Scientific evidence on gluten in seniors is limited and mixed. Celiac disease can develop at any age, including in older adults, but is often underdiagnosed because symptoms like fatigue, anemia, or osteoporosis are attributed to aging. The prevalence of celiac disease in seniors is about 1–2%, similar to the general population. Non-celiac gluten sensitivity (NCGS) remains controversial; many seniors report symptom improvement on a gluten-free diet, but controlled trials often show no difference from placebo. Moreover, unnecessary gluten restriction in older adults can lead to nutrient deficiencies (fiber, B vitamins, iron). The evidence is mostly observational and mechanistic. For seniors without a confirmed diagnosis (celiac disease or wheat allergy), there is no strong scientific basis for a gluten-free diet. Medical evaluation with serology and, if indicated, duodenal biopsy should precede any dietary change.
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