, tapioca flour, millet flour and psyllium seed husks. Special flour mixes can be bought for bread-making purposes.</figcaption></figure> A gluten-free diet is a diet that strictly excludes gluten, proteins present in wheat (and all wheat varieties such as <a href="/wiki/Spelt" title="Spelt">spelt</a> and <a href="/wiki/Kamut" class="mw-redirect" title="Kamut">kamut</a>), <a href="/wiki/Barley" title="Barley">barley</a>, <a href="/wiki/Rye" title="Rye">rye</a>, <a href="/wiki/Oat" title="Oat">oat</a>, and derivatives of these grains such as <a href="/wiki/Malt" title="Malt">malt</a> and <a href="/wiki/Triticale" title="Triticale">triticale</a>, and foods that may include them, or shared transportation or processing facilities with them.<a href="#cite_note-Biesiekierski2017-1">[1]</a><a href="#cite_note-Saturni-etal-2010-table2-p21-17">[17]</a> The inclusion of <a href="/wiki/Oats" class="mw-redirect" title="Oats">oats</a> in a gluten-free diet remains controversial.<a href="#cite_note-Biesiekierski2017-1">[1]</a> <a href="/wiki/Oat#Celiac_disease" title="Oat">Oat toxicity</a> in people with <a href="/wiki/Gluten-related_disorders" title="Gluten-related disorders">gluten-related disorders</a> depends on the oat <a href="/wiki/Cultivar" title="Cultivar">cultivar</a> consumed because the <a href="/wiki/Immunoreactivity" class="mw-redirect" title="Immunoreactivity">immunoreactivities</a> of toxic <a href="/wiki/Prolamin" title="Prolamin">prolamins</a> are different among oat <a href="/wiki/Cultivar" title="Cultivar">varieties</a>.<a href="#cite_note-PenaginiDilillo-4">[4]</a><a href="#cite_note-CominoMoreno2015-3">[3]</a> Furthermore, oats are frequently cross-contaminated with the other gluten-containing cereals.<a href="#cite_note-PenaginiDilillo-4">[4]</a> Pure oat (labelled as "pure oat" or "gluten-free oat"<a href="#cite_note-CiacciCiclitira2015-2">[2]</a>) refers to oats uncontaminated with any of the other gluten-containing cereals.<a href="#cite_note-CominoMoreno2015-3">[3]</a> Some cultivars of pure oat could be a safe part of a gluten-free diet, requiring knowledge of the oat variety used in food products for a gluten-free diet.<a href="#cite_note-CominoMoreno2015-3">[3]</a> Nevertheless, the long-term effects of pure oats consumption are still unclear<a href="#cite_note-HaboubiTaylor2006-79">[79]</a> and further studies identifying the cultivars used are needed before making final recommendations on their inclusion in the gluten-free diet.<a href="#cite_note-DeSouzaDeschenes2016-5">[5]</a> Other grains, although gluten-free in themselves, may contain gluten by cross-contamination with gluten-containing cereals during grain harvesting, transporting, milling, storing, processing, handling or cooking.<a href="#cite_note-FSAI-80">[80]</a><a href="#cite_note-CominoMoreno2013-81">[81]</a> Processed foods commonly contain gluten as an additive (as emulsifiers, thickeners, gelling agents, fillers, and coatings), so they would need specific labeling. Unexpected sources of gluten are, among others, processed meat, vegetarian meat substitutes, reconstituted seafood, stuffings, butter, seasonings, marinades, dressings, confectionary, candies, and ice cream.<a href="#cite_note-Biesiekierski2017-1">[1]</a> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Gluten_Free_Rice_Flour.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6f/Gluten_Free_Rice_Flour.jpg/220px-Gluten_Free_Rice_Flour.jpg" decoding="async" width="220" height="147" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6f/Gluten_Free_Rice_Flour.jpg/330px-Gluten_Free_Rice_Flour.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/6f/Gluten_Free_Rice_Flour.jpg/440px-Gluten_Free_Rice_Flour.jpg 2x" data-file-width="800" data-file-height="533" /></a><figcaption>Gluten-free rice flour</figcaption></figure> Cross-contamination in the home is also a consideration for those who have <a href="/wiki/Gluten-related_disorders" title="Gluten-related disorders">gluten-related disorders</a>.<a href="#cite_note-FrancavillaCristofori2014-23">[23]</a><a href="#cite_note-SeeKaukinen2015-10">[10]</a> There can be many sources of cross-contamination, as for example when family members prepare gluten-free and gluten-containing foods on the same surfaces (countertops, tables, etc.) or share utensils that have not been cleaned after being used to prepare gluten-containing foods (cutting boards, colanders, cutlery, etc.), kitchen equipment (toaster, cupboards, etc.) or certain packaged foods (butter, peanut butter, etc.).<a href="#cite_note-SeeKaukinen2015-10">[10]</a> <figure class="mw-halign-left" typeof="mw:File/Thumb"><a href="/wiki/File:Gluten-free_grocery_store_section.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/9c/Gluten-free_grocery_store_section.jpg/161px-Gluten-free_grocery_store_section.jpg" decoding="async" width="161" height="215" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/9c/Gluten-free_grocery_store_section.jpg/242px-Gluten-free_grocery_store_section.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/9c/Gluten-free_grocery_store_section.jpg/322px-Gluten-free_grocery_store_section.jpg 2x" data-file-width="3024" data-file-height="4032" /></a><figcaption>A grocery store's aisle of gluten-free food items.</figcaption></figure> Restaurants prove to be another source of cross-contamination for those following a strict gluten-free diet. A study conducted by Columbia University Medical Center found that 32% of foods labeled gluten-free at restaurants contain above 20 parts per million of gluten, meaning that it contains enough gluten that it is no longer considered gluten-free by the <a href="/wiki/Codex_Alimentarius" title="Codex Alimentarius">Codex Alimentarius</a>.<a href="#cite_note-82">[82]</a> Cross-contamination occurs in these areas frequently because of a general lack of knowledge about the needed level of caution and the prevalence of gluten in restaurant kitchens.<a href="#cite_note-83">[83]</a> If cooks are unaware of the severity of their guest's diet restrictions or of the important practices needed to limit cross-contamination, they can unknowingly deliver contaminated food. However, some restaurants utilize a training program for their employees to educate them about the gluten-free diet.<a href="#cite_note-84">[84]</a> The accuracy of the training varies. One resource to find these safer restaurants is an app and website called "Find Me Gluten Free" that allows people following a gluten-free diet to rate the safety of different restaurants from their point of view and describe their experience to help future customers. Easily locating gluten-free items is one of the main difficulties in following a gluten-free diet. To assist in this process, many restaurants and grocery stores choose to label food items. Restaurants often add a gluten-free section to their menu, or specifically mark gluten-free items with a symbol of some kind. Grocery stores often have a gluten-free aisle, or they will attach labels on the shelf underneath gluten-free items. Though the food is labeled gluten-free in this way, it does not necessarily mean that the food is safe for those with gluten-related disorders, as a compilation of studies suggest.<a href="#cite_note-:02-85">[85]</a> <a href="/wiki/Medication" title="Medication">Medications</a> and <a href="/wiki/Dietary_supplements" class="mw-redirect" title="Dietary supplements">dietary supplements</a> are made using <a href="/wiki/Excipients" class="mw-redirect" title="Excipients">excipients</a> that may contain gluten.<a href="#cite_note-86">[86]</a> <div class="mw-heading mw-heading3"><h3 id="Gluten-free_food">Gluten-free food</h3>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=9" title="Edit section: Gluten-free food">edit</a>]</div> The gluten-free diet includes naturally gluten-free food, such as meat, fish, <a href="/wiki/Seafood" title="Seafood">seafood</a>, eggs, milk and <a href="/wiki/Dairy_product" title="Dairy product">dairy products</a>, <a href="/wiki/Nut_(fruit)" title="Nut (fruit)">nuts</a>, <a href="/wiki/Legumes" class="mw-redirect" title="Legumes">legumes</a>, fruit, vegetables, <a href="/wiki/Potato" title="Potato">potatoes</a>, <a href="/wiki/Pseudocereal" title="Pseudocereal">pseudocereals</a> (in particular <a href="/wiki/Amaranth" title="Amaranth">amaranth</a>, <a href="/wiki/Buckwheat" title="Buckwheat">buckwheat</a>, <a href="/wiki/Chia_seed" title="Chia seed">chia seed</a>, <a href="/wiki/Quinoa" title="Quinoa">quinoa</a>), only certain <a href="/wiki/Cereal" title="Cereal">cereal</a> grains (<a href="/wiki/Maize" title="Maize">corn</a>, rice, <a href="/wiki/Sorghum" title="Sorghum">sorghum</a>), minor cereals (including <a href="/wiki/Fonio" title="Fonio">fonio</a>, <a href="/wiki/Job%27s_tears" title="Job's tears">Job's tears</a>, <a href="/wiki/Millet" title="Millet">millet</a>, <a href="/wiki/Teff" title="Teff">teff</a>, called "minor" cereals as they are "less common and are only grown in a few small regions of the world"),<a href="#cite_note-Saturni-etal-2010-table2-p21-17">[17]</a> some other plant products (<a href="/wiki/Arrowroot" title="Arrowroot">arrowroot</a>, <a href="/wiki/Mesquite_flour" title="Mesquite flour">mesquite flour</a>,<a href="#cite_note-Kohlstadt2012-p318-87">[87]</a> <a href="/wiki/Sago" title="Sago">sago</a>,<a href="#cite_note-pmid13560852-88">[88]</a> <a href="/wiki/Tapioca" title="Tapioca">tapioca</a><a href="#cite_note-pmid13560852-88">[88]</a>) and products made from these gluten-free foods. Many <a href="/wiki/Indian_cuisine" title="Indian cuisine">Indian cuisine</a> options, particularly <a href="/wiki/South_Indian_cuisine" title="South Indian cuisine">South Indian cuisine</a>, are gluten-free.<a href="#cite_note-89">[89]</a> <div class="mw-heading mw-heading3"><h3 id="Risks">Risks</h3>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=10" title="Edit section: Risks">edit</a>]</div> An unbalanced selection of food and an incorrect choice of gluten-free replacement products may lead to nutritional deficiencies. Replacing flour from wheat or other gluten-containing cereals with gluten-free flours in commercial products may lead to a lower intake of important nutrients, such as <a href="/wiki/Iron" title="Iron">iron</a> and <a href="/wiki/B_vitamins" title="B vitamins">B vitamins</a> and a higher intake of sugars and saturated fats. Some gluten-free commercial replacement products are not enriched or fortified as their gluten-containing counterparts, and often have greater <a href="/wiki/Lipid" title="Lipid">lipid</a> / <a href="/wiki/Carbohydrate" title="Carbohydrate">carbohydrate</a> content. Children especially often over-consume these products, such as snacks and biscuits. These nutritional complications can be prevented by a correct dietary education.<a href="#cite_note-PenaginiDilillo-4">[4]</a> <a href="/wiki/Pseudocereal" title="Pseudocereal">Pseudocereals</a> (<a href="/wiki/Quinoa" title="Quinoa">quinoa</a>, <a href="/wiki/Amaranth" title="Amaranth">amaranth</a>, and <a href="/wiki/Buckwheat" title="Buckwheat">buckwheat</a>) and some minor cereals are healthy alternatives to these prepared products and have higher biological and nutritional value.<a href="#cite_note-PenaginiDilillo-4">[4]</a><a href="#cite_note-LamacchiaCamarca2014-16">[16]</a> Advances towards higher nutrition-content gluten-free bakery products, improved for example in terms of fiber content and glycemic index, have been made by using not exclusively <a href="/wiki/Corn_starch" title="Corn starch">corn starch</a> or other starches to substitute for flour. In this aim, for example the dietary fibre <a href="/wiki/Inulin" title="Inulin">inulin</a> (which acts as a <a href="/wiki/Prebiotic_(nutrition)" title="Prebiotic (nutrition)">prebiotic</a><a href="#cite_note-90">[90]</a>) or quinoa or amaranth wholemeal have been as substitute for part of the flour. Similarly, <a href="/wiki/Xanthan_gum" title="Xanthan gum">xanthan gum</a> can be used in up to gram quantities per serving in some gluten-free baked goods and can be fermented by specific microbiomes in the gastrointestinal tract.<a href="#cite_note-91">[91]</a><a href="#cite_note-92">[92]</a> Such substitution has been found to also yield improved crust and texture of bread.<a href="#cite_note-GallagherGormley2004-93">[93]</a> It is recommended that anyone embarking on a gluten-free diet check with a registered dietitian to make sure they are getting the required amount of key nutrients like iron, calcium, fiber, thiamin, riboflavin, niacin and folate. Vitamins often contain gluten as a binding agent. Experts have advised that it is important to always read the content label of any product that is intended to be swallowed.<a href="#cite_note-94">[94]</a> Up to 30% of people with known coeliac disease often continue having or redeveloping symptoms.<a href="#cite_note-SeeKaukinen2015-10">[10]</a><a href="#cite_note-AGA2006-95">[95]</a> Also, a lack of symptoms or negative <a href="/wiki/Coeliac_disease#Blood_tests" title="Coeliac disease">blood antibodies</a> levels are not reliable indicators of intestinal recuperation. Several studies show an incomplete recovery of small bowel despite a strict gluten-free diet, and about 79% of such people have persistent <a href="/wiki/Villous_atrophy" class="mw-redirect" title="Villous atrophy">villous atrophy</a>.<a href="#cite_note-SeeKaukinen2015-10">[10]</a> This lack of recovery is mainly caused by inadvertent exposure to gluten.<a href="#cite_note-SeeKaukinen2015-10">[10]</a><a href="#cite_note-AGA2006-95">[95]</a> People with poor basic education and understanding of the gluten-free diet often believe that they are strictly following the diet, but are making regular errors.<a href="#cite_note-MulderWanrooij-11">[11]</a><a href="#cite_note-SeeKaukinen2015-10">[10]</a> In addition, some people often deliberately continue eating gluten because of limited availability, inferior taste, higher price, and inadequate labelling of gluten-free products. Poor compliance with the regimen is also influenced by age at diagnosis (adolescents), ignorance of the consequences of the lack of a strict treatment and certain psychological factors.<a href="#cite_note-SeeKaukinen2015-10">[10]</a> Ongoing gluten intake can cause severe disease complications, such as various types of cancers (both intestinal and extra-intestinal) and <a href="/wiki/Osteoporosis" title="Osteoporosis">osteoporosis</a>.<a href="#cite_note-SeeKaukinen2015-10">[10]</a><a href="#cite_note-AGA2006-95">[95]</a> <div class="mw-heading mw-heading2"><h2 id="Regulation_and_labels">Regulation and labels</h2>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=11" title="Edit section: Regulation and labels">edit</a>]</div> The term gluten-free is generally used to indicate a supposed harmless level of gluten rather than a complete absence.<a href="#cite_note-Akobeng2008-19">[19]</a> The exact level at which gluten is harmless is uncertain and controversial. A 2008 <a href="/wiki/Systematic_review" title="Systematic review">systematic review</a> tentatively concluded that consumption of less than 10 mg (10 ppm) of gluten per day is unlikely to cause histological abnormalities, although it noted that few reliable studies had been done.<a href="#cite_note-Akobeng2008-19">[19]</a> Regulation of the label gluten-free varies by country. Most countries derive key provisions of their gluten-free labelling regulations from the <a href="/wiki/Codex_Alimentarius" title="Codex Alimentarius">Codex Alimentarius</a> <a href="/wiki/International_standard" title="International standard">international standards</a> for <a href="/wiki/Food_labeling" class="mw-redirect" title="Food labeling">food labelling</a> as a standard relating to the labelling of products as gluten-free. It only applies to foods that would normally contain gluten.<a href="#cite_note-96">[96]</a> Gluten-free is defined as 20 ppm (= 20 mg/kg) or less. It categorizes gluten-free food as: <ul><li>Food that is gluten-free by composition</li> <li>Food that has become gluten-free through special processing.</li> <li>Reduced gluten content, food which includes food products with between 20 and 100 ppm of gluten Reduced gluten content is left up to individual nations to more specifically define.</li></ul> The Codex Standard suggests the enzyme-linked Immunoassay (ELISA) R5 Mendez method for indicating the presence of gluten, but allows for other relevant methods, such as DNA. The Codex Standard specifies that the gluten-free claim must appear in the immediate proximity of the name of the product, to ensure visibility. There is no general agreement on the analytical method used to measure gluten in ingredients and food products.<a href="#cite_note-97">[97]</a> The ELISA method was designed to detect w-gliadins, but it suffered from the setback that it lacked sensitivity for barley prolamins.<a href="#cite_note-98">[98]</a> The use of highly sensitive assays is mandatory to certify gluten-free food products. The European Union, World Health Organization, and Codex Alimentarius require reliable measurement of the wheat prolamins, gliadins rather than all-wheat proteins.<a href="#cite_note-99">[99]</a> <div class="mw-heading mw-heading3"><h3 id="Australia">Australia</h3>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=12" title="Edit section: Australia">edit</a>]</div> The Australian government recommends<a href="#cite_note-100">[100]</a> that: <ul><li>food labelled gluten-free include no detectable gluten (<3ppm <a href="#cite_note-101">[101]</a>) oats or their products, cereals containing gluten that have been malted or their products</li> <li>food labelled low gluten claims such that the level of 20 mg gluten per 100 g of the food</li></ul> <div class="mw-heading mw-heading3"><h3 id="Brazil">Brazil</h3>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=13" title="Edit section: Brazil">edit</a>]</div> All food products must be clearly labelled whether they contain gluten or they are gluten-free.<a href="#cite_note-"ANVISA2017"-102">[102]</a> Since April 2016, the declaration of the possibility of cross-contamination is mandatory when the product does not intentionally add any allergenic food or its derivatives, but the Good Manufacturing Practices and allergen control measures adopted are not sufficient to prevent the presence of accidental trace amounts.<a href="#cite_note-ANVISA2016-103">[103]</a> When a product contains the warning of cross-contamination with wheat, rye, barley, oats and their hybridized strains, the warning "contains gluten" is mandatory. The law does not establish a gluten threshold for the declaration of its absence.<a href="#cite_note-"ANVISA2017"-102">[102]</a> <div class="mw-heading mw-heading3"><h3 id="Canada">Canada</h3>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=14" title="Edit section: Canada">edit</a>]</div> <a href="/wiki/Health_Canada" title="Health Canada">Health Canada</a> considers that foods containing levels of gluten not exceeding 20 ppm as a result of contamination, meet the health and safety intent of section B.24.018 of the Food and Drug Regulations when a gluten-free claim is made.<a href="#cite_note-104">[104]</a> Any intentionally added gluten, even at low levels must be declared on the packaging and a gluten-free claim would be considered false and misleading. Labels for all food products sold in Canada must clearly identify the presence of gluten if it is present at a level greater than 10 ppm.<a href="#cite_note-105">[105]</a> <div class="mw-heading mw-heading3"><h3 id="European_Union">European Union</h3>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=15" title="Edit section: European Union">edit</a>]</div> The EU <a href="/wiki/European_Commission" title="European Commission">European Commission</a> delineates<a href="#cite_note-106">[106]</a> the categories as: <ul><li>gluten-free: 20 ppm or less of gluten</li> <li>very low gluten foodstuffs: 20-100ppm gluten.</li></ul> All foods containing gluten as an ingredient must be labelled accordingly as gluten is defined as one of the 14 recognized EU allergens.<a href="#cite_note-107">[107]</a> <div class="mw-heading mw-heading3"><h3 id="United_States">United States</h3>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=16" title="Edit section: United States">edit</a>]</div> Until 2012 anyone could use the gluten-free claim with no repercussion.<a href="#cite_note-108">[108]</a><a href="#cite_note-109">[109]</a> In 2008, Wellshire Farms chicken nuggets labelled gluten-free were purchased and samples were sent to a food allergy laboratory<a href="#cite_note-110">[110]</a> where they were found to contain gluten. After this was reported in the <a href="/wiki/Chicago_Tribune" title="Chicago Tribune">Chicago Tribune</a>, the products continued to be sold. The manufacturer has since replaced the batter used in its chicken nuggets.<a href="#cite_note-111">[111]</a> The U.S. first addressed gluten-free labelling in the 2004 <a href="/wiki/Food_Allergen_Labeling_and_Consumer_Protection_Act" title="Food Allergen Labeling and Consumer Protection Act">Food Allergen Labeling and Consumer Protection Act</a> (FALCPA). The <a href="/wiki/Alcohol_and_Tobacco_Tax_and_Trade_Bureau" title="Alcohol and Tobacco Tax and Trade Bureau">Alcohol and Tobacco Tax and Trade Bureau</a> published interim rules and proposed mandatory labelling for <a href="/wiki/Alcohol_(drug)" title="Alcohol (drug)">alcoholic</a> products in 2006.<a href="#cite_note-112">[112]</a> The FDA issued their Final Rule on August 5, 2013.<a href="#cite_note-113">[113]</a> When a food producer voluntarily chooses to use a gluten-free claim for a product, the food bearing the claim in its labelling may not contain: <ul><li>an ingredient that is a gluten-containing grain</li> <li>an ingredient that is derived from a gluten-containing grain that has not been processed to remove gluten</li> <li>an ingredient that is derived from a gluten-containing grain, that has been processed to remove gluten but results in the presence of 20 ppm or more gluten in the food. Any food product claiming to be gluten-free and also bearing the term "wheat" in its ingredient list or in a separate "Contains wheat" statement, must also include the language "*the wheat has been processed to allow this food to meet the FDA requirements for gluten-free foods," in close proximity to the ingredient statement.</li></ul> Any food product that inherently does not contain gluten may use a gluten-free label where any unavoidable presence of gluten in the food bearing the claim in its labelling is below 20 ppm gluten. <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=17" title="Edit section: See also">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1239009302">.mw-parser-output .portalbox{padding:0;margin:0.5em 0;display:table;box-sizing:border-box;max-width:175px;list-style:none}.mw-parser-output .portalborder{border:1px solid var(--border-color-base,#a2a9b1);padding:0.1em;background:var(--background-color-neutral-subtle,#f8f9fa)}.mw-parser-output .portalbox-entry{display:table-row;font-size:85%;line-height:110%;height:1.9em;font-style:italic;font-weight:bold}.mw-parser-output .portalbox-image{display:table-cell;padding:0.2em;vertical-align:middle;text-align:center}.mw-parser-output .portalbox-link{display:table-cell;padding:0.2em 0.2em 0.2em 0.3em;vertical-align:middle}@media(min-width:720px){.mw-parser-output .portalleft{clear:left;float:left;margin:0.5em 1em 0.5em 0}.mw-parser-output .portalright{clear:right;float:right;margin:0.5em 0 0.5em 1em}}</style><ul role="navigation" aria-label="Portals" class="noprint portalbox portalborder portalright"> <li class="portalbox-entry"><a href="/wiki/File:Foodlogo2.svg" class="mw-file-description"><img alt="icon" src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Foodlogo2.svg/32px-Foodlogo2.svg.png" decoding="async" width="32" height="23" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Foodlogo2.svg/48px-Foodlogo2.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Foodlogo2.svg/64px-Foodlogo2.svg.png 2x" data-file-width="146" data-file-height="106" /></a><a href="/wiki/Portal:Food" title="Portal:Food">Food portal</a></li><li class="portalbox-entry"><img alt="icon" src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/WHO_Rod.svg/12px-WHO_Rod.svg.png" decoding="async" width="12" height="28" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/WHO_Rod.svg/18px-WHO_Rod.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d6/WHO_Rod.svg/24px-WHO_Rod.svg.png 2x" data-file-width="107" data-file-height="250" /><a href="/wiki/Portal:Medicine" title="Portal:Medicine">Medicine portal</a></li></ul> <ul><li><a href="/wiki/2010s_in_food" class="mw-redirect" title="2010s in food">2010s in food</a></li> <li><a href="/wiki/Gluten-free,_casein-free_diet" title="Gluten-free, casein-free diet">Gluten-free, casein-free diet</a></li> <li><a href="/wiki/List_of_diets" title="List of diets">List of diets</a></li> <li><a href="/wiki/Paleolithic_diet" title="Paleolithic diet">Paleolithic diet</a></li> <li><a href="/wiki/Specific_carbohydrate_diet" title="Specific carbohydrate diet">Specific carbohydrate diet</a></li></ul> <div style="clear:both;" class=""></div> <div class="mw-heading mw-heading2"><h2 id="References">References</h2>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=18" title="Edit section: References">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-Biesiekierski2017-1">^ <a href="#cite_ref-Biesiekierski2017_1-0">a</a> <a href="#cite_ref-Biesiekierski2017_1-1">b</a> <a href="#cite_ref-Biesiekierski2017_1-2">c</a> <a href="#cite_ref-Biesiekierski2017_1-3">d</a> <style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFBiesiekierski2017" class="citation journal cs1">Biesiekierski JR (March 2017). <a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fjgh.13703">"What is gluten?"</a>. Journal of Gastroenterology and Hepatology (Review). 32 (Suppl 1): 78–81. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fjgh.13703">10.1111/jgh.13703</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28244676">28244676</a>. <q>Similar proteins to the gliadin found in wheat exist as secalin in rye, hordein in barley, and avenins in oats and are collectively referred to as 'gluten.' Derivatives of these grains such as triticale and malt and other ancient wheat varieties such as spelt and kamut also contain gluten. The gluten found in all of these grains has been identified as the component capable of triggering the immune-mediated disorder, coeliac disease.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Gastroenterology+and+Hepatology&rft.atitle=What+is+gluten%3F&rft.volume=32&rft.issue=Suppl+1&rft.pages=78-81&rft.date=2017-03&rft_id=info%3Adoi%2F10.1111%2Fjgh.13703&rft_id=info%3Apmid%2F28244676&rft.aulast=Biesiekierski&rft.aufirst=JR&rft_id=https%3A%2F%2Fdoi.org%2F10.1111%252Fjgh.13703&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGluten-free+diet" class="Z3988"><a href="/wiki/Open_access" title="open access publication – free to read"><img alt="Open access icon" src="//upload.wikimedia.org/wikipedia/commons/thumb/7/77/Open_Access_logo_PLoS_transparent.svg/9px-Open_Access_logo_PLoS_transparent.svg.png" decoding="async" width="9" height="14" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/77/Open_Access_logo_PLoS_transparent.svg/14px-Open_Access_logo_PLoS_transparent.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/77/Open_Access_logo_PLoS_transparent.svg/18px-Open_Access_logo_PLoS_transparent.svg.png 2x" data-file-width="640" data-file-height="1000" /></a> </li> <li id="cite_note-CiacciCiclitira2015-2">^ <a href="#cite_ref-CiacciCiclitira2015_2-0">a</a> <a href="#cite_ref-CiacciCiclitira2015_2-1">b</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFCiacciCiclitiraHadjivassiliouKaukinen2015" class="citation journal cs1">Ciacci C, Ciclitira P, Hadjivassiliou M, Kaukinen K, Ludvigsson JF, McGough N, et al. (April 2015). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406897">"The gluten-free diet and its current application in coeliac disease and dermatitis herpetiformis"</a>. United European Gastroenterology Journal (Review). 3 (2): 121–35. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1177%2F2050640614559263">10.1177/2050640614559263</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406897">4406897</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25922672">25922672</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=United+European+Gastroenterology+Journal&rft.atitle=The+gluten-free+diet+and+its+current+application+in+coeliac+disease+and+dermatitis+herpetiformis&rft.volume=3&rft.issue=2&rft.pages=121-35&rft.date=2015-04&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4406897%23id-name%3DPMC&rft_id=info%3Apmid%2F25922672&rft_id=info%3Adoi%2F10.1177%2F2050640614559263&rft.aulast=Ciacci&rft.aufirst=C&rft.au=Ciclitira%2C+P&rft.au=Hadjivassiliou%2C+M&rft.au=Kaukinen%2C+K&rft.au=Ludvigsson%2C+JF&rft.au=McGough%2C+N&rft.au=Sanders%2C+DS&rft.au=Woodward%2C+J&rft.au=Leonard%2C+JN&rft.au=Swift%2C+GL&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4406897&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGluten-free+diet" class="Z3988"> </li> <li id="cite_note-CominoMoreno2015-3">^ <a href="#cite_ref-CominoMoreno2015_3-0">a</a> <a href="#cite_ref-CominoMoreno2015_3-1">b</a> <a href="#cite_ref-CominoMoreno2015_3-2">c</a> <a href="#cite_ref-CominoMoreno2015_3-3">d</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFCominoMorenoSousa2015" class="citation journal cs1">Comino I, Moreno MD, Sousa C (November 2015). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4631980">"Role of oats in celiac disease"</a>. World Journal of Gastroenterology. 21 (41): 11825–31. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3748%2Fwjg.v21.i41.11825">10.3748/wjg.v21.i41.11825</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4631980">4631980</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26557006">26557006</a>. <q>It is necessary to consider that oats include many varieties, containing various amino acid sequences and showing different immunoreactivities associated with toxic prolamins. As a result, several studies have shown that the immunogenicity of oats varies depending on the cultivar consumed. Thus, it is essential to thoroughly study the variety of oats used in a food ingredient before including it in a gluten-free diet.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=World+Journal+of+Gastroenterology&rft.atitle=Role+of+oats+in+celiac+disease&rft.volume=21&rft.issue=41&rft.pages=11825-31&rft.date=2015-11&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4631980%23id-name%3DPMC&rft_id=info%3Apmid%2F26557006&rft_id=info%3Adoi%2F10.3748%2Fwjg.v21.i41.11825&rft.aulast=Comino&rft.aufirst=I&rft.au=Moreno%2C+MD&rft.au=Sousa%2C+C&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4631980&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGluten-free+diet" class="Z3988"> </li> <li id="cite_note-PenaginiDilillo-4">^ <a href="#cite_ref-PenaginiDilillo_4-0">a</a> <a href="#cite_ref-PenaginiDilillo_4-1">b</a> <a href="#cite_ref-PenaginiDilillo_4-2">c</a> <a href="#cite_ref-PenaginiDilillo_4-3">d</a> <a href="#cite_ref-PenaginiDilillo_4-4">e</a> <a href="#cite_ref-PenaginiDilillo_4-5">f</a> <a href="#cite_ref-PenaginiDilillo_4-6">g</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFPenaginiDililloMeneghinMameli2013" class="citation journal cs1">Penagini F, Dilillo D, Meneghin F, Mameli C, Fabiano V, Zuccotti GV (November 2013). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847748">"Gluten-free diet in children: an approach to a nutritionally adequate and balanced diet"</a>. Nutrients. 5 (11): 4553–65. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3390%2Fnu5114553">10.3390/nu5114553</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847748">3847748</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24253052">24253052</a>. <q>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 like 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. (...) 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.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nutrients&rft.atitle=Gluten-free+diet+in+children%3A+an+approach+to+a+nutritionally+adequate+and+balanced+diet&rft.volume=5&rft.issue=11&rft.pages=4553-65&rft.date=2013-11&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3847748%23id-name%3DPMC&rft_id=info%3Apmid%2F24253052&rft_id=info%3Adoi%2F10.3390%2Fnu5114553&rft.aulast=Penagini&rft.aufirst=F&rft.au=Dilillo%2C+D&rft.au=Meneghin%2C+F&rft.au=Mameli%2C+C&rft.au=Fabiano%2C+V&rft.au=Zuccotti%2C+GV&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3847748&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGluten-free+diet" class="Z3988"> </li> <li id="cite_note-DeSouzaDeschenes2016-5">^ <a href="#cite_ref-DeSouzaDeschenes2016_5-0">a</a> <a href="#cite_ref-DeSouzaDeschenes2016_5-1">b</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFde_SouzaDeschênesLaurencelleGodet2016" class="citation journal cs1">de Souza MC, Deschênes ME, Laurencelle S, Godet P, Roy CC, Djilali-Saiah I (2016). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4904650">"Pure Oats as Part of the Canadian Gluten-Free Diet in Celiac Disease: The Need to Revisit the Issue"</a>. 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"Gluten-free diet in gluten-related disorders". Digestive Diseases (Review). 31 (1): 57–62. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1159%2F000347180">10.1159/000347180</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23797124">23797124</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:14124370">14124370</a>. <q>The only treatment for CD, dermatitis herpetiformis (DH) and gluten ataxia is lifelong adherence to a GFD.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Digestive+Diseases&rft.atitle=Gluten-free+diet+in+gluten-related+disorders&rft.volume=31&rft.issue=1&rft.pages=57-62&rft.date=2013&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A14124370%23id-name%3DS2CID&rft_id=info%3Apmid%2F23797124&rft_id=info%3Adoi%2F10.1159%2F000347180&rft.aulast=Mulder&rft.aufirst=CJ&rft.au=van+Wanrooij%2C+RL&rft.au=Bakker%2C+SF&rft.au=Wierdsma%2C+N&rft.au=Bouma%2C+G&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGluten-free+diet" class="Z3988"> </li> <li id="cite_note-HischenhuberCrevelQuotation-8">^ <a href="#cite_ref-HischenhuberCrevelQuotation_8-0">a</a> <a href="#cite_ref-HischenhuberCrevelQuotation_8-1">b</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFHischenhuberCrevelJarryMäki2006" class="citation journal cs1">Hischenhuber C, Crevel R, Jarry B, Mäki M, Moneret-Vautrin DA, Romano A, et al. 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Alimentary Pharmacology & Therapeutics. 23 (5): 559–75. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fj.1365-2036.2006.02768.x">10.1111/j.1365-2036.2006.02768.x</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16480395">16480395</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:9970042">9970042</a>. <q>For both wheat allergy and coeliac disease the dietary avoidance of wheat and other gluten-containing cereals is the only effective treatment.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Alimentary+Pharmacology+%26+Therapeutics&rft.atitle=Review+article%3A+safe+amounts+of+gluten+for+patients+with+wheat+allergy+or+coeliac+disease&rft.volume=23&rft.issue=5&rft.pages=559-75&rft.date=2006-03&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A9970042%23id-name%3DS2CID&rft_id=info%3Apmid%2F16480395&rft_id=info%3Adoi%2F10.1111%2Fj.1365-2036.2006.02768.x&rft.aulast=Hischenhuber&rft.aufirst=C&rft.au=Crevel%2C+R&rft.au=Jarry%2C+B&rft.au=M%C3%A4ki%2C+M&rft.au=Moneret-Vautrin%2C+DA&rft.au=Romano%2C+A&rft.au=Troncone%2C+R&rft.au=Ward%2C+R&rft_id=https%3A%2F%2Fdoi.org%2F10.1111%252Fj.1365-2036.2006.02768.x&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGluten-free+diet" class="Z3988"> </li> <li id="cite_note-VoltaCaio2015Quotation-9"><a href="#cite_ref-VoltaCaio2015Quotation_9-0">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFVoltaCaioDe_GiorgioHenriksen2015" class="citation journal cs1">Volta U, Caio G, De Giorgio R, Henriksen C, Skodje G, Lundin KE (June 2015). 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(…) 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. 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Clinical Therapeutics (Review). 35 (5): 578–83. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.clinthera.2013.04.011">10.1016/j.clinthera.2013.04.011</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23688532">23688532</a>. <q>At this time, the studies attempting to treat symptoms of autism with diet have not been sufficient to support the general institution of a gluten-free or other diet for all children with autism. ...There may be a subgroup of patients who might benefit from a gluten-free diet, but the symptom or testing profile of these candidates remains unclear.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Clinical+Therapeutics&rft.atitle=The+relationship+of+autism+and+gluten&rft.volume=35&rft.issue=5&rft.pages=578-83&rft.date=2013-05&rft_id=info%3Adoi%2F10.1016%2Fj.clinthera.2013.04.011&rft_id=info%3Apmid%2F23688532&rft.aulast=Buie&rft.aufirst=T&rft_id=https%3A%2F%2Fdoi.org%2F10.1016%252Fj.clinthera.2013.04.011&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGluten-free+diet" class="Z3988"> </li> <li id="cite_note-Millward2008-15">^ <a href="#cite_ref-Millward2008_15-0">a</a> <a href="#cite_ref-Millward2008_15-1">b</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMillwardFerriterCalverConnell-Jones2008" class="citation journal cs1">Millward C, Ferriter M, Calver S, Connell-Jones G (April 2008). 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Gastroenterology (Review). 148 (6): 1195–204. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1053%2Fj.gastro.2014.12.049">10.1053/j.gastro.2014.12.049</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25583468">25583468</a>. <q>One of the most controversial and highly debated discussions concerns the role of gluten in causing NCGS. Recent reports have indicated that gluten might not be the cause of NCGS, and some investigators still question whether NCGS as a real clinical entity. (...) Cereals such as wheat and rye, when consumed in normal quantities, are only minor sources of FODMAPs in the daily diet (Table 1). Therefore, gluten-containing grains are not likely to induce IBS exclusively via FODMAPs. In contrast, there is growing evidence that other proteins that are unique to gluten-containing cereals can elicit an innate immune response that leads to NCGS, raising a nomenclature issue. For this reason, wheat sensitivity, rather than gluten sensitivity, seems to be a more appropriate term, keeping in mind that other gluten-containing grains such as barley and rye also can trigger the symptoms.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Gastroenterology&rft.atitle=Nonceliac+gluten+sensitivity&rft.volume=148&rft.issue=6&rft.pages=1195-204&rft.date=2015-05&rft_id=info%3Adoi%2F10.1053%2Fj.gastro.2014.12.049&rft_id=info%3Apmid%2F25583468&rft.aulast=Fasano&rft.aufirst=A&rft.au=Sapone%2C+A&rft.au=Zevallos%2C+V&rft.au=Schuppan%2C+D&rft_id=https%3A%2F%2Fdoi.org%2F10.1053%252Fj.gastro.2014.12.049&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGluten-free+diet" class="Z3988"> </li> <li id="cite_note-Verbeke2018-45">^ <a href="#cite_ref-Verbeke2018_45-0">a</a> <a href="#cite_ref-Verbeke2018_45-1">b</a> <a href="#cite_ref-Verbeke2018_45-2">c</a> <a href="#cite_ref-Verbeke2018_45-3">d</a> <a href="#cite_ref-Verbeke2018_45-4">e</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFVerbeke2018" class="citation journal cs1">Verbeke K (February 2018). <a rel="nofollow" class="external text" href="https://doi.org/10.1053%2Fj.gastro.2018.01.013">"Nonceliac Gluten Sensitivity: What Is the Culprit?"</a>. Gastroenterology. 154 (3): 471–473. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1053%2Fj.gastro.2018.01.013">10.1053/j.gastro.2018.01.013</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29337156">29337156</a>. <q>Although intolerance to fructans and other FODMAPs may contribute to NCGS, they may only explain gastrointestinal symptoms and not the extraintestinal symptoms observed in NCGS patients, such as neurologic dysfunction, psychological disturbances, fibromyalgia, and skin rash.15 Therefore, it is unlikely that they are the sole cause of NCGS.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Gastroenterology&rft.atitle=Nonceliac+Gluten+Sensitivity%3A+What+Is+the+Culprit%3F&rft.volume=154&rft.issue=3&rft.pages=471-473&rft.date=2018-02&rft_id=info%3Adoi%2F10.1053%2Fj.gastro.2018.01.013&rft_id=info%3Apmid%2F29337156&rft.aulast=Verbeke&rft.aufirst=K&rft_id=https%3A%2F%2Fdoi.org%2F10.1053%252Fj.gastro.2018.01.013&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGluten-free+diet" class="Z3988"> </li> <li id="cite_note-VoltaCaioQuestions-46">^ <a href="#cite_ref-VoltaCaioQuestions_46-0">a</a> <a href="#cite_ref-VoltaCaioQuestions_46-1">b</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFVoltaCaioTovoliDe_Giorgio2013" class="citation journal cs1">Volta U, Caio G, Tovoli F, De Giorgio R (September 2013). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003198">"Non-celiac gluten sensitivity: questions still to be answered despite increasing awareness"</a>. 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Retrieved September 20, 2009.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Chicagotribune.com&rft.atitle=Whole+Foods+pulls+%27gluten-free%27+products+from+shelves+after+Tribune+story&rft.aulast=Roe&rft.aufirst=S&rft_id=http%3A%2F%2Fwww.chicagotribune.com%2Fnews%2Fnationworld%2Fchi-whole_foodsdec31%2C0%2C4055580.story&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGluten-free+diet" class="Z3988"> </li> <li id="cite_note-112"><a href="#cite_ref-112">^</a> 71 <a href="/wiki/Federal_Register" title="Federal Register">FR</a> <a rel="nofollow" class="external text" href="https://www.federalregister.gov/citation/71-FR-42260">42260</a> (26 July 2006), 71 <a href="/wiki/Federal_Register" title="Federal Register">FR</a> <a rel="nofollow" class="external text" href="https://www.federalregister.gov/citation/71-FR-42329">42329</a> (26 July 2006) </li> <li id="cite_note-113"><a href="#cite_ref-113">^</a> 78 <a href="/wiki/Federal_Register" title="Federal Register">FR</a> <a rel="nofollow" class="external text" href="https://www.federalregister.gov/citation/78-FR-47154">47154</a> (5 August 2013). Codified at <a href="/wiki/Title_21_of_the_Code_of_Federal_Regulations" title="Title 21 of the Code of Federal Regulations">21 CFR</a> <a rel="nofollow" class="external text" href="https://www.ecfr.gov/current/title-21/section-101.91">101.91</a>. </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2>[<a href="/w/index.php?title=Gluten-free_diet&action=edit&section=19" title="Edit section: External links">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .side-box-abovebelow,.mw-parser-output .side-box-text{padding:0.25em 0.9em}.mw-parser-output .side-box-image{padding:2px 0 2px 0.9em;text-align:center}.mw-parser-output .side-box-imageright{padding:2px 0.9em 2px 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ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style> <div class="side-box-flex"> <div class="side-box-image"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/9/99/Wiktionary-logo-en-v2.svg/40px-Wiktionary-logo-en-v2.svg.png" decoding="async" width="40" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/99/Wiktionary-logo-en-v2.svg/60px-Wiktionary-logo-en-v2.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/99/Wiktionary-logo-en-v2.svg/80px-Wiktionary-logo-en-v2.svg.png 2x" data-file-width="512" data-file-height="512" /></div> <div class="side-box-text plainlist">Look up <a href="https://en.wiktionary.org/wiki/Gluten-Free" class="extiw" title="wiktionary:Gluten-Free">Gluten-Free</a> in Wiktionary, the free dictionary.</div></div> </div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1235681985"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1237033735"><div class="side-box side-box-right plainlinks sistersitebox"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"> <div class="side-box-flex"> <div class="side-box-image"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/d/df/Wikibooks-logo-en-noslogan.svg/40px-Wikibooks-logo-en-noslogan.svg.png" decoding="async" width="40" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/df/Wikibooks-logo-en-noslogan.svg/60px-Wikibooks-logo-en-noslogan.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/df/Wikibooks-logo-en-noslogan.svg/80px-Wikibooks-logo-en-noslogan.svg.png 2x" data-file-width="400" data-file-height="400" /></div> <div class="side-box-text plainlist">Wikibooks <a href="https://en.wikibooks.org/wiki/Cookbook" class="extiw" title="wikibooks:Cookbook">Cookbook</a> has a recipe/module on <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist" style="margin-left: 1.6em;"> <ul><li><a href="https://en.wikibooks.org/wiki/Cookbook:Gluten-Free" class="extiw" title="wikibooks:Cookbook:Gluten-Free"> Gluten-Free</a></li></ul> </div></div></div> </div> <ul><li><a rel="nofollow" class="external text" href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/gluten-free-diet/art-20048530">Gluten-free diet</a> by the <a href="/wiki/Mayo_Clinic" title="Mayo Clinic">Mayo Clinic</a></li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline 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style="width:1%">general</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Wheat_allergy" title="Wheat allergy">Wheat allergy</a></li> <li><a href="/wiki/Oat_sensitivity" title="Oat sensitivity">Oat sensitivity</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">nervous system</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gluten-sensitive_idiopathic_neuropathies" class="mw-redirect" title="Gluten-sensitive idiopathic neuropathies">GS idiopathic neuropathies</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">digestive system</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Coeliac_disease" title="Coeliac disease">Coeliac disease</a></li> <li><a href="/wiki/Gluten-sensitive_enteropathy-associated_conditions" class="mw-redirect" title="Gluten-sensitive enteropathy-associated conditions">GSE associated conditions</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">integumentary system</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Dermatitis_herpetiformis" title="Dermatitis herpetiformis">Dermatitis herpetiformis</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Antibody" title="Antibody">Antibodies</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anti-gliadin_antibodies" title="Anti-gliadin antibodies">Anti-gliadin antibodies</a></li> <li><a href="/wiki/Anti-transglutaminase_antibodies" title="Anti-transglutaminase antibodies">Anti-transglutaminase antibodies</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/HLA-DQ" title="HLA-DQ">HLA-DQ</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/HLA-DQ2" title="HLA-DQ2">HLA-DQ2</a></li> <li><a href="/wiki/HLA-DQ8" title="HLA-DQ8">HLA-DQ8</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gluten_immunochemistry" title="Gluten immunochemistry">Gluten immunochemistry</a></li> <li><a class="mw-selflink selflink">Gluten-free diet</a></li> <li><a href="/wiki/Gluten_challenge_test" title="Gluten challenge test">Gluten challenge test</a></li> <li><a href="/wiki/List_of_people_diagnosed_with_coeliac_disease" title="List of people diagnosed with coeliac disease">List of people diagnosed with coeliac disease</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Irritable_bowel_syndrome_(IBS)" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a 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diet</a></li> <li><a class="mw-selflink selflink">Gluten-free diet</a></li> <li><a href="/wiki/Soluble_fiber" class="mw-redirect" title="Soluble fiber">Soluble fiber</a></li> <li><a href="/wiki/Laxative" title="Laxative">Laxatives</a></li> <li><a href="/wiki/Antispasmodic" title="Antispasmodic">Antispasmodics</a></li> <li><a href="/wiki/Psychotherapy" title="Psychotherapy">Psychotherapy</a></li> <li><a href="/wiki/Tricyclic_antidepressant" title="Tricyclic antidepressant">Tricyclic antidepressants</a></li> <li><a href="/wiki/Selective_serotonin_reuptake_inhibitor" title="Selective serotonin reuptake inhibitor">SSRIs</a></li> <li><a href="/wiki/Probiotic" title="Probiotic">Probiotics</a></li> <li><a href="/wiki/Eluxadoline" title="Eluxadoline">Eluxadoline</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related topics</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gut%E2%80%93brain_axis" title="Gut–brain axis">Gut–brain axis</a></li> <li><a href="/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93adrenal_axis" title="Hypothalamic–pituitary–adrenal axis">Hypothalamic–pituitary–adrenal axis</a></li> <li><a href="/wiki/Sympathetic_nervous_system" title="Sympathetic nervous system">Sympathetic nervous system</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Fad_diets" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Fad_diets" title="Template:Fad diets"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Fad_diets" title="Template talk:Fad diets"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Fad_diets" title="Special:EditPage/Template:Fad diets"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Fad_diets" style="font-size:114%;margin:0 4em"><a href="/wiki/Fad_diet" title="Fad diet">Fad diets</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Food-specific diets</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Alkaline_diet" title="Alkaline diet">Alkaline diet</a></li> <li><a href="/wiki/Banana_and_skimmed_milk_diet" class="mw-redirect" title="Banana and skimmed milk diet">Banana and skimmed milk diet</a></li> <li><a href="/wiki/Cabbage_soup_diet" title="Cabbage soup diet">Cabbage soup diet</a></li> <li><a href="/wiki/Carnivore_diet" title="Carnivore diet">Carnivore diet</a></li> <li><a href="/wiki/Clean_eating" title="Clean eating">Clean eating</a></li> <li><a href="/wiki/Cookie_diet" title="Cookie diet">Cookie diet</a></li> <li><a href="/wiki/Egg_and_wine_diet" title="Egg and wine diet">Egg and wine diet</a></li> <li><a href="/wiki/Food_combining" title="Food combining">Food combining</a> <ul><li><a href="/wiki/Beverly_Hills_Diet" title="Beverly Hills Diet">Beverly Hills Diet</a></li> <li><a href="/wiki/Hay_diet" title="Hay diet">Hay diet</a></li> <li><a href="/wiki/Fit_for_Life" title="Fit for Life">Fit for Life</a></li></ul></li> <li><a href="/wiki/Fruitarianism" title="Fruitarianism">Fruitarianism</a></li> <li><a class="mw-selflink selflink">Gluten-free diet</a></li> <li><a href="/wiki/Grape_therapy" title="Grape therapy">Grape diet</a></li> <li><a href="/wiki/Grapefruit_diet" title="Grapefruit diet">Grapefruit diet</a></li> <li><a href="/wiki/High-protein_diet" title="High-protein diet">High-protein diet</a></li> <li><a href="/wiki/Lamb_chop_and_pineapple_diet" title="Lamb chop and pineapple diet">Lamb chop and pineapple diet</a></li> <li><a href="/wiki/Lectin-free_diet" title="Lectin-free diet">Lectin-free diet</a></li> <li><a href="/wiki/Macrobiotic_diet" title="Macrobiotic diet">Macrobiotic diet</a></li> <li><a href="/wiki/Milk_diet" class="mw-redirect" title="Milk diet">Milk diet</a></li> <li><a href="/wiki/Monotrophic_diet" title="Monotrophic diet">Monotrophic diet</a></li> <li><a href="/wiki/Morning_banana_diet" title="Morning banana diet">Morning banana diet</a></li> <li><a href="/wiki/Mucusless_Diet" class="mw-redirect" title="Mucusless Diet">Mucusless Diet</a></li> <li><a href="/wiki/Mushroom_diet" title="Mushroom diet">Mushroom diet</a></li> <li><a href="/wiki/No-Aging_Diet" title="No-Aging Diet">No-Aging Diet</a></li> <li><a href="/wiki/Paleolithic_diet" title="Paleolithic diet">Paleolithic diet</a></li> <li><a href="/wiki/Pegan_diet" class="mw-redirect" title="Pegan diet">Pegan diet</a></li> <li><a href="/wiki/Potato_diet" class="mw-redirect" title="Potato diet">Potato diet</a></li> <li><a href="/wiki/Raw_foodism" title="Raw foodism">Raw foodism</a> <ul><li><a href="/wiki/Raw_veganism" class="mw-redirect" title="Raw veganism">Raw veganism</a></li></ul></li> <li><a href="/wiki/Rhubarb_diet" class="mw-redirect" title="Rhubarb diet">Rhubarb diet</a></li> <li><a href="/wiki/Superfood" title="Superfood">Superfood</a></li> <li><a href="/wiki/Uric-acid_free_diet" class="mw-redirect" title="Uric-acid free diet">Uric-acid free diet</a></li> <li><a href="/wiki/Whole30" title="Whole30">Whole30</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Low-carbohydrate_diet" title="Low-carbohydrate diet">Low-carbohydrate</a> / high-fat diets</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Atkins_diet" title="Atkins diet">Atkins diet</a></li> <li><a href="/wiki/Banting_diet" class="mw-redirect" title="Banting diet">Banting diet</a></li> <li><a href="/wiki/Bulletproof_diet" class="mw-redirect" title="Bulletproof diet">Bulletproof diet</a></li> <li><a href="/wiki/Calories_Don%27t_Count" class="mw-redirect" title="Calories Don't Count">Calories Don't Count</a></li> <li><a href="/wiki/Drinking_Man%27s_Diet" class="mw-redirect" title="Drinking Man's Diet">Drinking Man's Diet</a></li> <li><a href="/wiki/Dukan_Diet" title="Dukan Diet">Dukan Diet</a></li> <li><a href="/wiki/Eat_and_Grow_Thin" class="mw-redirect" title="Eat and Grow Thin">Eat and Grow Thin</a></li> <li><a href="/wiki/Hal_Huggins_diet" class="mw-redirect" title="Hal Huggins diet">Hal Huggins diet</a></li> <li><a href="/wiki/Hamptons_Diet" class="mw-redirect" title="Hamptons Diet">Hamptons Diet</a></li> <li><a href="/wiki/Kimkins" title="Kimkins">Kimkins</a></li> <li><a href="/wiki/Kordel_diet" class="mw-redirect" title="Kordel diet">Kordel diet</a></li> <li><a href="/wiki/Montignac_diet" title="Montignac diet">Montignac diet</a></li> <li><a href="/wiki/Salisbury_diet" class="mw-redirect" title="Salisbury diet">Salisbury diet</a></li> <li><a href="/wiki/Scarsdale_diet" title="Scarsdale diet">Scarsdale diet</a></li> <li><a href="/wiki/Slimming_for_the_Million" class="mw-redirect" title="Slimming for the Million">Slimming for the Million</a></li> <li><a href="/wiki/South_Beach_Diet" title="South Beach Diet">South Beach Diet</a></li> <li><a href="/wiki/Pioppi_Diet" class="mw-redirect" title="Pioppi Diet">Pioppi Diet</a></li> <li><a href="/wiki/Protein_Power" title="Protein Power">Protein Power</a></li> <li><a href="/wiki/Rosedale_diet" title="Rosedale diet">Rosedale diet</a></li> <li><a href="/wiki/Stillman_diet" title="Stillman diet">Stillman diet</a></li> <li><a href="/wiki/Strong_Medicine_(book)" class="mw-redirect" title="Strong Medicine (book)">Strong Medicine</a></li> <li><a href="/wiki/Sugar_Busters!" title="Sugar Busters!">Sugar Busters!</a></li> <li><a href="/wiki/The_4-Hour_Body" title="The 4-Hour Body">The 4-Hour Body</a></li> <li><a href="/wiki/The_Cruise_Control_Diet" class="mw-redirect" title="The Cruise Control Diet">The Cruise Control Diet</a></li> <li><a href="/wiki/Wahls_Protocol_Diet" class="mw-redirect" title="Wahls Protocol Diet">Wahls Protocol Diet</a></li> <li><a href="/wiki/Wheat_Belly_diet" class="mw-redirect" title="Wheat Belly diet">Wheat Belly diet</a></li> <li><a href="/wiki/Zone_diet" title="Zone diet">Zone diet</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">High-carbohydrate / <a href="/wiki/Low-fat_diet" title="Low-fat diet">low-fat diets</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Engine_2_Diet" class="mw-redirect" title="Engine 2 Diet">Engine 2 Diet</a></li> <li><a href="/wiki/F-plan" class="mw-redirect" title="F-plan">F-plan</a></li> <li><a href="/wiki/McDougall_diet" class="mw-redirect" title="McDougall diet">McDougall diet</a></li> <li><a href="/wiki/Ornish_diet" class="mw-redirect" title="Ornish diet">Ornish diet</a></li> <li><a href="/wiki/Nutritarian_diet" class="mw-redirect" title="Nutritarian diet">Nutritarian diet</a></li> <li><a href="/wiki/Pritikin_diet" title="Pritikin diet">Pritikin diet</a></li> <li><a href="/wiki/Rice_diet" title="Rice diet">Rice diet</a></li> <li><a href="/wiki/The_Good_Carbohydrate_Revolution" class="mw-redirect" title="The Good Carbohydrate Revolution">The Good Carbohydrate Revolution</a></li> <li><a href="/wiki/The_Thrive_Diet" class="mw-redirect" title="The Thrive Diet">The Thrive Diet</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Detoxification_(alternative_medicine)" title="Detoxification (alternative medicine)">Detoxification</a> / <a href="/wiki/Fasting" title="Fasting">fasting</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/5:2_diet" class="mw-redirect" title="5:2 diet">5:2 diet</a></li> <li><a href="/wiki/Activated_charcoal_cleanse" title="Activated charcoal cleanse">Activated charcoal cleanse</a></li> <li><a href="/wiki/Breatharianism" class="mw-redirect" title="Breatharianism">Breatharianism</a></li> <li><a href="/wiki/Breuss_diet" class="mw-redirect" title="Breuss diet">Breuss diet</a></li> <li><a href="/wiki/Celery_juice_diet" class="mw-redirect" title="Celery juice diet">Celery juice diet</a></li> <li><a href="/wiki/Chase_Dietary_Method" title="Chase Dietary Method">Chase Dietary Method</a></li> <li><a href="/wiki/Detox_diet" class="mw-redirect" title="Detox diet">Detox diet</a></li> <li><a href="/wiki/Dubrow_Diet" class="mw-redirect" title="Dubrow Diet">Dubrow Diet</a></li> <li><a href="/wiki/Eliminating_Diet" class="mw-redirect" title="Eliminating Diet">Eliminating Diet</a></li> <li><a href="/wiki/Enzyme-Catalyst_Diet" class="mw-redirect" title="Enzyme-Catalyst Diet">Enzyme-Catalyst Diet</a></li> <li><a href="/wiki/Fasting_mimicking_diet" class="mw-redirect" title="Fasting mimicking diet">Fasting mimicking diet</a></li> <li><a href="/wiki/Fat_Flush_Plan" class="mw-redirect" title="Fat Flush Plan">Fat Flush Plan</a></li> <li><a href="/wiki/Hippocrates_Diet" class="mw-redirect" title="Hippocrates Diet">Hippocrates Diet</a></li> <li><a href="/wiki/Intermittent_fasting" title="Intermittent fasting">Intermittent fasting</a></li> <li><a href="/wiki/Time-restricted_feeding" class="mw-redirect" title="Time-restricted feeding">Time-restricted feeding</a></li> <li><a href="/wiki/Juice_fasting" title="Juice fasting">Juice fasting</a></li> <li><a href="/wiki/KE_diet" title="KE diet">KE diet</a></li> <li><a href="/wiki/Master_Cleanse" title="Master Cleanse">Master Cleanse</a></li> <li><a href="/wiki/No_Breakfast_Plan" class="mw-redirect" title="No Breakfast Plan">No Breakfast Plan</a></li> <li><a href="/wiki/Orthopathy" title="Orthopathy">Orthopathy</a></li> <li><a href="/wiki/Protein-sparing_modified_fast" class="mw-redirect" title="Protein-sparing modified fast">Protein-sparing modified fast</a></li> <li><a href="/wiki/The_Fast_Way_To_Health" class="mw-redirect" title="The Fast Way To Health">The Fast Way To Health</a></li> <li><a href="/wiki/The_Last_Chance_Diet" class="mw-redirect" title="The Last Chance Diet">The Last Chance Diet</a></li> <li><a href="/wiki/Wheatgrass_diet" class="mw-redirect" title="Wheatgrass diet">Wheatgrass diet</a></li> <li><a href="/wiki/Wigmore_diet" class="mw-redirect" title="Wigmore diet">Wigmore diet</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Blood_type_diet" title="Blood type diet">Blood type diet</a></li> <li><a href="/wiki/Budwig_diet" class="mw-redirect" title="Budwig diet">Budwig diet</a></li> <li><a href="/wiki/Cotton_ball_diet" title="Cotton ball diet">Cotton ball diet</a></li> <li><a href="/wiki/Fletcherism" class="mw-redirect" title="Fletcherism">Fletcherism</a></li> <li><a href="/wiki/Hallelujah_Diet" class="mw-redirect" title="Hallelujah Diet">Hallelujah Diet</a></li> <li><a href="/wiki/Hip_and_Thigh_Diet" class="mw-redirect" title="Hip and Thigh Diet">Hip and Thigh Diet</a></li> <li><a href="/wiki/Immune_Power_Diet" title="Immune Power Diet">Immune Power Diet</a></li> <li><a href="/wiki/Maker%27s_Diet" class="mw-redirect" title="Maker's Diet">Maker's Diet</a></li> <li><a href="/wiki/Seed_cycling" title="Seed cycling">Seed cycling</a></li> <li><a href="/wiki/Sensa_(diet)" title="Sensa (diet)">Sensa diet</a></li> <li><a href="/wiki/Swank_diet" title="Swank diet">Swank diet</a></li> <li><a href="/wiki/Tongue_Patch_Diet" title="Tongue Patch Diet">Tongue Patch Diet</a></li> <li><a href="/wiki/The_Cambridge_Diet" title="The Cambridge Diet">The Cambridge Diet</a></li> <li><a href="/wiki/Very-low-calorie_diet" title="Very-low-calorie diet">Very-low-calorie diet</a></li> <li><a href="/wiki/Werewolf_diet" title="Werewolf diet">Werewolf diet</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/List_of_fad_diets" class="mw-redirect" title="List of fad diets">List of fad diets</a></li> <li><a href="/wiki/List_of_food_faddists" title="List of food faddists">List of food faddists</a></li> <li><a href="/wiki/Pseudoscience" title="Pseudoscience">Pseudoscience</a></li> <li><a href="/wiki/Quackery" title="Quackery">Quackery</a></li> <li><a href="/wiki/Seed_oil_misinformation" title="Seed oil misinformation">Seed oil misinformation</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div> <ul><li><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/16px-Symbol_category_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/23px-Symbol_category_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/31px-Symbol_category_class.svg.png 2x" data-file-width="180" data-file-height="185" /> <a href="/wiki/Category:Fad_diets" title="Category:Fad diets">Category</a></li> <li><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/12px-Commons-logo.svg.png" decoding="async" width="12" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/18px-Commons-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/24px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /> <a href="https://commons.wikimedia.org/wiki/Category:Fad_diets" class="extiw" title="commons:Category:Fad diets">Commons</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r886047488">.mw-parser-output .nobold{font-weight:normal}</style></div><div role="navigation" class="navbox" aria-labelledby="Human_nutrition_and_healthy_diets" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2" style="text-align: center;"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Diets" title="Template:Diets"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Diets" title="Template talk:Diets"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Diets" title="Special:EditPage/Template:Diets"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Human_nutrition_and_healthy_diets" style="font-size:114%;margin:0 4em"><a href="/wiki/Human_nutrition" title="Human nutrition">Human nutrition</a> and <a href="/wiki/Healthy_diet" title="Healthy diet">healthy diets</a></div></th></tr><tr><td class="navbox-abovebelow" colspan="2" style="text-align: center;"><div> <dl><dt>Main articles</dt> <dd><a href="/wiki/Diet_(nutrition)" title="Diet (nutrition)">Diet</a></dd> <dd><a href="/wiki/Dieting" title="Dieting">Dieting</a></dd> <dd><a href="/wiki/Cuisine" title="Cuisine">Cuisine</a></dd> <dd><a href="/wiki/Dietitian" title="Dietitian">Dietitian</a></dd> <dd><a href="/wiki/Hunger_(motivational_state)" class="mw-redirect" title="Hunger (motivational state)">Hunger</a></dd> <dd><a href="/wiki/Leptin" title="Leptin">Leptin</a></dd> <dd><a href="/wiki/Meal" title="Meal">Meal</a></dd> <dd><a href="/wiki/Nutrition" title="Nutrition">Nutrition</a></dd> <dd><a href="/wiki/Obesity" title="Obesity">Obesity</a></dd> <dd><a href="/wiki/Staple_food" title="Staple food">Staple food</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="text-align: center;;width:1%"><a href="/wiki/Dieting" title="Dieting">Dieting</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Basic types</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Omnivore" title="Omnivore">Omnivore</a></li> <li><a href="/wiki/Plant-based_diet" title="Plant-based diet">Plant-based</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Regional diets</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Western_pattern_diet" title="Western pattern diet">Western</a></li> <li><a href="/wiki/Mediterranean_diet" title="Mediterranean diet">Mediterranean</a></li> <li><a href="/wiki/Atlantic_diet" title="Atlantic diet"> Atlantic</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Sustainable_diet" title="Sustainable diet">Sustainable diets</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Low-carbon_diet" title="Low-carbon diet">Low carbon</a></li> <li><a href="/wiki/Planetary_health_diet" title="Planetary health diet">Planetary health</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Religious diets</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Buddhist_cuisine" title="Buddhist cuisine">Buddhist</a></li> <li><a href="/wiki/Christian_dietary_laws" title="Christian dietary laws">Christian</a></li> <li><a href="/wiki/Diet_in_Hinduism" title="Diet in Hinduism">Hindu</a></li> <li><a href="/wiki/Islamic_dietary_laws" title="Islamic dietary laws">Islamic</a></li> <li><a href="/wiki/Jain_vegetarianism" title="Jain vegetarianism">Jain</a></li> <li><a href="/wiki/Kashrut" title="Kashrut">Jewish</a></li> <li><a href="/wiki/Ital" title="Ital">Rastafari</a></li> <li><a href="/wiki/Diet_in_Sikhism" title="Diet in Sikhism">Sikh</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Vegetarianism" title="Vegetarianism">Vegetarianism</a> and <a href="/wiki/Veganism" title="Veganism">veganism</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Fruitarianism" title="Fruitarianism">Fruitarianism</a></li> <li><a href="/wiki/Meat_analogue" class="mw-redirect" title="Meat analogue">Meat analogue</a></li> <li><a href="/wiki/Milk_substitute" title="Milk substitute">Milk substitute</a></li> <li><a href="/wiki/Raw_veganism" class="mw-redirect" title="Raw veganism">Raw vegan</a></li> <li><a href="/wiki/Tofu" title="Tofu">Tofu</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Semi-vegetarianism" class="mw-redirect" title="Semi-vegetarianism">Semi-vegetarianism</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Lacto-ovo_vegetarianism" title="Lacto-ovo vegetarianism">Ovo-lacto vegetarianism</a></li> <li><a href="/wiki/Pescetarianism" title="Pescetarianism">Pescetarian</a></li> <li><a href="/wiki/Pollotarianism" title="Pollotarianism">Pollotarian</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Dietary_supplement" title="Dietary supplement">Supplement diets</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bodybuilding_supplement" title="Bodybuilding supplement">Bodybuilding supplements</a></li> <li><a href="/wiki/Meal_replacement" title="Meal replacement">Meal replacement</a></li> <li><a href="/wiki/Therapeutic_food" title="Therapeutic food">Therapeutic food</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Non-solid diets</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Liquid_diet" title="Liquid diet">Liquid diets</a></li> <li><a href="/wiki/Very-low-calorie_diet" title="Very-low-calorie diet">Very-low-calorie diet</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Specific restrictions</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Calorie_restriction" title="Calorie restriction">Calorie restriction</a></li> <li><a href="/wiki/Cardiac_diet" title="Cardiac diet">Cardiac diet</a></li> <li><a href="/wiki/Diabetic_diet" class="mw-redirect" title="Diabetic diet">Diabetic diet</a></li> <li><a href="/wiki/Elimination_diet" title="Elimination diet">Elimination diet</a></li> <li><a href="/wiki/Fluid_restriction_diet" title="Fluid restriction diet">Fluid restriction diet</a></li> <li><a class="mw-selflink selflink">Gluten-free</a></li> <li><a href="/wiki/Gluten-free,_casein-free_diet" title="Gluten-free, casein-free diet">Gluten-free and casein-free</a></li> <li><a href="/wiki/Intermittent_fasting" title="Intermittent fasting">Intermittent fasting</a></li> <li><a href="/wiki/Low_sodium_diet" title="Low sodium diet">Low-sodium</a></li> <li><a href="/wiki/Low-FODMAP_diet" title="Low-FODMAP diet">Low-FODMAP</a></li> <li><a href="/wiki/Low-carbohydrate_diet" title="Low-carbohydrate diet">Low-carbohydrate</a></li> <li><a href="/wiki/Low-fat_diet" title="Low-fat diet">Low-fat</a></li> <li><a href="/wiki/Low-fiber/low-residue_diet" title="Low-fiber/low-residue diet">Low-fiber/low-residue diet</a></li> <li><a href="/wiki/Low-protein_diet" title="Low-protein diet">Low-protein</a></li> <li><a href="/wiki/Monotrophic_diet" title="Monotrophic diet">Monotrophic diet</a></li> <li><a href="/wiki/Nothing_by_mouth" title="Nothing by mouth">NPO</a></li> <li><a href="/wiki/Renal_diet" title="Renal diet">Renal diet</a></li> <li><a href="/wiki/Soft_diet" title="Soft diet">Soft diet</a></li> <li><a href="/wiki/Specific_carbohydrate_diet" title="Specific carbohydrate diet">Specific carbohydrate</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other diets</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Entomophagy_in_humans" title="Entomophagy in humans">Entomophagy</a></li> <li><a href="/wiki/Cotton_ball_diet" title="Cotton ball diet">Cotton ball</a></li> <li><a href="/wiki/Pica_(disorder)" title="Pica (disorder)">Pica</a></li> <li><a href="/wiki/DASH_diet" title="DASH diet">DASH</a></li> <li><a href="/wiki/Inuit_cuisine" title="Inuit cuisine">Inuit</a></li> <li><a href="/wiki/MIND_diet" title="MIND diet">MIND</a></li> <li><a href="/wiki/Intermittent_fasting" title="Intermittent fasting">Time Restricted Eating</a></li> <li><a href="/wiki/Liquid_diet" title="Liquid diet">Liquid diet</a></li> <li><a href="/wiki/Ninja_diet" class="mw-redirect" title="Ninja diet">Ninja diet</a></li> <li><a href="/wiki/Raw_foodism" title="Raw foodism">Raw foodism</a></li> <li><a href="/wiki/History_of_military_nutrition_in_the_United_States" title="History of military nutrition in the United States">U.S. military</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Fad_diet" title="Fad diet">Fad diets</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/The_Cambridge_Diet" title="The Cambridge Diet">Cambridge</a></li> <li><a href="/wiki/Macrobiotic_diet" title="Macrobiotic diet">Macrobiotic</a></li> <li><a href="/wiki/Master_Cleanse" title="Master Cleanse">Master Cleanse</a></li> <li><a href="/wiki/Junk_food" title="Junk food">Junk food</a></li> <li><a href="/wiki/Superfood" title="Superfood">Superfood</a></li> <li><a href="/wiki/The_4-Hour_Body" title="The 4-Hour Body">Slow-Carb</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/List_of_diets" title="List of diets">List of diets</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Diet_food" title="Diet food">Diet food</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="text-align: center;;width:1%"><a href="/wiki/Human_nutrition" title="Human nutrition">Nutrition</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Amino_acid" title="Amino acid">Amino acids</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Alanine" title="Alanine">Alanine</a></li> <li><a href="/wiki/Arginine" title="Arginine">Arginine</a></li> <li><a href="/wiki/Asparagine" title="Asparagine">Asparagine</a></li> <li><a href="/wiki/Aspartic_acid" title="Aspartic acid">Aspartic acid</a></li> <li><a href="/wiki/Cysteine" title="Cysteine">Cysteine</a></li> <li><a href="/wiki/Glutamic_acid" title="Glutamic acid">Glutamic acid</a></li> <li><a href="/wiki/Glutamine" title="Glutamine">Glutamine</a></li> <li><a href="/wiki/Glycine" title="Glycine">Glycine</a></li> <li><a href="/wiki/Histidine" title="Histidine">Histidine</a></li> <li><a href="/wiki/Isoleucine" title="Isoleucine">Isoleucine</a></li> <li><a href="/wiki/Leucine" title="Leucine">Leucine</a></li> <li><a href="/wiki/Lysine" title="Lysine">Lysine</a></li> <li><a href="/wiki/Methionine" title="Methionine">Methionine</a></li> <li><a href="/wiki/Phenylalanine" title="Phenylalanine">Phenylalanine</a></li> <li><a href="/wiki/Proline" title="Proline">Proline</a></li> <li><a href="/wiki/Selenocysteine" title="Selenocysteine">Selenocysteine</a></li> <li><a href="/wiki/Serine" title="Serine">Serine</a></li> <li><a href="/wiki/Threonine" title="Threonine">Threonine</a></li> <li><a href="/wiki/Tryptophan" title="Tryptophan">Tryptophan</a></li> <li><a href="/wiki/Tyrosine" title="Tyrosine">Tyrosine</a></li> <li><a href="/wiki/Valine" title="Valine">Valine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Vitamin" title="Vitamin">Vitamins</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Vitamin_A" title="Vitamin A">Vitamin A</a></li> <li><a href="/wiki/Thiamine" title="Thiamine">Vitamin B1</a></li> <li><a href="/wiki/Riboflavin" title="Riboflavin">Vitamin B2</a></li> <li><a href="/wiki/Niacin_(nutrient)" class="mw-redirect" title="Niacin (nutrient)">Vitamin B3</a></li> <li><a href="/wiki/Pantothenic_acid" title="Pantothenic acid">Vitamin B5</a></li> <li><a href="/wiki/Vitamin_B6" title="Vitamin B6">Vitamin B6</a></li> <li><a href="/wiki/Biotin" title="Biotin">Vitamin B7</a></li> <li><a href="/wiki/Folate" title="Folate">Vitamin B9</a></li> <li><a href="/wiki/Vitamin_B12" title="Vitamin B12">Vitamin B12</a></li> <li><a href="/wiki/Vitamin_C" title="Vitamin C">Vitamin C</a></li> <li><a href="/wiki/Vitamin_D" title="Vitamin D">Vitamin D</a></li> <li><a href="/wiki/Vitamin_E" title="Vitamin E">Vitamin E</a></li> <li><a href="/wiki/Vitamin_K" title="Vitamin K">Vitamin K</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Mineral" title="Mineral">Minerals</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Calcium_in_biology" title="Calcium in biology">Calcium</a></li> <li><a href="/wiki/Chlorine" title="Chlorine">Chlorine</a></li> <li><a href="/wiki/Chromium" title="Chromium">Chromium</a></li> <li><a href="/wiki/Cobalt" title="Cobalt">Cobalt</a></li> <li><a href="/wiki/Copper_in_health" class="mw-redirect" title="Copper in health">Copper</a></li> <li><a href="/wiki/Iodine_in_biology" title="Iodine in biology">Iodine</a></li> <li><a href="/wiki/Human_iron_metabolism" title="Human iron metabolism">Iron</a></li> <li><a href="/wiki/Magnesium_in_biology" title="Magnesium in biology">Magnesium</a></li> <li><a href="/wiki/Manganese" title="Manganese">Manganese</a></li> <li><a href="/wiki/Molybdenum" title="Molybdenum">Molybdenum</a></li> <li><a href="/wiki/Nickel" title="Nickel">Nickel</a></li> <li><a href="/wiki/Phosphorus" title="Phosphorus">Phosphorus</a></li> <li><a href="/wiki/Potassium_in_biology" title="Potassium in biology">Potassium</a></li> <li><a href="/wiki/Selenium_in_biology" title="Selenium in biology">Selenium</a></li> <li><a href="/wiki/Sodium_in_biology" title="Sodium in biology">Sodium</a></li> <li><a href="/wiki/Vanadium" title="Vanadium">Vanadium</a></li> <li><a href="/wiki/Zinc" title="Zinc">Zinc</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="text-align: center;;width:1%">Nutritional advice</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/5_A_Day" title="5 A Day">5 A Day</a></li> <li><a href="/wiki/Dairy_Council_of_California" title="Dairy Council of California">Dairy Council of California</a></li> <li><a href="/wiki/Food_pyramid_(nutrition)" title="Food pyramid (nutrition)">Food pyramid</a></li> <li><a href="/wiki/Fruits_%26_Veggies_%E2%80%93_More_Matters" title="Fruits & Veggies – More Matters">Fruits & Veggies – More Matters</a></li> <li><a href="/wiki/Healthy_eating_pyramid" title="Healthy eating pyramid">Healthy eating pyramid</a></li> <li><a href="/wiki/Latin_American_Diet_Pyramid" title="Latin American Diet Pyramid">Latin American Diet Pyramid</a></li> <li><a href="/wiki/French_paradox" title="French paradox">French paradox</a></li> <li><a href="/wiki/Mediterranean_Diet_Pyramid" title="Mediterranean Diet Pyramid">Mediterranean Diet Pyramid</a></li> <li><a href="/wiki/MyPlate" title="MyPlate">MyPlate</a></li> <li><a href="/wiki/MyPyramid" title="MyPyramid">MyPyramid</a></li> <li><a href="/wiki/Vegetarian_Diet_Pyramid" title="Vegetarian Diet Pyramid">Vegetarian Diet Pyramid</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2" style="text-align: center;;font-weight: bold;"><div> <ul><li><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/16px-Symbol_category_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/23px-Symbol_category_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/31px-Symbol_category_class.svg.png 2x" data-file-width="180" data-file-height="185" /> <a href="/wiki/Category:Diets" title="Category:Diets">Category</a></li> <li><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/12px-Commons-logo.svg.png" 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