Clinical Nutrition

A comparison of the nutritional status between adult celiac patients on a long-term, strictly gluten-free diet and healthy subjects

Abstract

Background/Objectives:

There are conflicting data on the effect of a gluten-free diet (GFD) on the nutritional status of celiac patients. In the present study, we evaluated, in adult celiac patients, the influence of a long-term, strictly GFD on their nutritional status and compared it with matched healthy volunteers.

Subjects/Methods:

Our study included 39 celiac patients and 39 healthy volunteers. The body mass index (BMI) of patients and controls was evaluated at enrollment, while the patients’ BMI before the GFD was retrieved from clinical records. In addition, at enrollment, in both groups, we compared BMI, fat mass (FM), bone mineral density (BMD), as well as their dietary intake, recorded on a 7-day diary.

Results:

At the time of diagnosis, the majority of celiac patients (82.0%) had a normal BMI or were overweight, while 10.3% were malnourished. After the GFD, patients with a normal BMI showed a significant weight increase (P=0.002), but none of them switched in the overweight or obese category. Two (50%) of the four malnourished patients achieved a normal BMI. Controls and patients on a GFD had a similar BMI, FM, BMD and total calorie intake, but the amount of lipids and fiber intake was significantly different in the two groups (P=0.003 and P<0.0001, respectively).

Conclusions:

Our study demonstrates that a GFD is able to improve the nutritional status of celiac patients without inducing overweight or obesity. Our findings are related to a celiac population adopting a GFD based on a Mediterranean-type diet.

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References

  1. 1

    Rampertab SD, Pooran N, Brar P, Singh P, Green PH . Trends in the presentation of celiac disease. Am J Med 2006; 119: e9–14.

  2. 2

    Maki M, Mustalahti K, Kokkonen J, Kumala P, Haapalahti M, Karttunen T et al. Prevalence of celiac disease among children in Finland. N Engl J Med 2003; 348: 2517–2524.

  3. 3

    Fasano A, Berti I, Gerarduzzi T, Not T, Colletti RB, Drago S et al. Prevalence of celiac disease in at-risk and not at risk group in United States: a large multicenter study. Arch Intern Med 2003; 163: 286–292.

  4. 4

    Lohi S, Mustalahti K, Kaukinen K, Laurila K, Collin P, Rissanen H et al. Increasing prevalence of celiac disease over time. Aliment Pharmacol Ther 2007; 26: 1217–1225.

  5. 5

    Trier JS . Celiac sprue. N Engl J Med 1991; 325: 1709–1719.

  6. 6

    Murray JA . The widening sprectrum of celiac disease. Am J Clin Nutr 1999; 69: 354–365.

  7. 7

    Fasano A, Catassi C . Clinical practice. Celiac disease. N Engl J Med 2012; 367: 2419–2426.

  8. 8

    Sapone A, Bai JC, Ciacci C, Dolinsek J, Green PH, Hadjivassiliou M et al. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Med 2012; 10: 13.

  9. 9

    Kupper C . Dietary guidelines and implementation for celiac disease. Gastroenterology 2005; 128: S121–S127.

  10. 10

    Bodè S, Hassanger C, Gudman-Hoyer E, Christiansen C . Body composition and calcium metabolism in adult treated celiac disease. Gut 1991; 32: 1342–1345.

  11. 11

    Dickey W, Kearney N . Overweight in celiac disease: prevalence, clinical characteristics, and effect of a gluten-free diet. Am J Gastroenterol 2006; 101: 2356–2359.

  12. 12

    Olén O, Montgomery SM, Marcus C, Ekbom A, Ludvigsson JF . Coeliac disease and body mass index: a study of two Swedish general population-based registers. Scand J Gastroenterol 2009; 44: 1198–1206.

  13. 13

    Cheng J, Brar PS, Lee AR, Green PH . Body mass index in celiac disease: beneficial effect of a gluten-free diet. J Clin Gastroenterol 2010; 44: 267–271.

  14. 14

    Ciacci C, Cirillo M, Cavallaro R, Mazzacca G . Long-term follow up of celiac adults on gluten-free diet: prevalence and correlates of intestinal damage. Digestion 2002; 66: 178–185.

  15. 15

    Bardella MT, Fredella C, Prampolini L, Molteni N, Giunta AM, Bianchi PA . Body composition and dietary intakes in adult celiac disease patients consuming strict gluten-free diet. Am J Clin Nutr 2000; 72: 937–939.

  16. 16

    Kabbani TA, Goldberg A, Kelly CP, Pallav K, Tariq S, Peer A et al. Body mass index and the risk of obesity in coeliac disease treated with the gluten-free diet. Aliment Pharmacol Ther 2012; 35: 723–729.

  17. 17

    Oberhuber G, Granditsch G, Vogelsang H . The histopathology of coeliac disease: time for a standardized report scheme for pathologists. Eur J Gastroenterol Hepatol 1999; 11: 1185–1194.

  18. 18

    Linee guida diagnosi e follow up della celiachia http://www.celiachia.it/public/bo/upload/aic%5Cdoc/lineee_guida_followup_it.pdf.

  19. 19

    Lynch J, Kaplan GA, Salonen R, Cohen RD, Salonen JT . Socioeconomic status and carotid atherosclerosis. Circulation 1995; 92: 1786-1792.

  20. 20

    WHO Body mass index classification. http://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi.

  21. 21

    WHO Guidelines for Preclinical Evaluation and Clinical Trials in Osteoporosis. Geneva World Health Organization 1998. http://whqlibdoc.who.int/publications/1998/9241545224_eng.pdf.

  22. 22

    Prevention and Management of Osteoporosis WHO Technical report series, Geneva, Switzerland, 2003; 921, http://whqlibdoc.who.int/trs/who_trs_921.pdf.

  23. 23

    Livelli di assunzione di riferimento di nutrienti ed energia per la popolazione italiana (LARN)http://www.sinu.it/documenti/20121016_LARN_bologna_sintesi_prefinale.pdf.

  24. 24

    Trigoni E, Tsirogianni A, Pipi E, Mantzaris G, Papasteriades C . Celiac disease in adult patients: specific autoantibodies in the diagnosis, monitoring, and screening. Autoimmune Dis 2014; 2014: 623514.

  25. 25

    Coin A, Sergi G, Minicuci N, Giannini S, Barbiero E, Manzato E et al. Fat free mass and fat mass reference values by dual-energy X ray absorptiometry (DEXA) in a 20-80 years old Italian population. Clin Nutr 2008; 27: 87–94.

  26. 26

    Kurppa K, Paavola A, Collin P, Sievänen H, Laurila K, Huhtala H et al. Benefits of a gluten-free diet for asymptomatic patients with serologic markers of celiac disease. Gastroenterology 2014; 147: 610–617.

  27. 27

    Passananti V, Santonicola A, Bucci C, Andreozzi P, Ranaudo A, Di Giacomo DV et al. Bone mass in women with celiac disease: role of exercise and gluten-free diet. Dig Liver Dis 2012; 44: 379–383.

  28. 28

    Turnbaugh PJ, Ridaura VK, Taith JJ, Rey FE, Knight R, Gordon JI . The effect of diet on the human gut microbiome: a metagenomic analysis in humanized genotobiotic mice. Sci Transl Med 2009; 1 6ra14.

  29. 29

    Ley RE, Turnbaugh PJ, Klein S, Gordon JI . Microbial ecology: human gut microbes associated with obesity. Nature 2006; 444: 1022–1023.

  30. 30

    Turnbaugh PJ, Ley RE, Mahowald MA, Magrini V, Mardis ER, Gordon JI . An obesity-associated gut microbiome with increased capacity for energy harvest. Nature 2006; 444: 1027–1031.

  31. 31

    Thompson T, Dennis M, Higgins LA, Lees AR, Sharrett MK . Gluten-free diet survey: are Americans with celiac disease consuming recommended amounts of fibre, iron, calcium and grain foods? J Hum Nutr Diet 2005; 18: 163–169.

  32. 32

    Miranda J, Lasa A, Bustamante MA, Churruca I, Simon E . Nutritional differences between a gluten-free diet and a diet containing equivalent products with gluten. Plant Foods Hum Nutr 2014; 69: 182–187.

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Correspondence to M Barone.

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Barone, M., Della Valle, N., Rosania, R. et al. A comparison of the nutritional status between adult celiac patients on a long-term, strictly gluten-free diet and healthy subjects. Eur J Clin Nutr 70, 23–27 (2016) doi:10.1038/ejcn.2015.114

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