Reviewer’s report
Title: 
Non-Celiac Wheat Sensitivity: Rationality and Irrationality of a Gluten-
Free Diet in Individuals affected with Non-Celiac Disease
Version: 
0 
Date: 
19 Apr 2020
Reviewer: 
Giulia Catassi
Reviewer's report:
In this paper authors review available literature about non celiac gluten
sensitivity (NCGS), particularly related to the histological aspects of gluten-
related disorders.
Overall the paper could be interesting but should be more properly focused and
organized, in my view. The study methodology is not clearly described in a
structured "Methods and results" section (how many papers were initially
considered? How many of them were selected for consideration? etc) but is only
summarized in the abstract. The "core" section mostly describes the histological
features of NCGS but does not include other aspects that could be relevant to the
purpose of this review, given the broad spectrum included in the title (Non-
Celiac Wheat sensitivity: Rationality and Irrationality of a Gluten-Free Diet in
Individuals affected with Non-Celiac Disease - by the way: the terminology
"affected with Non-Celiac Disease" makes no sense). Several statements appear
arbitrary or inappropriate, for instance:
Line 67 and following: These are classifications of the histological damage
associated with CD instead than classification of CD; furthermore I don't see the
need of discussing the different histological classifications of CD in detail given
that this review should focus on NCGS;
Line 106: "the journey started": what does this mean?
Lines 117-119: this has nothing to do with the scientific background of NCGS
Lines 130-131: this statement may be acceptable in a newspaper article but not
in a scientific paper;
Lines 134-136: "Although some may consider NCGS/NCWS as a mild form of
celiac disease, the 
experience of the authors has revealed that patients with
NCGS/NCWS may also evidence very aggressive disease patterns". 
I don't think
anybody consider NCGS as a mild form of celiac disease. Personal experiences
should only find place by quotation in the reference section;
Line 151: the term "Latent celiac disease" has been removed from the
international classifications of celiac disease;
Line 175: 
"We found that the influence of community belief and culture plays a
role that was unknown in the 20th century or before" is an unproven statement;
Line 195: Ref #28 describes a peculiar type of allergic reaction to gluten instead
than a true NCGS;
Line 214-215: "Of course, there are clear-cut cases of celiac disease, but few
cases of IELs may easily cross the borders of the categories" What does this
mean?
Line 358-360: This statement is totally unproven, i.e. a properly done GFD is
nutritionally balanced and safe;
Line 381 and following: I do not understand the link between the concept of a
Mediterranean diet and the GFD;
Lines 397-399: "At first glance, the South Asian diet may be healthier because of
the lack of bloating complains that often South Asian may experience" what does
this mean?
Quality of written English
Please indicate the quality of language in the manuscript:
Not suitable for publication unless extensively edited
Declaration of competing interests
Please complete a declaration of competing interests, considering the following
questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests
I agree to the open peer review policy of the journal. I understand that my name
will be included on my report to the authors and, if the manuscript is accepted
for publication, my named report including any attachments I upload will be
posted on the website along with the authors' responses. I agree for my report to
be made available under an Open Access Creative Commons CC-BY license
(
http://creativecommons.org/licenses/by/4.0/
). I understand that any comments
which I do not wish to be included in my named report can be included as
confidential comments to the editors, which will not be published.
I agree to the open peer review policy of the journal
Reviewer’s report
Title: 
Non-Celiac Wheat Sensitivity: Rationality and Irrationality of a Gluten-
Free Diet in Individuals affected with Non-Celiac Disease
Version: 
0 
Date: 
19 Apr 2020
Reviewer: 
Giulia Catassi
Reviewer's report:
In this paper authors review available literature about non celiac gluten
sensitivity (NCGS), particularly related to the histological aspects of gluten-
related disorders.
Overall the paper could be interesting but should be more properly focused and
organized, in my view. The study methodology is not clearly described in a
structured "Methods and results" section (how many papers were initially
considered? How many of them were selected for consideration? etc) but is only
summarized in the abstract. The "core" section mostly describes the histological
features of NCGS but does not include other aspects that could be relevant to the
purpose of this review, given the broad spectrum included in the title (Non-
Celiac Wheat sensitivity: Rationality and Irrationality of a Gluten-Free Diet in
Individuals affected with Non-Celiac Disease - by the way: the terminology
"affected with Non-Celiac Disease" makes no sense). Several statements appear
arbitrary or inappropriate, for instance:
Line 67 and following: These are classifications of the histological damage
associated with CD instead than classification of CD; furthermore I don't see the
need of discussing the different histological classifications of CD in detail given
that this review should focus on NCGS;
Line 106: "the journey started": what does this mean?
Lines 117-119: this has nothing to do with the scientific background of NCGS
Lines 130-131: this statement may be acceptable in a newspaper article but not
in a scientific paper;
Lines 134-136: "Although some may consider NCGS/NCWS as a mild form of
celiac disease, the 
experience of the authors has revealed that patients with
NCGS/NCWS may also evidence very aggressive disease patterns". 
I don't think
anybody consider NCGS as a mild form of celiac disease. Personal experiences
should only find place by quotation in the reference section;
Line 151: the term "Latent celiac disease" has been removed from the
international classifications of celiac disease;
Line 175: 
"We found that the influence of community belief and culture plays a
role that was unknown in the 20th century or before" is an unproven statement;
Line 195: Ref #28 describes a peculiar type of allergic reaction to gluten instead
than a true NCGS;
Line 214-215: "Of course, there are clear-cut cases of celiac disease, but few
cases of IELs may easily cross the borders of the categories" What does this
mean?
Line 358-360: This statement is totally unproven, i.e. a properly done GFD is
nutritionally balanced and safe;
Line 381 and following: I do not understand the link between the concept of a
Mediterranean diet and the GFD;
Lines 397-399: "At first glance, the South Asian diet may be healthier because of
the lack of bloating complains that often South Asian may experience" what does
this mean?
Quality of written English
Please indicate the quality of language in the manuscript:
Not suitable for publication unless extensively edited
Declaration of competing interests
Please complete a declaration of competing interests, considering the following
questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests
I agree to the open peer review policy of the journal. I understand that my name
will be included on my report to the authors and, if the manuscript is accepted
for publication, my named report including any attachments I upload will be
posted on the website along with the authors' responses. I agree for my report to
be made available under an Open Access Creative Commons CC-BY license
(
http://creativecommons.org/licenses/by/4.0/
). I understand that any comments
which I do not wish to be included in my named report can be included as
confidential comments to the editors, which will not be published.
I agree to the open peer review policy of the journal
Please review this paper.
user
Reviewer’s report
Title: 
Non-Celiac Wheat Sensitivity: Rationality and Irrationality of a Gluten-
Free Diet in Individuals affected with Non-Celiac Disease
Version: 
0 
Date: 
19 Apr 2020
Reviewer: 
Giulia Catassi
Reviewer's report:
In this paper authors review available literature about non celiac gluten
sensitivity (NCGS), particularly related to the histological aspects of gluten-
related disorders.
Overall the paper could be interesting but should be more properly focused and
organized, in my view. The study methodology is not clearly described in a
structured "Methods and results" section (how many papers were initially
considered? How many of them were selected for consideration? etc) but is only
summarized in the abstract. The "core" section mostly describes the histological
features of NCGS but does not include other aspects that could be relevant to the
purpose of this review, given the broad spectrum included in the title (Non-
Celiac Wheat sensitivity: Rationality and Irrationality of a Gluten-Free Diet in
Individuals affected with Non-Celiac Disease - by the way: the terminology
"affected with Non-Celiac Disease" makes no sense). Several statements appear
arbitrary or inappropriate, for instance:
Line 67 and following: These are classifications of the histological damage
associated with CD instead than classification of CD; furthermore I don't see the
need of discussing the different histological classifications of CD in detail given
that this review should focus on NCGS;
Line 106: "the journey started": what does this mean?
Lines 117-119: this has nothing to do with the scientific background of NCGS
Lines 130-131: this statement may be acceptable in a newspaper article but not
in a scientific paper;
Lines 134-136: "Although some may consider NCGS/NCWS as a mild form of
celiac disease, the 
experience of the authors has revealed that patients with
NCGS/NCWS may also evidence very aggressive disease patterns". 
I don't think
anybody consider NCGS as a mild form of celiac disease. Personal experiences
should only find place by quotation in the reference section;
Line 151: the term "Latent celiac disease" has been removed from the
international classifications of celiac disease;
Line 175: 
"We found that the influence of community belief and culture plays a
role that was unknown in the 20th century or before" is an unproven statement;
Line 195: Ref #28 describes a peculiar type of allergic reaction to gluten instead
than a true NCGS;
Line 214-215: "Of course, there are clear-cut cases of celiac disease, but few
cases of IELs may easily cross the borders of the categories" What does this
mean?
Line 358-360: This statement is totally unproven, i.e. a properly done GFD is
nutritionally balanced and safe;
Line 381 and following: I do not understand the link between the concept of a
Mediterranean diet and the GFD;
Lines 397-399: "At first glance, the South Asian diet may be healthier because of
the lack of bloating complains that often South Asian may experience" what does
this mean?
Quality of written English
Please indicate the quality of language in the manuscript:
Not suitable for publication unless extensively edited
Declaration of competing interests
Please complete a declaration of competing interests, considering the following
questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests
I agree to the open peer review policy of the journal. I understand that my name
will be included on my report to the authors and, if the manuscript is accepted
for publication, my named report including any attachments I upload will be
posted on the website along with the authors' responses. I agree for my report to
be made available under an Open Access Creative Commons CC-BY license
(
http://creativecommons.org/licenses/by/4.0/
). I understand that any comments
which I do not wish to be included in my named report can be included as
confidential comments to the editors, which will not be published.
I agree to the open peer review policy of the journal
assistant