{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:28:32Z","timestamp":1788049712468,"version":"build-2784847793"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100010600","name":"Tays","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010600","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009960","name":"Pirkanmaan Sairaanhoitopiiri","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009960","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005744","name":"Lastentautien Tutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005744","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002341","name":"Academy of Finland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006306","name":"Sigrid Jus\u00e9liuksen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006306","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003125","name":"Suomen Kulttuurirahasto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003125","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Clin Nutr"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Self-reported abdominal symptoms after consuming gluten-containing cereals in individuals without celiac disease (CeD) are common. The long-term outcomes of these individuals are unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Seventy-six adults experiencing symptoms from gluten-containing cereals underwent exclusion of CeD and wheat allergy in 1995\u20131997 and were thus advised to revert to a normal gluten-containing diet. These individuals were invited to a comprehensive health examination, including measurement of CeD antibodies and symptoms and assessment of quality of life using the Gastrointestinal Symptom Rating Scale (GSRS) and Psychological General Well-Being Index (PGWB). Healthy individuals (<jats:italic>n<\/jats:italic>\u2009=\u2009160) and untreated CeD patients (<jats:italic>n<\/jats:italic>\u2009=\u2009128) served as controls.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Altogether, 28 individuals participated, half of whom were still avoiding gluten-containing cereals. None had acquired a diagnosis of any gastrointestinal disease, and all had negative CeD serology. The entire study group presented with significantly higher GSRS total (participants 2.8, 95% confidence interval 2.5\u20133.1 vs. controls 1.8, 1.7\u20131.9; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and other sub-scores than healthy controls, and higher total (vs. patients 2.5, 2.3\u20132.6; <jats:italic>p<\/jats:italic>\u2009=\u20090.041) and constipation scores than untreated CeD patients. Additionally, the group had worse PGWB total (participants 92.1, 84.9\u201399.4 vs. controls 105.3, 102.5\u2013108.7; <jats:italic>p<\/jats:italic>\u2009=\u20090.002) and anxiety, self-control, general health, and vitality sub-cores than healthy controls, as well as self-control, general health, and vitality scores than untreated CeD patients. Twelve participants fulfilled the criteria for irritable bowel syndrome.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>None of the participants had developed CeD or been diagnosed with gastrointestinal disease for 25 years. They reported more gastrointestinal symptoms and a poorer quality of life, even when compared to untreated CeD patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1038\/s41430-025-01641-x","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T04:48:50Z","timestamp":1751950130000},"page":"1053-1059","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Long-term health outcomes of people without celiac disease avoiding gluten consumption: a 25-year prospective cohort study"],"prefix":"10.1038","volume":"79","author":[{"given":"Eeva","family":"Salmela","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurppa","family":"Kalle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katri","family":"Lindfors","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e4ivi","family":"Saavalainen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1372-430X","authenticated-orcid":false,"given":"Heini","family":"Huhtala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katri","family":"Kaukinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3948-9555","authenticated-orcid":false,"given":"Juha","family":"Taavela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"1641_CR1","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1038\/ajg.2010.487","volume":"106","author":"JR Biesiekierski","year":"2011","unstructured":"Biesiekierski JR, Newnham ED, Irving PM, Barrett JS, Haines M, Doecke JD, et al. Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial. Am J Gastroenterol. 2011;106:508\u201315. https:\/\/doi.org\/10.1038\/ajg.2010.487.","journal-title":"Am J Gastroenterol"},{"key":"1641_CR2","doi-asserted-by":"publisher","first-page":"4966","DOI":"10.3390\/nu7064966","volume":"7","author":"C Catassi","year":"2015","unstructured":"Catassi C, Elli L, Bonaz B, Bouma G, Carroccio A, Castillejo G, et al. Diagnosis of non-celiac gluten sensitivity (NCGS): the Salerno experts\u2019 criteria. Nutrients. 2015;7:4966\u201377. https:\/\/doi.org\/10.3390\/nu7064966.","journal-title":"Nutrients"},{"key":"1641_CR3","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1053\/j.gastro.2017.10.040","volume":"154","author":"GI Skodje","year":"2018","unstructured":"Skodje GI, Sarna VK, Minelle IH, Rolfsen KL, Muir JG, Gibson PR, et al. Fructan, rather than gluten, induces symptoms in patients with self-reported non-celiac gluten sensitivity. Gastroenterology. 2018;154:529\u201339.e2. https:\/\/doi.org\/10.1053\/j.gastro.2017.10.040.","journal-title":"Gastroenterology"},{"key":"1641_CR4","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1053\/j.gastro.2013.04.051","volume":"145","author":"JR Biesiekierski","year":"2013","unstructured":"Biesiekierski JR, Peters SL, Newnham ED, Rosella O, Muir JG, Gibson PR. No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Gastroenterology. 2013;145:320\u20138.e1-3. https:\/\/doi.org\/10.1053\/j.gastro.2013.04.051.","journal-title":"Gastroenterology"},{"key":"1641_CR5","doi-asserted-by":"publisher","first-page":"1264","DOI":"10.1016\/j.clnesp.2024.07.900","volume":"63","author":"PP Petersen","year":"2024","unstructured":"Petersen PP, Linder AM, H\u00f6lscher K, Rosa LF, Bischoff SC. Assessing the tolerability of different types of wheat breads in patients with suspected wheat sensitivity: a randomized, blinded, monocentric study (INDICATE-FH). Clin Nutr ESPEN. 2024;63:1264. https:\/\/doi.org\/10.1016\/j.clnesp.2024.07.900.","journal-title":"Clin Nutr ESPEN"},{"key":"1641_CR6","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1053\/j.gastro.2015.05.040","volume":"149","author":"A Carroccio","year":"2015","unstructured":"Carroccio A, D\u2019Alcamo A, Cavataio F, Soresi M, Seidita A, Scium\u00e8 C, et al. High proportions of people with nonceliac wheat sensitivity have autoimmune disease or antinuclear antibodies. Gastroenterology. 2015;149:596\u2013603.e1. https:\/\/doi.org\/10.1053\/j.gastro.2015.05.040.","journal-title":"Gastroenterology"},{"key":"1641_CR7","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.clnesp.2019.02.012","volume":"31","author":"GI Skodje","year":"2019","unstructured":"Skodje GI, Minelle IH, Rolfsen KL, Iacovou M, Lundin KEA, Veier\u00f8d MB, et al. Dietary and symptom assessment in adults with self-reported non-coeliac gluten sensitivity. Clin Nutr ESPEN. 2019;31:88\u201394. https:\/\/doi.org\/10.1016\/j.clnesp.2019.02.012.","journal-title":"Clin Nutr ESPEN"},{"key":"1641_CR8","doi-asserted-by":"publisher","first-page":"136","DOI":"10.3390\/nu11010136","volume":"11","author":"L Roncoroni","year":"2019","unstructured":"Roncoroni L, Bascu\u00f1\u00e1n KA, Vecchi M, Doneda L, Bardella MT, Lombardo V, et al. Exposure to different amounts of dietary gluten in patients with non-celiac gluten sensitivity (NCGS): an exploratory study. Nutrients. 2019;11:136. https:\/\/doi.org\/10.3390\/nu11010136.","journal-title":"Nutrients"},{"key":"1641_CR9","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1053\/j.gastro.2017.03.034","volume":"153","author":"A Carroccio","year":"2017","unstructured":"Carroccio A, D\u2019Alcamo A, Iacono G, Soresi M, Iacobucci R, Arini A, et al. Persistence of nonceliac wheat sensitivity, based on long-term follow-up. Gastroenterology. 2017;153:56\u20138.e3. https:\/\/doi.org\/10.1053\/j.gastro.2017.03.034.","journal-title":"Gastroenterology"},{"key":"1641_CR10","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1080\/003655200750022995","volume":"35","author":"K Kaukinen","year":"2000","unstructured":"Kaukinen K, Turjanmaa K, M\u00e4ki M, Partanen J, Ven\u00e4l\u00e4inen R, Reunala T, et al. Intolerance to cereals is not specific for coeliac disease. Scand J Gastroenterol. 2000;35:942\u20136. https:\/\/doi.org\/10.1080\/003655200750022995.","journal-title":"Scand J Gastroenterol"},{"key":"1641_CR11","doi-asserted-by":"publisher","first-page":"429","DOI":"10.3390\/nu8070429","volume":"8","author":"P Laurikka","year":"2016","unstructured":"Laurikka P, Salmi T, Collin P, Huhtala H, M\u00e4ki M, Kaukinen K, et al. Gastrointestinal symptoms in celiac disease patients on a long-term gluten-free diet. Nutrients. 2016;8:429. https:\/\/doi.org\/10.3390\/nu8070429.","journal-title":"Nutrients"},{"key":"1641_CR12","doi-asserted-by":"publisher","first-page":"99","DOI":"10.3390\/jcm6110099","volume":"6","author":"BE Lacy","year":"2017","unstructured":"Lacy BE, Patel NK. Rome criteria and a diagnostic approach to irritable bowel syndrome. J Clin Med. 2017;6:99. https:\/\/doi.org\/10.3390\/jcm6110099.","journal-title":"J Clin Med"},{"key":"1641_CR13","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1136\/gut.35.6.776","volume":"35","author":"B Ladinser","year":"1994","unstructured":"Ladinser B, Rossipal E, Pittschieler K. Endomysium antibodies in coeliac disease: an improved method. Gut. 1994;35:776\u20138. https:\/\/doi.org\/10.1136\/gut.35.6.776.","journal-title":"Gut"},{"key":"1641_CR14","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1007\/s00251-009-0361-3","volume":"61","author":"L Koskinen","year":"2009","unstructured":"Koskinen L, Romanos J, Kaukinen K, Mustalahti K, Korponay-Szabo I, Barisani D, et al. Cost-effective HLA typing with tagging SNPs predicts celiac disease risk haplotypes in the Finnish, Hungarian, and Italian populations. Immunogenetics. 2009;61:247\u201356. https:\/\/doi.org\/10.1007\/s00251-009-0361-3.","journal-title":"Immunogenetics"},{"key":"1641_CR15","unstructured":"Fimlab. Basic blood count test. 2024. https:\/\/fimlab.fi\/en\/the-most-common-examinations\/basic-blood-count-test\/."},{"key":"1641_CR16","doi-asserted-by":"publisher","first-page":"907","DOI":"10.21873\/invivo.12330","volume":"35","author":"I Saimanen","year":"2021","unstructured":"Saimanen I, Kuosmanen V, Harju J, Selander T, Aspinen S, Eskelinen M. A Finnish version of RAND-36-item health survey versus structured interview 8 years postoperatively. Vivo. 2021;35:907\u201311. https:\/\/doi.org\/10.21873\/invivo.12330.","journal-title":"Vivo"},{"key":"1641_CR17","doi-asserted-by":"publisher","first-page":"8","DOI":"10.3109\/00365529609095544","volume":"221","author":"E Dimen\u00e4s","year":"1996","unstructured":"Dimen\u00e4s E, Carlsson G, Glise H, Israelsson B, Wiklund I. Relevance of norm values as part of the documentation of quality of life instruments for use in upper gastrointestinal disease. Scand J Gastroenterol Suppl. 1996;221:8\u201313. https:\/\/doi.org\/10.3109\/00365529609095544.","journal-title":"Scand J Gastroenterol Suppl"},{"key":"1641_CR18","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1007\/BF01535722","volume":"33","author":"J Svedlund","year":"1988","unstructured":"Svedlund J, Sj\u00f6din I, Dotevall G. GSRS\u2013a clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease. Dig Dis Sci. 1988;33:129\u201334. https:\/\/doi.org\/10.1007\/BF01535722.","journal-title":"Dig Dis Sci"},{"key":"1641_CR19","doi-asserted-by":"publisher","first-page":"908","DOI":"10.1016\/s0002-9149(84)80232-5","volume":"54","author":"NK Wenger","year":"1984","unstructured":"Wenger NK, Mattson ME, Furberg CD, Elinson J. Assessment of quality of life in clinical trials of cardiovascular therapies. Am J Cardiol. 1984;54:908\u201313. https:\/\/doi.org\/10.1016\/s0002-9149(84)80232-5.","journal-title":"Am J Cardiol"},{"key":"1641_CR20","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1002\/hec.4730020305","volume":"2","author":"RD Hays","year":"1993","unstructured":"Hays RD, Sherbourne CD, Mazel RM. The RAND 36-Item Health Survey 1.0. Health Econ. 1993;2:217\u201327. https:\/\/doi.org\/10.1002\/hec.4730020305.","journal-title":"Health Econ"},{"key":"1641_CR21","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1023\/b:ejep.0000036568.02655.f8","volume":"19","author":"V Kristman","year":"2004","unstructured":"Kristman V, Manno M, C\u00f4t\u00e9 P. Loss to follow-up in cohort studies: how much is too much?. Eur J Epidemiol. 2004;19:751\u201360. https:\/\/doi.org\/10.1023\/b:ejep.0000036568.02655.f8.","journal-title":"Eur J Epidemiol"},{"key":"1641_CR22","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1038\/sj.ki.5002650","volume":"73","author":"KJ Jager","year":"2008","unstructured":"Jager KJ, Zoccali C, Macleod A, Dekker FW. Confounding: what it is and how to deal with it. Kidney Int. 2008;73:256\u201360. https:\/\/doi.org\/10.1038\/sj.ki.5002650.","journal-title":"Kidney Int"},{"key":"1641_CR23","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1038\/ajg.2012.433","volume":"108","author":"J Molina-Infante","year":"2013","unstructured":"Molina-Infante J, Santolaria S, Fernandez-Ba\u00f1ares F, Montoro M, Esteve M. Lymphocytic enteropathy, HLA-DQ2\/DQ8 genotype and wheat-dependent symptoms: non-celiac wheat sensitivity or Marsh I celiac disease?. Am J Gastroenterol. 2013;108:451. https:\/\/doi.org\/10.1038\/ajg.2012.433.","journal-title":"Am J Gastroenterol"},{"key":"1641_CR24","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.cgh.2016.08.007","volume":"15","author":"J Molina-Infante","year":"2017","unstructured":"Molina-Infante J, Carroccio A. Suspected nonceliac gluten sensitivity confirmed in few patients after gluten challenge in double-blind, placebo-controlled trials. Clin Gastroenterol Hepatol. 2017;15:339\u201348. https:\/\/doi.org\/10.1016\/j.cgh.2016.08.007.","journal-title":"Clin Gastroenterol Hepatol"},{"key":"1641_CR25","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1111\/cei.13578","volume":"204","author":"RP Anderson","year":"2021","unstructured":"Anderson RP, Goel G, Hardy MY, Russell AK, Wang S, Szymczak E, et al. Whole blood interleukin-2 release test to detect and characterize rare circulating gluten-specific T cell responses in coeliac disease. Clin Exp Immunol. 2021;204:321\u201334. https:\/\/doi.org\/10.1111\/cei.13578.","journal-title":"Clin Exp Immunol"},{"key":"1641_CR26","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1080\/17474124.2021.1850262","volume":"15","author":"A Kurki","year":"2021","unstructured":"Kurki A, Kemppainen E, Laurikka P, Kaukinen K, Lindfors K. The use of peripheral blood mononuclear cells in celiac disease diagnosis and treatment. Expert Rev Gastroenterol Hepatol. 2021;15:305\u201316. https:\/\/doi.org\/10.1080\/17474124.2021.1850262.","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"1641_CR27","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1097\/MCG.0b013e3182372541","volume":"46","author":"U Volta","year":"2012","unstructured":"Volta U, Tovoli F, Cicola R, Parisi C, Fabbri A, Piscaglia M, et al. Serological tests in gluten sensitivity (nonceliac gluten intolerance). J Clin Gastroenterol. 2012;46:680\u20135.","journal-title":"J Clin Gastroenterol"},{"key":"1641_CR28","doi-asserted-by":"publisher","first-page":"1966","DOI":"10.1136\/gutjnl-2019-319281","volume":"69","author":"MR Barbaro","year":"2020","unstructured":"Barbaro MR, Cremon C, Morselli-Labate AM, Di Sabatino A, Giuffrida P, Corazza GR, et al. Serum zonulin and its diagnostic performance in non-coeliac gluten sensitivity. Gut. 2020;69:1966\u201374. https:\/\/doi.org\/10.1136\/gutjnl-2019-319281.","journal-title":"Gut"},{"key":"1641_CR29","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/j.clnu.2017.12.017","volume":"38","author":"F Tovoli","year":"2019","unstructured":"Tovoli F, Granito A, Negrini G, Guidetti E, Faggiano C, Bolondi L. Long term effects of gluten-free diet in non-celiac wheat sensitivity. Clin Nutr. 2019;38:357\u201363. https:\/\/doi.org\/10.1016\/j.clnu.2017.12.017.","journal-title":"Clin Nutr"},{"key":"1641_CR30","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.3390\/nu9111268","volume":"9","author":"C Catassi","year":"2017","unstructured":"Catassi C, Alaedini A, Bojarski C, Bonaz B, Bouma G, Carroccio A, et al. The overlapping area of non-celiac gluten sensitivity (NCGS) and wheat-sensitive irritable bowel syndrome (IBS): an update. Nutrients. 2017;9:1268. https:\/\/doi.org\/10.3390\/nu9111268.","journal-title":"Nutrients"},{"key":"1641_CR31","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-10-13","volume":"10","author":"A Sapone","year":"2012","unstructured":"Sapone A, Bai JC, Ciacci C, Dolinsek J, Green PHR, Hadjivassiliou M, et al. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Med. 2012;10:13. https:\/\/doi.org\/10.1186\/1741-7015-10-13.","journal-title":"BMC Med"},{"key":"1641_CR32","doi-asserted-by":"publisher","first-page":"1845","DOI":"10.1038\/ajg.2013.353","volume":"108","author":"A Carroccio","year":"2013","unstructured":"Carroccio A, Mansueto P, D\u2019Alcamo A, Iacono G. Non-celiac wheat sensitivity as an allergic condition: personal experience and narrative review. Am J Gastroenterol. 2013;108:1845\u201352. https:\/\/doi.org\/10.1038\/ajg.2013.353.","journal-title":"Am J Gastroenterol"},{"key":"1641_CR33","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1016\/j.bpg.2015.04.002","volume":"29","author":"D Schuppan","year":"2015","unstructured":"Schuppan D, Pickert G, Ashfaq-Khan M, Zevallos V. Non-celiac wheat sensitivity: differential diagnosis, triggers and implications. Best Pr Res Clin Gastroenterol. 2015;29:469\u201376. https:\/\/doi.org\/10.1016\/j.bpg.2015.04.002.","journal-title":"Best Pr Res Clin Gastroenterol"},{"key":"1641_CR34","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.jad.2014.10.015","volume":"173","author":"N Markkula","year":"2015","unstructured":"Markkula N, Suvisaari J, Saarni SI, Pirkola S, Pe\u00f1a S, Saarni S, et al. Prevalence and correlates of major depressive disorder and dysthymia in an eleven-year follow-up\u2013results from the Finnish Health 2011 Survey. J Affect Disord. 2015;173:73\u201380. https:\/\/doi.org\/10.1016\/j.jad.2014.10.015.","journal-title":"J Affect Disord"},{"key":"1641_CR35","doi-asserted-by":"publisher","first-page":"S64","DOI":"10.1111\/apt.16912","volume":"56","author":"P Laurikka","year":"2022","unstructured":"Laurikka P, Kivel\u00e4 L, Kurppa K, Kaukinen K. Review article: systemic consequences of coeliac disease. Aliment Pharm Ther. 2022;56:S64\u201372. https:\/\/doi.org\/10.1111\/apt.16912.","journal-title":"Aliment Pharm Ther"},{"key":"1641_CR36","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1111\/apt.12730","volume":"39","author":"SL Peters","year":"2014","unstructured":"Peters SL, Biesiekierski JR, Yelland GW, Muir JG, Gibson PR. Randomised clinical trial: gluten may cause depression in subjects with non-coeliac gluten sensitivity \u2013 an exploratory clinical study. Aliment Pharm Ther. 2014;39:1104\u201312. https:\/\/doi.org\/10.1111\/apt.12730.","journal-title":"Aliment Pharm Ther"}],"container-title":["European Journal of Clinical Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41430-025-01641-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41430-025-01641-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41430-025-01641-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T11:14:04Z","timestamp":1760958844000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41430-025-01641-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,8]]},"references-count":36,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["1641"],"URL":"https:\/\/doi.org\/10.1038\/s41430-025-01641-x","relation":{},"ISSN":["0954-3007","1476-5640"],"issn-type":[{"value":"0954-3007","type":"print"},{"value":"1476-5640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,8]]},"assertion":[{"value":"23 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 June 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 June 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 July 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The study protocol and participant recruitment were approved by the Ethics Committee of the Pirkanmaa Hospital District. Written informed consent was obtained from all participants. The Declaration of Helsinki was followed throughout the study process.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}]}}