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Consumption of fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) can promote gut health in individuals with a healthy gastrointestinal tract. However, FODMAPs, as well as amylase-trypsin inhibitors (ATIs), have been identified as potential triggers of intestinal symptoms in irritable bowel syndrome (IBS) and non-celiac wheat sensitivity (NCWS) patients. Wheat is a major staple worldwide, and hence, accounts for a large proportion of the intake of FODMAPs and ATIs. Thus, this paper aims to provide an overview of the strategies utilized in reducing the levels of FODMAPs and ATIs in wheat.

Background and aimsA wheat-free diet (WFD) represents the elective treatment for Non-celiac Wheat Sensitivity (NCWS) patients. Preliminary reports have shown a possible better tolerability of ancient grains in these subjects. The aim of this observational study was to evaluate the frequency of consumption of ancient grains and its correlation with clinical manifestations in NCWS patients.Methods223 NCWS patients were recruited, and their consumption of ancient grains was monitored. Participants were first administered a modified version of the Pavia/Biagi questionnaire to investigate their adherence to “modern WFD.” The appearance/exacerbation of symptoms after ingestion of ancient grains was then assessed with WHO toxicity grading scale.Results50.2% of the recruited patients reported consuming ancient grains before NCWS diagnosis; the diagnostic delay in this group was significantly higher than in non-consumers [median (range) 72 (6–612) vs. 60 months (3–684), P = 0.03] and these patients reported lower frequency of constipation (P = 0.04). Of the 107 patients with optimal adherence to modern WFD, 14 reported eating ancient wheat after NCWS diagnosis. Among them, 5 reported milder symptoms than those caused by modern wheat intake and 3 had an excellent tolerability without symptoms. Timilia/Tumminia variety was the most frequently used ancient grain.ConclusionsNCWS patients who consume ancient grains may receive a late diagnosis due to the possible clinical benefit (tolerability) obtained with these grains. Even after diagnosis, 10% of the patients still consumed ancient grains and had mild or no symptoms. Further studies are required to define the pathophysiological mechanism behind their putative greater tolerability.

Gluten-related disorders have recently been reclassified with an emerging scientific literature supporting the concept of non-celiac gluten sensitivity (NCGS). New research has specifically addressed prevalence, immune mechanisms, the recognition of non-immunoglobulin E (non-IgE) wheat allergy and overlap of NCGS with irritable bowel syndrome (IBS)-type symptoms. This review article will provide clinicians with an update that directly impacts on the management of a subgroup of their IBS patients whose symptoms are triggered by wheat ingestion. [ABSTRACT FROM AUTHOR]

Gluten-related disorders have recently been reclassified with an emerging scientific literature supporting the concept of non-celiac gluten sensitivity (NCGS). New research has specifically addressed prevalence, immune mechanisms, the recognition of non-immunoglobulin E (non-IgE) wheat allergy and overlap of NCGS with irritable bowel syndrome (IBS)-type symptoms. This review article will provide clinicians with an update that directly impacts on the management of a subgroup of their IBS patients whose symptoms are triggered by wheat ingestion.

Background and Aims: A wheat-free diet (WFD) represents the elective treatment for Non-celiac Wheat Sensitivity (NCWS) patients. Preliminary reports have shown a possible better tolerability of ancient grains in these subjects. The aim of this observational study was to evaluate the frequency of consumption of ancient grains and its correlation with clinical manifestations in NCWS patients., Methods: 223 NCWS patients were recruited, and their consumption of ancient grains was monitored. Participants were first administered a modified version of the Pavia/Biagi questionnaire to investigate their adherence to "modern WFD." The appearance/exacerbation of symptoms after ingestion of ancient grains was then assessed with WHO toxicity grading scale., Results: 50.2% of the recruited patients reported consuming ancient grains before NCWS diagnosis; the diagnostic delay in this group was significantly higher than in non-consumers [median (range) 72 (6-612) vs. 60 months (3-684), P = 0.03] and these patients reported lower frequency of constipation ( P = 0.04). Of the 107 patients with optimal adherence to modern WFD, 14 reported eating ancient wheat after NCWS diagnosis. Among them, 5 reported milder symptoms than those caused by modern wheat intake and 3 had an excellent tolerability without symptoms. Timilia/Tumminia variety was the most frequently used ancient grain., Conclusions: NCWS patients who consume ancient grains may receive a late diagnosis due to the possible clinical benefit (tolerability) obtained with these grains. Even after diagnosis, 10% of the patients still consumed ancient grains and had mild or no symptoms. Further studies are required to define the pathophysiological mechanism behind their putative greater tolerability., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Seidita, Mansueto, Giuliano, Chiavetta, Mandreucci, Soresi, Pistone, Compagnoni, Castellucci, Bisso, Faraci, Maestri, Disclafani, Sapone, Fasano and Carroccio.)

Abstract: After earlier debates on the role of fat, high fructose corn syrup, and added sugar in the aetiology of obesity, it has recently been suggested that wheat consumption is involved. Suggestions have been made that wheat consumption has adverse effects on health by mechanisms related to addiction and overeating. We discuss these arguments and conclude that they cannot be substantiated. Moreover, we conclude that assigning the cause of obesity to one specific type of food or food component, rather than overconsumption and inactive lifestyle in general, is not correct. In fact, foods containing whole-wheat, which have been prepared in customary ways (such as baked or extruded), and eaten in recommended amounts, have been associated with significant reductions in risks for type 2 diabetes, heart disease, and a more favourable long term weight management. Nevertheless, individuals that have a genetic predisposition for developing celiac disease, or who are sensitive or allergic to wheat proteins, will benefit from avoiding wheat and other cereals that contain proteins related to gluten, including primitive wheat species (einkorn, emmer, spelt) and varieties, rye and barley. It is therefore important for these individuals that the food industry should develop a much wider spectrum of foods, based on crops that do not contain proteins related to gluten, such as teff, amaranth, oat, quinoa, and chia. Based on the available evidence, we conclude that whole-wheat consumption cannot be linked to increased prevalence of obesity in the general population. [Copyright &y& Elsevier]