Exploring the popularity, experiences, and beliefs surrounding gluten-free diets in nonceliac athletes

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.