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There is increasing research to suggest dietary allergies and intolerances may contribute to mental health disorders such as depression, anxiety, bipolar disorder, and schizophrenia [1]. Common food culprits include gluten, dairy, nightshades (e.g., tomatoes, eggplant, capsicum), nuts, and shellfish. When such foods are consumed by susceptible individuals, they can damage the intestinal tract and trigger an immune response. It is believed that this immune response can have a negative effect on the brain and alter mood-supporting neurotransmitters.
Gluten is a protein that is found in wheat, rye, and barley. People with coeliac disease have a severe reaction to gluten often resulting in significant digestive symptoms. However, there are many people who believe they have a milder form of gluten intolerance, often referred to as non-coeliac gluten sensitivity. In people with schizophrenia, approximately one-third of people have been shown to have elevated levels of anti-gliadin antibodies of the immunoglobulin G type (AGA IgG) [2]. As a result, in a recent double-blind study published in the Journal of Psychiatry and Neuroscience [3], researchers examined the effects of a gluten-free versus gluten-containing diet in a subset of patients with schizophrenia who were positive for AGA IgG.
Sixteen participants with schizophrenia or schizoaffective disorder who had elevated AGA IgG (but not coeliac disease) were admitted to an inpatient unit for 5 weeks. All participants received standardised gluten-free meals and were randomised into one of two groups:
Of the 14 participants who completed the trial, the researchers found that compared with participants on the gluten-containing diet, participants on the gluten-free diet experienced:
However, there were no differences in changes in positive symptoms (e.g., hallucinations and delusional beliefs) or global cognitive symptoms.
Overall, this is a positive study demonstrating the effects of a gluten-free diet on several symptoms in people with schizophrenia presenting with elevated anti-gliadin antibodies. However, the results of this study need to be confirmed in a larger scale design. The effects of a gluten-free diet in patients without elevated anti-gliadin antibodies would also be interesting to investigate. Furthermore, the effects of a gluten-free diet over a longer duration requires investigation.
However, the pressing problem with a gluten-free diet is its sustainability outside of hospital. Sticking to a gluten-free diet is difficult for most people and would be very difficult to sustain in people with schizophrenia. An alternative option is to identify treatments that target the negative physiological effects triggered by gluten. This could include eating more anti-inflammatory foods including herbs and spices (e.g., saffron and curcumin), treating the gut with probiotics and gut-healing herbs, and identifying natural agents to help module the immune response.
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