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Descriptive Study of the Different Tools Used to Evaluate the Adherence to a Gluten-Free Diet in Celiac Disease Patients

Gluten-Free Diet in Celiac Disease—Forever and for All?

Division of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany
Center for the Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
Author to whom correspondence should be addressed.
Nutrients 2018, 10(11), 1796;
Received: 16 October 2018 / Revised: 4 November 2018 / Accepted: 15 November 2018 / Published: 18 November 2018
(This article belongs to the Special Issue Gluten-Free Diet)
The gluten-free diet is the only effective treatment available for celiac disease. However, it is difficult to adhere to and a closer look on the diet’s implementation and indications reveals several ambiguities: Not only is there controversy on the threshold of gluten that can be tolerated in the frame of a strict gluten-free diet, but it is also unclear whether the gluten-free diet is an appropriate treatment in patient subgroups with asymptomatic or potential celiac disease. Reports from a number of research groups suggest that a certain proportion of patients may effectively develop tolerance to gluten and thus become suitable for gluten reintroduction over time. In this review, we set out to create an overview about the current state of research as regards the definition of a strict gluten-free diet in terms of the gluten thresholds considered tolerable and the indication for a gluten-free diet in the absence of histological abnormalities or symptoms. Furthermore, we discuss the concept that a gluten-free diet must be followed for life by all patients. View Full-Text
Keywords: gluten; adherence; serology; villous atrophy; mucosal recovery; threshold gluten; adherence; serology; villous atrophy; mucosal recovery; threshold
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MDPI and ACS Style

Itzlinger, A.; Branchi, F.; Elli, L.; Schumann, M. Gluten-Free Diet in Celiac Disease—Forever and for All? Nutrients 2018, 10, 1796.

AMA Style

Itzlinger A, Branchi F, Elli L, Schumann M. Gluten-Free Diet in Celiac Disease—Forever and for All? Nutrients. 2018; 10(11):1796.

Chicago/Turabian Style

Itzlinger, Alice, Federica Branchi, Luca Elli, and Michael Schumann. 2018. "Gluten-Free Diet in Celiac Disease—Forever and for All?" Nutrients 10, no. 11: 1796.

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