Athletes and Gluten-Free Diets: Exploring the popularly, experiences and beliefs of this diet in non-coeliac athletes
Lis, DM and Stellingwerff, T and Shing, C and Ahuja, KDK and Fell, JW, Athletes and Gluten-Free Diets: Exploring the popularly, experiences and beliefs of this diet in non-coeliac athletes, 2013 Sports Dietitians Australia Conference, 19 October, 2013, Melbourne, Australia (2013) [Conference Extract]
Adherence to a gluten-free diet (GFD) for non-coeliac non-gluten sensitive athletes has become increasingly popular. Many associate the elimination of dietary gluten with improved exercise performance, reduced gastrointestinal distress and inflammation, despite the lack of supportive medical evidence. The restrictive nature of a GFD has the potential risk of suboptimal nutrient intake, compromised beneficial gut bacterial populations and increased food expenditure. The aim of this study was to quantify the types of non-coeliac athletes (NCA), following a GFD and subsequently investigate related experiences, viewpoints and recommendations. Athletes (n=922) were recruited globally via National Sport Institutes and social media outlets. A 17-question survey was delivered through Survey Monkey. Data were analyzed using SPSS. Survey results indicated that 40% of NCA respondents, including 10 Olympic medalists, follow a GFD 50%-100% of the time; 13% of respondents for treatment of medical conditions. Endurance sport athletes (69% of respondents) were most likely to adopt a GFD, with 25% adhering to this diet 100% of the time and reduced gastrointestinal distress being the foremost reason (52%). Symptom-based self-diagnosed gluten-sensitivity (19%) and non-symptom based GFD self-prescription (11%) were the primary reasons for GFD implementation. Other athletes (46%) were the most accessed source of GFD information with registered dietitians indicated by only 12% of respondents. The percent of NCAs following a GFD (40%) was greater than the incidence in the general population estimated to benefit clinically from a GFD (~5-10%). The prescription of a GFD amongst athletes is not as a result of evidence-based practice, which suggests three possible rationalizations: (1) higher rates of gluten-sensitivity or undiagnosed coeliac disease in athletes, (2) athletes follow a GFD due to perceived physiological improvements that may coincide simultaneously with other dietary changes, or (3) a potentially unidentified association between exercise stress, gut function and dietary gluten, which warrants further investigation.