Non-celiac gluten sensitivity and the protective role of polyphenols

NCGS and gluten/wheat sensitivity manifest with nonspecific symptoms. Gastro- and extraintestinal symptoms that occur in connection with the intake of foods containing gluten are considered characteristic. Despite the reliable exclusion of celiac disease after testing for appropriate serological, histological or genetic markers, patients experience significant relief from their symptoms when following a gluten-free diet.

A lifelong, completely gluten-free diet requires a lot of perseverance. There is therefore great interest in exploring alternative possibilities. The aim is to reduce the gluten concentration or to alleviate the symptoms caused by gluten. In this context, plant-based diets are the focus. A plant-based diet is rich in bioactive compounds, including polyphenols, which are secondary plant substances. They only occur in plants and are found in the outer layers of fruits, vegetables and grains. Polyphenols have been proven to have health benefits thanks to their antioxidant activity and their antibacterial, anti-inflammatory and immunomodulatory properties. Polyphenols have been shown to prevent, delay or even reverse chronic diseases – including intestinal diseases.

However, there is currently only limited research into the role of polyphenols in mitigating the effects of gluten-containing foods. In the current review (Calabriso, N., et al. 2022), a variety of protective functions of polyphenols - especially in NCGS - were compiled. Calabriso, N. et al. analyzed the potential mechanisms of action of polyphenols, including gluten peptide bioavailability, intestinal epithelial barrier disruption, intestinal immune response, oxidative stress and inflammation, and microbial dysbiosis. Overall, the review provides an overview of the effects of polyphenols as a possible dietary strategy to counteract the reaction to gluten and improve the quality of life of those affected with gluten-related diseases

Conclusion

The potential supportive and protective functions of polyphenols in gluten-related diseases, particularly NCGS and gluten/wheat sensitivity, are highlighted in this publication. The possible mechanisms of action of polyphenols in alleviating the symptoms of NCGS could be as follows: Polyphenols can have a direct effect on dietary gluten by reducing the bioavailability of gluten and the resulting symptoms. They can also reduce oxidative stress and inflammation, regulate immune reactions and have a positive effect on the intestinal microbiome and the intestinal barrier. Although much scientific evidence supports the protective role of polyphenols in gut health, there is currently no evidence from controlled studies to suggest the use of polyphenols in gut disorders. Further studies are needed before physicians and nutrition professionals can draw conclusions about the use of polyphenols in the diet to improve symptoms of NCGS as an alternative or addition to a gluten-free diet.