title: Exploring the popularity, experiences, and beliefs surrounding gluten-free diets in nonceliac athletes.
abstract: Adherence to a gluten-free diet (GFD) for nonceliac athletes (NCA) has become increasingly popular despite a paucity of supportive medical or ergogenic evidence. This study aimed to quantify the demographics of NCA and determine associated experiences, perceptions, and sources of information related to GFD. Athletes (n = 910, female = 528, no gender selected = 5) completed a 17-question online survey. Forty-one percent of NCA respondents, including 18-world and/or Olympic medalists, follow a GFD 50-100% of the time (GFD > 50): only 13% for treatment of reported medical conditions with 57% self-diagnosing their gluten sensitivity. The GFD > 50 group characteristics included predominantly endurance sport athletes (70.0%) at the recreationally competitive level (32.3%), between 31 and 40 years of age (29.1%). Those who follow a GFD > 50 reported experiencing, abdominal/gastrointestinal (GI) symptoms alone (16.7%) or in conjunction with two (30.7%) or three (35.7%) additional symptoms (e.g., fatigue) believed to be triggered by gluten. Eighty-four percent of GFD > 50 indicated symptom improvement with gluten-removal. Symptom-based and non-symptom-based self-diagnosed gluten-sensitivity (56.7%) was the primary reason for adopting a GFD. Leading sources of GFD information were online (28.7%), trainer/coach (26.2%) and other athletes (17.4%). Although 5-10% of the general population is estimated to benefit clinically from a GFD a higher prevalence of GFD adherence was found in NCA (41.2%). Prescription of a GFD among many athletes does not result from evidence-based practice suggesting that adoption of a GFD in the majority of cases was not based on medical rationale and may be driven by perception that gluten removal provides health benefits and an ergogenic edge in NCA.
authors.affiliation: Sport Performance Optimisation Research Team, School of Human Life Sciences, University of Tasmania, Tasmania, Australia.
authors.forename: Dana M
authors.initials: DM
authors.lastname: Lis
authors.forename: Trent
authors.initials: T
authors.lastname: Stellingwerff
authors.forename: Cecilia M
authors.initials: CM
authors.lastname: Shing
authors.forename: Kiran D K
authors.initials: KD
authors.lastname: Ahuja
authors.forename: James W
authors.initials: JW
authors.lastname: Fell
mesh_terms: D056352:Athletes; D054874:Athletic Performance; D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy / Q000503:physiopathology; D015331:Cohort Studies; D003258:Consumer Behavior; D054626:Consumer Health Information; D059026:Diagnostic Self Evaluation; D004034:Diet Surveys; D055050:Diet, Gluten-Free; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D012648:Self Care; D012720:Severity of Illness Index; D064133:Sports Nutritional Physiological Phenomena