Opinion Review
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 28, 2019; 25(24): 2973-2976
Published online Jun 28, 2019. doi: 10.3748/wjg.v25.i24.2973
Dietary Lectin exclusion: The next big food trend?
Kirpal Panacer, Peter J Whorwell
Kirpal Panacer, University of Manchester Medical Student, Stopford Building, University of Manchester, Manchester M13 9PG, United Kingdom
Peter J Whorwell, Neurogastroenterology Unit, Wythenshawe Hospital, Manchester M23 9LT, United Kingdom
Author contributions: Whorwell PJ conceived the idea; and Panacer K and Whorwell PJ searched the literature; Panacer K wrote an initial draft of the paper which was then edited by Whorwell PJ until both authors approved the final draft.
Conflict-of-interest statement: KP has no conflicts of interest. Over the last 3 years PJW has acted as a consultant to or received research funding from Danone, Allergan Pharma, Ironwood Pharma and Salix Pharma but it is not felt that the contents of this viewpoint have been influenced at all by any of these relationships.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Peter J Whorwell, BSc, FRCP (Hon), MBBS, MD, PhD, Full Professor, Neurogastroenterology Unit, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, United Kingdom. peter.whorwell@mft.nhs.uk
Telephone: +44-1612914177 Fax: +44-1612912611
Received: January 16, 2019
Peer-review started: January 16, 2019
First decision: March 27, 2019
Revised: April 15, 2019
Accepted: April 29, 2019
Article in press: April 29, 2019
Published online: June 28, 2019
Processing time: 163 Days and 15.9 Hours
Abstract

Until recently, with the exception of coeliac disease, gastroenterologists have not been particularly interested in the role of diet in the management of gastrointestinal disorders. However, patients have always felt that diet must play a part in their symptoms and, in the absence of any medical interest, have turned to alternative dietary practitioners for help, which can often have no evidence base. Fortunately, with the advent of the FODMAP diet (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) and the realisation that diet can have a profound effect on the microbiome, medical opinion is now changing. Nevertheless, research on the various diets that are now available is often completely lacking. Lectins are carbohydrate binding proteins which are widely distributed in nature and are found in a whole variety of commonly consumed foods. It seems likely that the exclusion of lectins from the diet could become the next “food fashion” for alternative practitioners to promote, especially as there is some evidence to suggest that certain lectins may be harmful to health. It is, therefore, the purpose of this viewpoint to try and stimulate research on the dietary effects of lectins, which is currently minimal, so that we can pre-empt a situation where we are unable to give patients or the public evidence based advice on this topic.

Keywords: Dietary lectins; Exclusion diets; Gastrointestinal system; Harm; Carbohydrate

Core tip: Patients with gastrointestinal problems, as well as the general public, are being offered an increasing number of different diets which claim to improve their health, often without any evidence to support a beneficial effect. Lectins are carbohydrate binding proteins which are found in many foods and some of them, such as those found in red kidney beans, can cause gastrointestinal symptoms if not cooked properly. Consequently, it is possible that a lectin exclusion diet could become fashionable in the future and research is needed to find out under what circumstances, if any, such a diet may be advisable.