Gluten-Free Diet and Metabolic Syndrome: Could Be a Not Benevolent Encounter?

Abstract

Celiac disease is a rising disorder and is becoming frequently diagnosed in recent years. To date, the only available treatment is the gluten-free diet (GFD). The role of gluten on components of metabolic syndrome and on related inflammatory response is still unclear due to controversial results. In recent years, scientific focus on this topic has been growing up, in particular regarding the role of the GFD on glycometabolic parameters and diabetes. In addition, studies on the remaining components showed discordant results, which was likely due to heterogeneous and large celiac disease populations and to the lack of prospective studies. Furthermore, knowledge about the role of the GFD on inflammatory cytokines and the relationship among vitamin D and celiac disease, metabolic syndrome (MS) and GFD is needed. In this narrative review, we provided evidence regarding the role of the GFD on glycometabolic parameters, cholesterol, triglycerides, waist circumference, blood pressure and inflammatory cascade, also evaluating the role of vitamin D, trying to summarize whether this nutritional pattern may be a value-added for subjects with dysmetabolic conditions. Finally, due to the limited findings and very low-certainty evidence, predominantly based on observational studies, the real effects of a GFD on different components of MS, however, are unclear; nevertheless, an improvement in HDL levels has been reported, although data on glycemic levels are discordant.

Keywords: celiac disease; gluten-free diet; glycemia; inflammation; metabolic syndrome; nutrition.

Figure 1

Impact of GFD on components of MS in subjects with CD. Green arrow: improvement of component; Red arrow: worsening of component; =: not significant data. The number of arrows means in a scale 1–4 the power of data. GFT: Gluten-free diet; MS: metabolic syndrome; CD: celiac disease; HDL: HDL Cholesterol.