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

Teresa Nestares,José Maldonado,Virginia A Aparicio,Marta Flor-Alemany,Rafael Martín-Masot,Magdalena López-Frías,Ana Labella

doi:10.3390/nu12030844

Abstract

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.

Highlights

Celiac disease (CD) occurs in about 1% of people in most populations [1,2]
A total of 68 children with CD participated in the study
The CD group showed lower levels of hemoglobin, erythrocyte and hematocrit compared to healthy children (p < 0.05)

Summary

Introduction

Celiac disease (CD) occurs in about 1% of people in most populations [1,2]. Diagnosis rates are increasing, which seems to be due to a true rise in incidence that requires greater awareness and early detection. In response to unknown environmental factors, it is believed that ingestion of gluten promotes an immunologically mediated small intestinal enteropathy in genetically susceptible individuals [3]. The disease primarily affects the small intestine; the clinical manifestations are large, with both intestinal and extra-intestinal symptoms. Patients with CD might present with various deficiency states, including anemia, osteopenia or osteoporosis.

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