Nutritional Imbalances in Adult Celiac Patients Following a Gluten-Free Diet.

Aner Cardo,Maialen Vázquez-Polo,Itziar Churruca,Virginia Navarro,Idoia Larretxi,Arrate Lasa,Gesala Perez-Junkera

doi:10.3390/nu13082877

Aner Cardo, Maialen Vázquez-Polo + Show 5 more

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https://doi.org/10.3390/nu13082877

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Abstract

Celiac disease (CD) is a chronic autoimmune disorder of the small intestine, whose only effective treatment is a gluten-free diet (GFD). It is characterized by the atrophy of the intestinal villi that leads to altered nutrient absorption. This study describes the nutritional imbalances which may be found in adults with CD following a GFD. During the first year of treatment, deficiencies will overcome as the intestinal mucosa recovers. Thus, biochemical data will show this progression, together with the decrease in symptoms. In contrast, in the long term, when a strict GFD is followed and mucosal recovery is achieved, analyzing nutrient intake makes more sense. Macronutrient consumption is characterized by its low complex carbohydrate and fiber intakes, and high fat (especially SFA) and sugar intakes. This profile has been related to the consumption of GFP and their nutritional composition, in addition to unbalanced dietary habits. The most notable deficiencies in micronutrients are usually those of iron, calcium and magnesium and vitamin D, E and some of group B. It is necessary to follow up patients with CD and to promote nutritional education among them, since it could help not only to achieve a gluten free but also a balanced diet.

Highlights

The incidence of celiac disease (CD) is rising all over the world. This fact is due to environmental factors that may decrease tolerance to gluten in diet, and because there has been an improvement in its diagnosis [1,2]
The present review provides the most important dietary guidelines to achieve the nutritional balance with a gluten-free diet (GFD), so that it could represent a useful tool of nutritional education for dietitians and nutritionists working in the field of celiac disease
PUBMED database was searched for articles published since 2000, and using different combinations of the following terms: celiac disease and gluten-free diet and dietary deficiencies, nutritional deficiencies, nutrient intake, micronutrient, macronutrient, vitamin, mineral, or fiber intake

Summary

Introduction

The incidence of celiac disease (CD) is rising all over the world. This fact is due to environmental factors that may decrease tolerance to gluten in diet, and because there has been an improvement in its diagnosis [1,2]. It has been estimated that in Western countries it is approximately 1% of the population, with a global rate of 0.7–1.4%, detected by biopsy or serologic tests [3,4]. This disease is sometimes undetected, with a 1/3 to 1/5 ratio between diagnosed and undiagnosed [5]. The etiology of CD is not very clear, apart from genetic factors, some environmental factors can be mentioned, such as the consumption of gluten-containing cereals, infections in the first year of life or low economic status along with unsanitary environments [6]

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