Nutritional Status, Dietary Intake, and Adherence to the Mediterranean Diet of Children with Celiac Disease on a Gluten-Free Diet: A Case-Control Prospective Study.

Elena Lionetti,Beatrice Bartolomei,Michele Marinelli,Elisa Franceschini,Anil K Verma,Carlo Catassi,Simona Gatti,Giulia Naspi Catassi,Niki Antonucci,Chiara Monachesi

doi:10.3390/nu12010143

Elena Lionetti, Beatrice Bartolomei + Show 8 more

Open Access

https://doi.org/10.3390/nu12010143

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Abstract

The only effective treatment for celiac disease (CD) is a life-long strict gluten-free diet (GFD). Nutritional adequacy of the GFD has remained controversial and a matter of debate for a long time. No large case-control studies on children regarding the nutritional adequacy of the GFD has been performed. In this study, children diagnosed with CD on a GFD for ≥ 2 years were recruited. Controls were age and gender-matched healthy children not affected with CD. In both groups, anthropometric measurements and energy expenditure information were collected. Dietary assessment was performed by a 3-day food diary. Adherence to the Mediterranean diet was estimated by the KIDMED index. Overall, 120 children with CD and 100 healthy children were enrolled. No differences were found between CD children and controls in anthropometric measurements and energy expenditure. In the CD group, the daily intake of fats was significantly higher while the consumption of fiber was lower in comparison with the control group. The median KIDMED index was 6.5 in CD children and 6.8 in healthy controls. The diet of children with CD in this study was nutritionally less balanced than controls, with a higher intake of fat and a lower intake of fiber, highlighting the need for dietary counseling.

Highlights

Celiac disease (CD) is a systemic immune-mediated disorder caused in genetically susceptible persons by the ingestion of gluten-containing grains [1]
The present case-control study shows that the nutritional status of celiac disease (CD) children does not differ from healthy children
There are studies suggesting that the gluten-free diet (GFD) may have a negative effect on body composition and anthropometric parameters in CD patients, with an increased prevalence of overweight and obesity [5,27,28]

Summary

Introduction

Celiac disease (CD) is a systemic immune-mediated disorder caused in genetically susceptible persons by the ingestion of gluten-containing grains [1]. The only available treatment is the gluten-free diet (GFD), which consists of the dietary exclusion of grains containing gluten (i.e., wheat, rye, barley) [2]. The nutritional adequacy of the GFD remained controversial and a matter of debate for a long time [3]. Apart from maintaining the safe limit of gluten intake (below 10–50 mg/day), a suitable. GFD must be nutritionally balanced and cover all energy and nutrient requirements to prevent deficiencies and ensure a healthy life. The GFD must allow appropriate growth and pubertal development [4]. A body of evidence has so far suggested that the GFD may be nutritionally

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