A NUTRITIONIST’S VIEW

Gluten-Free Diets and Exercise Performance

by Stella Lucia Volpe, Ph.D., R.D., L.D.N., FACSM
INTRODUCTION lead to an autoimmune response, where the body will attack
here is a great amount of discussion about whether in- the small intestine, which will lead to malabsorption of nutrients.

T dividuals who do not have celiac disease should consume

gluten-free diets. Gluten-free diets certainly have been a
topic of discussion among athletes. Some athletes believe that
consuming a gluten-free diet provides an ergogenic (performance-
Therefore, individuals with celiac disease must avoid foods con-
taining gluten (1).

enhancing) effect, despite the lack of evidence to support this
belief. In this Nutritionist’s View, I will first provide a definition
of celiac disease and then present research that has been con-
ducted in the area of consuming gluten-free diets.
WHAT IS CELIAC DISEASE?
Celiac disease, also known as celiac sprue, nontropical sprue,
and gluten-sensitive enteropathy, is an autoimmune condition
that, if not diagnosed, will lead to damage to the small intestine.
In addition to damage to the small intestine, undiagnosed celiac
disease can lead to iron deficiency anemia, early onset osteopo-
rosis, lactose intolerance, and nervous system disorders, to name
a few. Celiac disease typically is hereditary (1).
In individuals with celiac disease, the consumption of glu-
ten, which is a protein found in rye, barley, and wheat, will
In individuals with celiac disease, the
consumption of gluten, which is a protein found
in rye, barley, and wheat, will lead to an
autoimmune response, where the body will
attack the small intestine, which will lead to
malabsorption of nutrients. Therefore,
individuals with celiac disease must avoid foods
containing gluten (1).
Because of the increased diagnoses of celiac disease, there has
been a rise in the production of gluten-free products. With
this rise in availability of gluten-free products, there has been

Volume 22 | Number 1 www.acsm-healthfitness.org 35

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A NUTRITIONIST’S VIEW
an increase in the number of individuals without celiac disease
who now consume gluten-free products. Is there a basis for this?
With respect to athletes, will consuming a gluten-free diet en-
hance performance? Let’s see what the research tells us.
GLUTEN-FREE DIETS AND ATHLETIC PERFORMANCE
Before discussing the effect of a gluten-free diet on athletic per-
formance, it is important to understand why athletes choose to
consume a gluten-free diet if they do not have celiac disease.
Lis et al. (2) aimed to evaluate the demographics of athletes
without celiac disease and ascertain the experiences and per-
ceptions of why athletes choose to consume gluten-free diets.
They administered an online survey to 910 athletes (528 women,
377 men, and 5 athletes who did not choose a gender). They re-
ported that 41% of all athletes (18 of whom were world and/or
Olympic medalists), consumed a gluten-free diet 50% to 100%
of the time. A total of 13% consumed a gluten-free diet for man-
agement of a medical condition, whereas 57% of the athletes
self-identified their gluten sensitivity. Athletes who consumed a
gluten-free diet more than 50% of the time were mostly endur-
ance athletes who reported gastrointestinal symptoms alone or
in addition to other symptoms they believed were caused by glu-
ten. More than 80% of the athletes who consumed gluten-free
diets more than 50% of the time reported that their symptoms
improved by removing gluten from their diets. Most of the ath-
letes retrieved their information about gluten-free diets from
online sources, coaches, and/or other athletes.
Lis et al. (3) conducted another study to evaluate the effects of
consuming a gluten-free diet on exercise performance, gastroin-
testinal symptoms and injury, and inflammatory markers as well
as perceived well-being among athletes without celiac disease. In
this randomized, double-blind, crossover study, five female and
eight male competitive cyclists, who did not have celiac disease,
were provided either a 7-day diet that contained gluten or a
7-day gluten-free diet. These were separated by a 10-day wash-
out period, at which point the athletes would receive the
opposite diet.
Lis et al. (3) did not report any significant differences between
the diets on exercise performance, in gastrointestinal symptoms
during exercise, well-being, intestinal injury, or inflammation.
Although this was a short-term study, with only 13 participants,
it warrants that athletes need to be informed of the food choices
they make on a daily basis.
Lis et al. (4) state that there are reasonable explanations be-
tween endurance exercise and gastrointestinal effects and why
individuals may deem it beneficial to consume a gluten-free diet
even if they do not have celiac disease. Nonetheless, the risk of
dietary restriction and financial burden are just two factors that
require further investigation on the consumption of gluten-free
diets in athletes without celiac disease.
36 ACSM’s Health & Fitness Journal ®
Copyright © 2018 American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
SUMMARY
Although there is a paucity of research in the area of gluten-free
diets and athletic performance, early research indicates there is
no benefit for athletes who do not have celiac disease to con-
sume gluten-free diets. More research is required in larger pop-
ulations, and in different laboratories, to determine definitively
if there is (or is not) a benefit.
Although there is a paucity of research in the
area of gluten-free diets and athletic
performance, early research indicates there is
no benefit for athletes who do not have celiac
disease to consume gluten-free diets.
1. Celiac Disease Foundation Web site [Internet]. Woodland Hills (CA): Celiac Disease
Foundation; [cited September 18, 2017]. Available from: https://celiac.org/celiac-
disease/understanding-celiac-disease-2/what-is-celiac-disease/.
2. Lis DM, Stellingwerff T, Shing CM, Ahuja KD, Fell JW. Exploring the popularity,
experiences, and beliefs surrounding gluten-free diets in nonceliac athletes. Int J
Sport Nutr Exerc Metab. 2015;25(1):37–45. [Epub 2014 Jun 5].
3. Lis D, Stellingwerff T, Kitic CM, Ahuja KD, Fell J. No effects of a short-term
gluten-free diet on performance in nonceliac athletes. Med Sci Sports Exerc. 2015;
47(12):2563–70.
4. Lis DM, Fell JW, Ahuja KD, Kitic CM, Stellingwerff T. Commercial hype versus reality:
our current scientific understanding of gluten and athletic performance. Curr Sports
Med Rep. 2016;15(4):262–8.
Recommended Resource:
 Celiac Disease Foundation. Available from: https://celiac.
org/celiac-disease/understanding-celiac-disease-2/what-is-
celiac-disease/
Disclosure: The author declares no conflict of interest and does not have any
financial disclosures.
Stella Lucia Volpe, Ph.D., R.D., L.D.N., FACSM,
is professor and chair of the Department of Nutrition
Science at Drexel University, Philadelphia, PA. Her
degrees are in both Nutrition and Exercise Physiology;
she also is an ACSM Certified Clinical Exercise
Physiologist® and a registered dietitian. Dr. Volpe’s
research focuses on obesity and diabetes prevention
using traditional interventions, mineral supplementa-
tion, and by altering the environment to result in greater physical activity and
healthy eating. Dr. Volpe serves on the Board of Trustees for the International
Life Sciences Institute North America. Dr. Volpe is an associate editor of
ACSM’s Health & Fitness Journal® and the Translational Journal
of the American College of Sports Medicine.
January/February 2018