The gluten-free diet: Why? How? What risks?

A gluten-free diet is the treatment of celiac disease, and it must be strict and lifelong. It is also indicated in wheat allergy, most often transiently, the allergy disappearing with age, or periodically, in combination with physical exercise, in wheat dependent exercice-induced anaphylaxis. It is also possibly justified in non-celiac gluten sensitivity, but the existence of this entity and the actual involvement of gluten remain controversial. The increase in gluten-related pathologies in the general population could be explained by an increase in gluten intake and/or changes in gluten digestibility. A gluten-free diet should only be adopted after medical and dietary consultations in order to make the diagnosis, not to ignore an organic pathology, and to limit the diet-related risk of nutritional deficiencies, but also, potentially, of metabolic syndrome and coronary heart disease