scholarly journals The Gluten-Free Diet for Celiac Disease and Beyond

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3993
Author(s):  
Bara Aljada ◽  
Ahmed Zohni ◽  
Wael El-Matary
Keyword(s):  
Celiac Disease ◽  
Dermatitis Herpetiformis ◽  
Cognitive Disorders ◽  
Gluten Free Diet ◽  
Nutritional Deficiencies ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Immune Mediated ◽  
The Brain

The gluten-free diet (GFD) has gained popularity beyond its main medical indication as the treatment for gluten-induced immune-mediated disorders such as celiac disease (CD), dermatitis herpetiformis, gluten ataxia, wheat allergy, and non-celiac gluten sensitivity. However, the diet carries some disadvantages such as elevated costs, nutritional deficiencies, and social and psychological barriers. The present work aims to review indications, proven benefits, and adverse events of a gluten-free diet. Close follow-up with patients following the diet is recommended. More data is needed to assess the effectiveness of the diet in managing mental and cognitive disorders and to establish a connection between the brain and gluten.

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

2015 ◽  
Vol 33 (2) ◽  
pp. 175-182 ◽  
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.

scholarly journals Novel Therapeutic/Integrative Approaches for Celiac Disease and Dermatitis Herpetiformis

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Alessio Fasano
Keyword(s):  
Celiac Disease ◽  
Molecular Basis ◽  
Dermatitis Herpetiformis ◽  
Protein Component ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
New Concepts ◽  
Immune Mediated ◽  
New Treatments ◽  
Novel Therapeutic

Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically susceptible individuals. Gluten is a protein component in wheat and other cereals like rye and barley. At present, the only available treatment is a strict gluten-free diet. Recent advances have increased our understanding of the molecular basis for this disorder. Last decade has seen new scientific developments in this disease and led to the formulation of new concepts of pathophysiology that offer possible targets for new treatments or interventions integrative to the gluten-free diet.

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

Nutrients ◽  
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.

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

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1777 ◽  
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.

scholarly journals The Relationship of Perceived Health Benefits and Information Sources to Following a Gluten-Free Diet Among People Without Celiac Disease or Non-Celiac Gluten Sensitivity

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 704-704
Author(s):  
Kristina Arslain ◽  
Pratiksha Baishya ◽  
Christopher Gustafson ◽  
Devin Rose
Keyword(s):  
Celiac Disease ◽  
Information Sources ◽  
Agricultural Research ◽  
Health Benefits ◽  
Perceived Health ◽  
Gluten Free Diet ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Relationship Of ◽  
The Relationship

Abstract Objectives The gluten-free diet (GFD) has been adopted by many people who do not have Celiac disease or non-Celiac gluten sensitivity, but no studies examine the relationship of perceived health benefits of, and the sources that recommend trying, the GFD to the decision to follow the diet. Methods We surveyed a large, nationally representative sample of 3051 US residents about their attitudes, perceptions, and experiences with the GFD. Logistic regression was used to compare respondents who had no diagnosed need for a GFD but were currently avoiding or had avoided gluten previously (GF-Consumer) to the consumers that had never tried a GFD. Results Over one-fifth of our respondents were GF-Consumers. Beliefs that “a gluten-reduced diet is healthier for people than a full-gluten containing diet” (OR 1.55; P < 0.01), that “gluten-free products are generally more nutritious than their gluten-containing variant” (OR 1.53; P < 0.01) and that a GFD can help clear acne (OR 1.44; P < 0.01) were all positively associated with trying a GFD. The most influential source that suggested the diet was oneself who learned about a GFD through personal research (OR 3.35; P < 0.01). This was followed by “family member or friend” (OR 2.68; P < 0.01) and “healthcare center or health professional (doctor, dietitian, etc.)” (OR 2.10; P < 0.01). Conclusions Positive, but scientifically unsubstantiated, beliefs about the benefits of the GFD were strongly associated with trying a GF diet. Both conventional and unconventional sources of information about the GFD were positively associated with following the diet. These findings about beliefs and information sources highlight potential barriers to the promotion of scientifically based nutritional recommendations to consumers. Funding Sources University of Nebraska Agricultural Research Division Innovation Fund for Wheat/Cereal Crops.

scholarly journals Nutritional Deficiencies in Children with Celiac Disease Resulting from a Gluten-Free Diet: A Systematic Review

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1588 ◽  
Author(s):  
Giovanni Di Nardo ◽  
Maria Pia Villa ◽  
Laura Conti ◽  
Giusy Ranucci ◽  
Claudia Pacchiarotti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Celiac Disease ◽  
Gluten Free Diet ◽  
Nutritional Deficiencies ◽  
Gluten Free ◽  
Clinical Consequences ◽  
Macro And Micronutrients ◽  
High Glycemic Index ◽  
Therapeutic Protocols ◽  
Not At Risk

Background: A strictly gluten-free diet (GFD) is the basis for managing celiac disease (CD). Numerous studies have reported nutritional deficiencies/imbalances ascribable to a GFD. The aim of this review is to describe nutritional deficiencies observed in children with celiac disease on a GFD, to discuss the clinical consequences related to these nutritional imbalances, and to identify strategies that may be adopted to treat them. Methods: We reviewed the MEDLINE and EMBASE databases between January 1998 and January 2019. Results: Children are, regardless of whether they are on a gluten-free diet or not, at risk of consuming too much fat and insufficient fiber, iron, vitamin D, and calcium. These imbalances may be exacerbated when children are on a gluten-free diet. In particular, the intake of folate, magnesium, zinc, and foods with a high glycemic index in children with CD who are on a GFD is significantly altered. Conclusions: Therapeutic protocols should include nutritional education to help teach subjects affected by disorders such as CD the importance of labels, the choice of foods, and the combination of macro- and micronutrients. Children with CD on a GFD should be encouraged to rotate pseudo-cereals, consume gluten-free commercial products that have been fortified or enriched, and use foods that are local and naturally gluten-free.

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

2000 ◽  
Vol 136 (6) ◽  
pp. 0841-0843 ◽  
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

scholarly journals Metabolic effects in patients with celiac disease, patients with nonceliac gluten sensitivity, and asymptomatic controls, after six months of a gluten-free diet

2020 ◽  
Vol 85 (2) ◽  
pp. 109-117 ◽  
Author(s):  
J.M. Remes-Troche ◽  
O. De J. Cobos-Quevedo ◽  
X. Rivera-Gutiérrez ◽  
G. Hernández ◽  
E. de la Cruz-Patiño ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Gluten Free Diet ◽  
Metabolic Effects ◽  
Gluten Sensitivity ◽  
Gluten Free

scholarly journals A23 NUTRITIONAL DEFICIENCIES ARE FREQUENT IN CELIAC PATIENTS ON A GLUTEN-FREE DIET, REGARDLESS OF THE DURATION AND COMPLIANCE OF THE DIET

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 27-28
Author(s):  
A Jivraj ◽  
V Connan ◽  
T Balart ◽  
E Ching ◽  
A Marwaha ◽  
...  
Keyword(s):  
Tissue Transglutaminase ◽  
Gluten Free Diet ◽  
Nutritional Deficiencies ◽  
Gluten Free ◽  
Dietary Compliance ◽  
Persistent Symptoms ◽  
Funding Agencies ◽  
Adherence Test

Abstract Background The only available treatment for celiac disease (CD) is adherence to a strict gluten-free diet (GFD). CD is associated with several nutritional deficiencies, which could be explained by malabsorption when the disease is active. However, the magnitude of nutritional deficiencies in treated CD and how this is influenced by the duration and compliance of GFD is less clear. Aims We aim to evaluate the presence of nutritional deficiencies in celiac patients on short term (≤2yrs) vs long-term (>2yrs) GFD, and in those with persistent symptoms or asymptomatic in the follow up. Methods We included consecutive biopsy-proven CD patients attending the McMaster Adult Celiac Clinic. GFD adherence was assessed by validated Celiac Dietary Adherence Test (CDAT) and by anti-tissue transglutaminase antibody IgA(tTG IgA) levels. Serology, vitamins and minerals were measured in blood samples collected at enrolment. Continuous data was expressed as Median (IQR) and categorical data as proportion%. Mann-U-Whitney and Chi2 were used to compare difference between groups. Results We enrolled 171 CD patients (80% female; Median age 43 years). 76/171 (44%) of CD patients were following a GFD for over 2 years. Eighty-two percent of the patients (141/171) had persistent symptoms in the follow up and 80.7% had normal tTG IgA levels. The most common nutritional abnormalities were deficiencies in zinc (56%), iron (23%), copper (20%). Chromium was increased in 74% of patients. There were no differences in nutritional deficiencies between group of patients with short and long-term duration of GFD, nor between those strictly compliant with GFD compared to those fairly compliant (p>0.05). Conclusions Nutritional deficiencies are frequent in celiac patients on a GFD regardless of the presence of symptoms, dietary compliance or duration. The previous suggest that nutrients deficiencies may be more related to GFD nutritional inadequacy rather than malabsorption. Funding Agencies None

scholarly journals A266 IS A MULTIVITAMIN SUFFICIENT TO MEET NUTRITIOAL REQUIREMENTS IN CANADIAN ADULTS FOLLOWING A GLUTEN-FREE DIET?

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 143-144
Author(s):  
R Chibbar ◽  
D Weiten ◽  
K H Green ◽  
L Rigaux ◽  
C N Bernstein ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Calcium Supplementation ◽  
Gluten Free Diet ◽  
Nutritional Deficiencies ◽  
Gluten Free ◽  
Food Record ◽  
Time Points ◽  
Supplement Use ◽  
Funding Agencies ◽  
Dietary Supplement Use

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 (>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

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