Table 2:

50 years of real world clinical experience with a gluten-free diet

“It was the best of times, It was the worst of times” *Charles Dickens
Millions have been helped	Gluten elimination not achievable for many/most patients
Safe	Adverse effects common – weight gain, nutritional deficiencies (unfortified grains), social effects/isolation/implications
Efficacious	Limited effectiveness – especially on an “intent to treat” basis
Non-pharmacologic	A GFD is more costly and the cost is borne by the patient in most countries
Self-administered	Minimal medical support and high treatment burden
The “only” treatment for celiac disease	Research and development stifled – NO approved treatments