Gluten-free diets in athletes

Gluten is the structural protein component of the grains wheat, rye and barley, and it is the basis for a variety of food products consumed throughout the world. Gluten proteins, major determinants of the bread-making quality of wheat, are related to several digestive disorders, and celiac disease is the most studied of these pathologies. Health effects of gluten have received increasing attention both in medical research and popular media, and remain highly controversial. People with diagnosed coeliac disease require a lifelong strictly gluten-free diet. In addition to celiac disease patients, it has been hypothesized that a substantial proportion of the population may be gluten intolerant (non-celiac gluten sensitivity), and could benefit from reducing gluten in their diet. However, clinical evidence for the existence of such conditions and other purported adverse health effects of gluten remain inconsistent. Nevertheless, there is growing popular perception that gluten-freefoods are healthier, and in recent years, there has been a dramatic increase in demand and consumption of gluten-free foods in many Western countries. Adherence to a gluten-free diet for non-celiac athletes has become increasingly popular. In this narrative review, the effects of gluten-free diet are discussed, and its impact on health and sports performance in athletes is examined. A gluten-free diet among many athletes does not result from evidencebased practice, and in the majority of cases is not based on medical rationale and may be driven by perception that gluten removal provides health benefits and an ergogenic edge in non-celiac athletes. Actually, athletes with inadequate energy intake and/or who exclude certain foods or food groups may not meet sports nutrition guidelines for key nutrients, and as a result, athletes could have at increased risk for musculoskeletal injuries, iron-deficiency anemia, hormonal imbalances, and immune suppression. Keywords: Gluten free diet, nutrition, sport, athletes, celiac disease.