Clinical Benefit of a Gluten-Free Diet in Type 1 Diabetic Children With Screening-Detected Celiac Disease: A population-based screening study with 2 years' follow-up

ABSTRACT Background The number of gluten-free diet followers without celiac disease (CD) is increasing. However, little is known about the characteristics of these individuals. Objectives We address this issue by investigating a wide range of genetic and phenotypic characteristics in association with following a gluten-free diet. Methods The cross-sectional association between lifestyle and health-related characteristics and following a gluten-free diet was investigated in 124,447 women and men aged 40–69 y from the population-based UK Biobank study. A genome-wide association study (GWAS) of following a gluten-free diet was performed. Results A total of 1776 (1.4%) participants reported following a gluten-free diet. Gluten-free diet followers were more likely to be women, nonwhite, highly educated, living in more socioeconomically deprived areas, former smokers, have lost weight in the past year, have poorer self-reported health, and have made dietary changes as a result of illness. Conversely, these individuals were less likely to consume alcohol daily, be overweight or obese, have hypertension, or use cholesterol-lowering medication. Participants with hospital inpatient diagnosed blood and immune mechanism disorders (OR: 1.62; 95% CI: 1.18, 2.21) and non-CD digestive system diseases (OR: 1.58; 95% CI: 1.42, 1.77) were more likely to follow a gluten-free diet. The GWAS demonstrated that no genetic variants were associated with being a gluten-free diet follower. Conclusions Gluten-free diet followers have a better cardiovascular risk profile than non-gluten-free diet followers but poorer self-reported health and a higher prevalence of blood and immune disorders and digestive conditions. Reasons for following a gluten-free diet warrant further investigation.

Download Full-text

Rationale for Timing of Follow-Up Visits to Assess Gluten-Free Diet in Celiac Disease Patients Based on Data Mining

Nutrients ◽

10.3390/nu13020357 ◽

2021 ◽

Vol 13 (2) ◽

pp. 357

Author(s):

Alfonso Rodríguez-Herrera ◽

Joaquín Reyes-Andrade ◽

Cristina Rubio-Escudero

Keyword(s):

Data Mining ◽

Celiac Disease ◽

Cultural Context ◽

Gluten Free Diet ◽

Gluten Free ◽

Adherence To Diet ◽

And Gender ◽

Few Data

The assessment of compliance of gluten-free diet (GFD) is a keystone in the supervision of celiac disease (CD) patients. Few data are available documenting evidence-based follow-up frequency for CD patients. In this work we aim at creating a criterion for timing of clinical follow-up for CD patients using data mining. We have applied data mining to a dataset with 188 CD patients on GFD (75% of them are children below 14 years old), evaluating the presence of gluten immunogenic peptides (GIP) in stools as an adherence to diet marker. The variables considered are gender, age, years following GFD and adherence to the GFD by fecal GIP. The results identify patients on GFD for more than two years (41.5% of the patients) as more prone to poor compliance and so needing more frequent follow-up than patients with less than 2 years on GFD. This is against the usual clinical practice of following less patients on long term GFD, as they are supposed to perform better. Our results support different timing follow-up frequency taking into consideration the number of years on GFD, age and gender. Patients on long term GFD should have a more frequent monitoring as they show a higher level of gluten exposure. A gender perspective should also be considered as non-compliance is partially linked to gender in our results: Males tend to get more gluten exposure, at least in the cultural context where our study was carried out. Children tend to perform better than teenagers or adults.

Download Full-text

Descriptive Study of the Different Tools Used to Evaluate the Adherence to a Gluten-Free Diet in Celiac Disease Patients

Nutrients ◽

10.3390/nu10111777 ◽

2018 ◽

Vol 10 (11) ◽

pp. 1777 ◽

Cited By ~ 5

Author(s):

Luis Rodrigo ◽

Isabel Pérez-Martinez ◽

Eugenia Lauret-Braña ◽

Adolfo Suárez-González

Keyword(s):

Celiac Disease ◽

Multidisciplinary Approach ◽

Descriptive Study ◽

Duodenal Mucosa ◽

Gluten Free Diet ◽

Gluten Free ◽

Autoimmune Process ◽

Duodenal Biopsies

Celiac disease (CD) is a genetically conditioned autoimmune process that appears in susceptible people. It can affect people of any age, and slightly predominates in females. It has a fairly homogenous global distribution, with an average prevalence of 1–2%, the frequency having increased in recent decades. The only effective treatment is a strict and permanent gluten-free diet (GFD), although the level of compliance is poor, at about 50% of cases. To monitor the effectiveness of the GFD, several procedures involving various approaches are employed: (a) Periodic visits by expert Nutritionists; (b) Clinical follow-up; (c) Serological time controls of specific antibodies; (d) Serial endoscopies with collection of duodenal biopsies; (e) Use of structured questionnaires; and (f) Determination of gluten peptides derived from gluten in faeces and/or urine. All of these procedures are useful when applied, alone or in combination, depending on the cases. Some patients will only need to consult to their doctors, while others will require a multidisciplinary approach to assess their compliance with the GFD. In children, normalization of duodenal mucosa was achieved in 95% of cases within two years, while it is more delayed in adults, whose mucosa take longer time (3–5 years) to heal completely.

Download Full-text

Compliance with gluten-free diet in adolescents with screening-detected celiac disease: A 5-year follow-up study

The Journal of Pediatrics ◽

10.1067/mpd.2000.105351 ◽

2000 ◽

Vol 136 (6) ◽

pp. 0841-0843 ◽

Cited By ~ 32

Author(s):

Elisabetta Fabiani ◽

Luciana Maria Taccari ◽

Ilse-Maria R[auml ]tsch ◽

Silvia Di Giuseppe ◽

Giovanni Valentino Coppa ◽

...

Keyword(s):

Celiac Disease ◽

Gluten Free Diet ◽

Gluten Free ◽

Follow Up Study

Download Full-text

The influence of gluten free diet on quantitative ultrasound of proximal phalanxes in children and adolescents with type 1 diabetes mellitus and celiac disease

Bone ◽

10.1016/j.bone.2008.04.004 ◽

2008 ◽

Vol 43 (2) ◽

pp. 322-326 ◽

Cited By ~ 11

Author(s):

Giuliana Valerio ◽

Raffaella Spadaro ◽

Dario Iafusco ◽

Francesca Lombardi ◽

Antonio del Puente ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Celiac Disease ◽

Type 1 Diabetes Mellitus ◽

Children And Adolescents ◽

Quantitative Ultrasound ◽

Gluten Free Diet ◽

Gluten Free

Download Full-text

Effect of Gluten-Free Diet on Growth and Glycemic Control in Children with Type 1 Diabetes and Asymptomatic Celiac Disease

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem.2010.183 ◽

2010 ◽

Vol 23 (11) ◽

Cited By ~ 2

Author(s):

Vi Lier Goh ◽

D. Elizabeth Estrada ◽

Trudy Lerer ◽

Fabiola Balarezo ◽

Francisco A. Sylvester

Keyword(s):

Type 1 Diabetes ◽

Celiac Disease ◽

Glycemic Control ◽

Gluten Free Diet ◽

Gluten Free

Download Full-text

Design of a dietary intervention to assess the impact of a gluten-free diet in a population with type 1 Diabetes and Celiac Disease

BMC Gastroenterology ◽

10.1186/s12876-015-0413-0 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 7

Author(s):

Esther Assor ◽

Margaret A. Marcon ◽

Natasha Hamilton ◽

Marilyn Fry ◽

Tammy Cooper ◽

...

Keyword(s):

Type 1 Diabetes ◽

Celiac Disease ◽

Dietary Intervention ◽

Gluten Free Diet ◽

Gluten Free ◽

The Impact

Download Full-text

Celiac Disease and the Gluten-Free Diet: Consequences and Recommendations for Improvement

Digestive Diseases ◽

10.1159/000369504 ◽

2015 ◽

Vol 33 (2) ◽

pp. 175-182 ◽

Cited By ~ 52

Author(s):

Thimmaiah G. Theethira ◽

Melinda Dennis

Keyword(s):

Celiac Disease ◽

Critical Role ◽

Nutrition Therapy ◽

Gluten Free Diet ◽

Nutritional Deficiencies ◽

Gluten Free ◽

Immune Mediated ◽

Macro And Micronutrients ◽

Medical Nutrition

Background: Celiac disease (CD) is a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically susceptible individuals. CD-related enteropathy leads to multiple nutritional deficiencies involving macro- and micronutrients. Currently, medical nutrition therapy consisting of the gluten-free diet (GFD) is the only accepted treatment for CD. Key Messages: The GFD is the cornerstone of treatment for CD. Prior published studies have concluded that maintenance of the GFD results in improvement of the majority of nutritional deficiencies. In the past, counseling for CD focused mainly on the elimination of gluten in the diet. However, the GFD is not without its inadequacies; compliance to the GFD may result in certain deficiencies such as fiber, B vitamins, iron, and trace minerals. Paucity of fortified gluten-free foods may be responsible for certain deficiencies which develop on the GFD. Weight gain and obesity have been added to the list of nutritional consequences while on the GFD and have been partially attributed to hypercaloric content of commercially available gluten-free foods. Follow-up of patients diagnosed with CD after starting the GFD has been reported to be irregular and, hence, less than ideal. Conclusions: Monitoring of the nutritional status using blood tests and use of appropriate gluten-free supplementation are integral components in the management of CD. The ideal GFD should be nutrient-dense with naturally gluten-free foods, balanced with macro- and micronutrients, reasonably priced, and easily accessible. Rotation of the pseudo-cereals provides a good source of complex carbohydrates, protein, fiber, fatty acids, vitamins and minerals. Fortification/enrichment of commonly consumed gluten-free commercial grain products should be encouraged. Dietitians specializing in CD play a critical role in the education and maintenance of the GFD for patients with CD.

Download Full-text