scholarly journals Is a Gluten-Free Diet Enough to Maintain Correct Micronutrients Status in Young Patients with Celiac Disease?

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 844 ◽  
Author(s):  
Teresa Nestares ◽  
Rafael Martín-Masot ◽  
Ana Labella ◽  
Virginia A. Aparicio ◽  
Marta Flor-Alemany ◽  
...  

The current study assesses whether the use of a gluten-free diet (GFD) is sufficient for maintaining correct iron status in children with celiac disease (CD). The study included 101 children. The celiac group (n = 68) included children with CD, with long (> 6 months) (n = 47) or recent (< 6 months) (n = 21) adherence to a GFD. The control group (n = 43) included healthy children. Dietary assessment was performed by a food frequency questionnaire and a 3-day food record. Celiac children had lower iron intake than controls, especially at the beginning of GFD (p < 0.01). The group CD-GFD >6 months showed a higher intake of cobalamin, meat derivatives and fish compared to that of CD-GFD <6 months (all, p < 0.05). The control group showed a higher consumption of folate, iron, magnesium, selenium and meat derivatives than that of children CD-GFD >6 months (all, p < 0.05). Control children also showed a higher consumption of folate and iron compared to that of children CD-GFD <6 months (both, p < 0.05). The diet of celiac children was nutritionally less balanced than that of the control. Participation of dietitians is necessary in the management of CD to guide the GFD as well as assess the inclusion of iron supplementation and other micronutrients that may be deficient.

2006 ◽  
Vol 13 (01) ◽  
pp. 145-150
Author(s):  
HINA AYESHA ◽  
Muhammed Asghar Butt ◽  
MUHAMMED SHAMOON ◽  
Maqbool Ahmed ◽  
BUSHRA NAZIR ◽  
...  

Introduction: Celiac disease is an autoimmune inflammatory disorder ofsmall intestine precipitated by ingestion of gluten. Clinical and histological improvement occurs on withdrawal of glutenfrom the diet. Objectives: The present study were to identify the trace mineral deficiency in newly diagnosed celiacchildren and to assess how far these deficiencies are corrected after strict gluten free diet. The study also assessedthe nutritional status of celiac children compared to the healthy controls before and after Gluten Free Diet. Setting:Department of Pediatrics Punjab Medical College Faisalabad. Duration: January 2004 to March 2005. Study Design:Interventional case control study. Patients and Methods: 22 children aged 2 to 14 years diagnosed as Celiac diseaseon the basis of typical intestinal biopsy findings were included. 15 healthy children served as controls. Anthropometricmeasurements and serum Zinc Copper Magnesium and Iron along with albumin were done for both patients andcontrols initially and repeated after 6 months while patients were receiving strict GFD and controls receiving normaldiet. The general linear model was used for the analysis of variance using SPSS (2004). Results: Serum Zinc wasbelow the reference range in 68%. Serum copper and Magnesium in 31%, Iron in 95%and albumin in 59% of thepatients. There was a statistically significant increase in serum zinc, iron and magnesium levels (p value, < 0 05) whileserum copper and albumin did not show any significant rise after Gluten free diet. Control group did not show any significant change in their trace mineral levels .Celiac patients gained more weight (mean 4.47 versus 2.91 cm) andheight (3.34cm versus 1.022 cm) as compared to the control group. Conclusion: Celiac children receiving strict Glutenfree diet and showing good clinical response probably do not need mineral supplementation.


Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1817 ◽  
Author(s):  
Paweł Więch ◽  
Zdzisława Chmiel ◽  
Dariusz Bazaliński ◽  
Izabela Sałacińska ◽  
Anna Bartosiewicz ◽  
...  

The primary and proven therapy, in cases of celiac disease (CD), is a rigorous gluten-free diet (GFD). However, there are reports of its negative effects in the form of nutritional deficiencies, obesity, and adverse changes in body composition. The study aimed to assess the impact of a GFD on the body composition of children with CD. In a case-controlled study (n = 41; mean age 10.81 y; SD = 3.96) children with CD, in various stages of treatment, underwent medical assessment. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. More than half of the examined children (n = 26) followed a GFD. CD children had significantly higher mean values of the fat free mass (FFM% = 80.68 vs. 76.66, p = 0.015), and total body water (TBW% = 65.22 vs. 60.47, p = 0.012), and lower mean values of the fat mass (FM% = 19.32 vs. 23.34, p = 0.015). Children who were on a GFD presented slightly higher, but not statistically significant, mean values of FM and FFM, than children who did not follow dietary recommendations (FM [kg] = 7.48 vs. 5.24, p = 0.064; FM% = 20.81 vs. 16.73, p = 0.087; FFM [kg] = 28.19 vs. 22.62, p = 0.110). After minimum one year of a GFD, CD children showed significantly higher values of FFM [kg] (p = 0.001), muscle mass (MM) [kg] (p < 0.001), TBW [L] (p < 0.001) and body cell mass (BCM) [kg] (p < 0.001). Furthermore, CD children who were on a GFD presented a significantly higher increase in weight (p = 0.034) and body mass index (BMI) (p = 0.021). The children adhering to a GFD demonstrate a tendency towards higher indices of selected body composition components.


Author(s):  
Paweł Więch ◽  
Zdzisława Chmiel ◽  
Dariusz Bazaliński ◽  
Izabela Sałacińska ◽  
Anna Bartosiewicz ◽  
...  

The primary and proven therapy, in cases of celiac disease (CD), is a rigorous gluten-free diet. However, there are reports of its negative effects in the form of nutritional deficiencies, obesity and adverse changes in body composition. The aim of the study was to assess the impact of a gluten free diet (GFD) on the body composition of children with CD. In a case-controlled study (n = 41; mean age 10.81 y; SD = 3.96) children with CD, in various stages of treatment, underwent medical assessment. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. More than half of the examined children (n = 26) followed a GFD. CD children had significantly higher mean values of the fat free mass (FFM% = 80.68 vs. 76.66, p = 0.015), and total body water (TBW% = 65.22 vs. 60.47, p = 0.012), and lower mean values of the fat mass (FM% = 19.32 vs. 23.34, p = 0.015). Children who were on a GFD presented slightly higher, but not statistically significant, mean values of FM and FFM, than children who did not follow dietary recommendations (FM [kg] = 7.48 vs. 5.24, p = 0.064; FM% = 20.81 vs. 16.73, p = 0.087; FFM [kg] = 28.19 vs. 22.62, p = 0.110). After minimum one year of a GFD, CD children showed significantly higher values of FFM [kg] (p = 0.001), MM [kg] (p &lt; 0.001), TBW [L] (p &lt; 0.001) and BCM [kg] (p &lt; 0.001). Furthermore, CD children who were on a GFD presented significantly higher weight (p = 0.034) and body mass index (BMI) (p = 0.021) increase. The children adhering to a GFD demonstrate a tendency towards higher indices of selected body composition components.


2020 ◽  
Vol 17 (2) ◽  
pp. 59-63
Author(s):  
Biljana Stojanović-Jovanović ◽  
Stevan Jovanović ◽  
Biljana Vuletić

Objective. determine if there are symptoms of depression and thus the impairment of the emotional functioning of children with celiac disease in relation to healthy children of the same age Methods. The research was conducted as a prospective, observational study. The study group consisted of N 116 subjects (children and adolescents) aged 5-18 years who were diagnosed with celiac disease. The control group consisted of the same number of healthy children who met the basic criteria of "matching" with the examined group according to age and gender. To assess emotional functioning and detect symptoms of depression Mood and Feelings Questionnaire Short - MFQ -Child was used. Results. In the gruoup of children with celiac disease there is a statistically significant greater preference for depression (p <0.001). Conclusion. In children and adolescents with a diagnosis of celiac disease, it is necessary to keep in mind the psychological dimension of the disease. A gluten-free diet can create problems in the acceptance of a child by its peers. In children and adolescents with a diagnosis of celiac disease a state of psychological stress can also occur, mainly due to the discomfort caused by a different diet compared to their peers. Accepting the disease and successfully managing a gluten-free diet requires a team approach.


2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Allysson Costa ◽  
Gleisson A. P. Brito

This review compiled anthropometric data from 29 original articles, published between 1995 and 2015, corresponding to a total sample of 6368 celiac disease subjects. Body mass index was the main parameter for measuring anthropometry (82.1%), followed by body mass (78.6%), body fat (51.7%), bone mineral density and bone mineral content (46.4%), and fat-free mass (44.8%). The main evaluation method was dual x-ray absorptiometry (83.3%), followed by bioimpedance (16.6%), skinfold thickness (16.6%), and isotope dilution (5.5%). This compilation suggests that celiac disease patients without a gluten-free diet (WGFD) and celiac disease patients with a gluten-free diet (GFD) show a lower body mass than the control group, with inconclusive data about WGFD versus GFD. Body mass index is lower in WGFD and GFD compared to control group, and is lower in WGFD compared to GFD. We observed lower values of FM and FFM in WGFD and GFD versus the control group. No difference was found between WGFD versus GFD. BMD and BMC are lower in WGFD versus GFD and GFD versus the control group, with inconclusive data about WGFD versus GFD. The findings of this review suggest that celiac disease patients must be periodically evaluated through anthropometric parameters, since the pathology has the potential to modulate such values even in a gluten-free diet, with these variables reflecting their healthy status. In parallel, the screening of different anthropometric assessment methodologies can provide support for more accurate evaluations by scientists and clinical professionals who work with celiac disease patients.


2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 143-144
Author(s):  
R Chibbar ◽  
D Weiten ◽  
K H Green ◽  
L Rigaux ◽  
C N Bernstein ◽  
...  

Abstract Background Concerns exist regarding nutritional deficiencies and risk of metabolic syndrome in patients with celiac disease (CD) on a gluten-free diet (GFD). Aims This study assessed if patients with CD trying to follow a GFD meet Recommended Dietary Allowance (RDA) targets for macro- and micronutrients and the effect of supplement use in reaching RDA targets. Methods Adults (&gt;16 years) with biopsy confirmed CD (Marsh 3) were recruited within 6 weeks of starting a GFD. Participants prospectively completed a 3-day food record, including dietary supplement use, at 6, 12, and 24 months after study entry. Macro- and micronutrient consumption was determined using the Nutrition Coordinating Center Food & Nutrient Database (NCCDB), USDA National Nutrient Database for Standard Reference (USDA SR28), and CRON-O-Meter Community Database (CCDB). RDA targets were analyzed using a paired t-test and logistic regression, adjusted for age and sex. Results Forty-nine participants (71% female; mean age 49 years) completed interpretable food records at all time points. Most (59%) used supplements and supplement use was highest at 6 months (51%). Considering macronutrients, ≥88% met the RDA for carbohydrates and protein at each time point; however, only 44% met the target for fibre. Participants who took a supplement plus a multivitamin were significantly more likely than those who took only a multivitamin to meet the RDA for vitamins B12 and D. Fewer than 20% of those who took neither a multivitamin nor an iron supplement met the RDA, whereas ≥70% of those taking a multivitamin had adequate iron intake. Participants were significantly more likely to meet RDA targets for calcium with a supplement than with a multivitamin only. Even with supplementation, ≤55% met the RDA for folate. Conclusions There is a need for ongoing monitoring and dietician support for GFD treatment in CD. Adults with celiac disease met RDA targets for protein and carbohydrate, but not fibre. While specific calcium supplementation was required to meet RDA targets for calcium, a multivitamin was generally sufficient to meet RDA targets for iron, Vitamin B12 and D. Folate was below target at all time points even with supplementation. Funding Agencies CAG, CIHRNIH


2016 ◽  
Vol 23 (07) ◽  
pp. 807-811
Author(s):  
Nagina Shahzadi ◽  
Muhammad Almas Hashmi ◽  
Sadida Bahawal

Objectives: Probiotics are alive organisms which confer health benefit whentaken at an appropriate dosage. This study was done to determine the efficacy of probiotics indecreasing the frequency of diarrhea in children with celiac disease. Study Design: Randomizedcontrolled trial. Setting: Department of Pediatrics/DHQ Allied Hospital, Faisalabad. Period:November 2011 to October 2012. Methods: Newly diagnosed patients with CD having diarrheawere included by consecutive non-probability sampling. Patients were randomized in twogroups using computer generated numbers. One group was given probiotic along with glutenfree diet while other was only prescribed gluten free diet. Reduction in frequency of diarrhea intwo groups was compared after a period of 28 days. Results: A total of 116 cases (58 in eachgroup) were enrolled. Mean age was 9.11 years. The groups were similar in age and gender ofpatients. Comparison of efficacy of probiotics in children with CD was done with control groupwhich revealed reduction in stools frequency to less than half in 86.21% (n=50) in probioticgroup but only 62.07% (n=36) in control group. P-value was 0.00015 which shows a highlysignificant difference in both groups. Conclusion: Probiotics in addition to gluten free diet arehighly effective in reducing the frequency of diarrhea in newly diagnosed patients with CD, incomparison with gluten free diet alone.


2019 ◽  
Vol 51 ◽  
pp. e218
Author(s):  
L. Roncoroni ◽  
K. Bascuñán ◽  
N. Pellegrini ◽  
A. Scricciolo ◽  
V. Lombardo ◽  
...  

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Grażyna Rowicka ◽  
Grażyna Czaja-Bulsa ◽  
Magdalena Chełchowska ◽  
Agnieszka Riahi ◽  
Małgorzata Strucińska ◽  
...  

Aims. Oxidative stress is a factor involved in the pathogenesis of celiac disease (CD), possibly affecting the course of the disease and celiac-related complications. We assessed the intensity of oxidative processes and the efficiency of antioxidant defense in children with celiac disease. Methods. Group I (n=32) consisted of children with CD treated with a gluten-free diet, and group II (n=24) consisted of healthy children on a traditional diet. Antioxidative and oxidative status was assessed by measurement of serum total antioxidant capacity (TAC), total oxidant capacity (TOC), and oxidized low-density lipoprotein (ox-LDL) and on the basis of oxidative stress index (OSI).Results. There were no significant differences in serum TAC, TOC, ox-LDL, and OSI between children with CD and healthy children. Cluster analysis showed that the group of children with CD is not homogeneous in terms of serum TAC and TOC levels. About 50% of these children had TAC levels < 1.3 mmol/L and TOC levels > 0.35 mmol/L.Conclusions. Strict adherence to a gluten-free diet by children with CD seems to be important for maintaining oxidative-antioxidant balance. However, further research is needed to identify factors potentially responsible for increased oxidative stress in some children with celiac disease despite adherence to a gluten-free diet.


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1859
Author(s):  
Katarzyna Gładyś ◽  
Jolanta Dardzińska ◽  
Marek Guzek ◽  
Krystian Adrych ◽  
Zdzisław Kochan ◽  
...  

Access to a registered dietitian experienced in celiac disease (CD) is still limited, and consultation when available focuses primarily on the elimination of gluten from the diet. Thus, the aim of this study was to evaluate the nutritional value of a gluten-free diet (GFD) in adult CD patients before, and one year after, the standard dietary education. The study included 72 CD patients on a GFD and 30 healthy controls. The dietary intake of both groups was assessed through a 3-day food diary, while adherence to a GFD in celiac subjects was assessed using Standardized Dietician Evaluation (SDE). Subsequently, all CD patients received detailed education on gluten sources, and 48 of them participated in a one-year follow-up. Results: Comparison with the control group showed that consumption of plant protein in CD patients was significantly lower, whereas fat and calories were higher. At baseline, only 62% of CD patients adhered to a GFD, but the standard dietary education successfully improved it. However, the nutritional value of a GFD after one year did not change, except for a reduced sodium intake. The CD subjects still did not consume enough calcium, iron, vitamin D, folic acid or fiber. In conclusion, while the standard dietary education improved GFD adherence, it did not significantly alter its nutritional value. Therefore, it is necessary to increase the role of a dietitian in the treatment of CD.


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