Abstract
Patients who follow a gluten-free diet (GFD) may be prone to nutritional deficiencies, due to food restriction and consumption of gluten-free products. The aim was to assess nutritional status in celiac children and adolescents on a long-term GFD. A cross-sectional age and gender-matched study in 70 celiac and 67 non-celiac volunteers was conducted, using dietary, anthropometric, biochemical parameters, and assessing bone mineral density and physical activity. Adequacy of vitamin D intake to recommendations was very low, in both groups, and intakes for calcium and magnesium were significantly lower in celiac volunteers. Celiac children and adolescents may have a higher risk of iron and folate deficiencies. Both groups followed a high-lipid, high-protein, low fiber diet. Median vitamin D plasma levels fell below reference values, in celiac and non-celiac participants, and were significantly lower in celiac girls. Other biochemical parameters were within normal ranges. Anthropometry and bone mineral density were similar within groups. With the exception of some slightly lower intakes, children and adolescents following a GFD appear to follow the same trends as healthy individuals on a normal diet. No effect of food restriction or gluten-free product consumption was observed.
Highlights
Celiac disease (CD) is a systemic immune disorder that, after the ingestion of gluten, causes progressive atrophy of the villi in the small intestine of genetically susceptible individuals, resulting in an alteration in the absorption of nutrients, and leading to various deficiency states, in many cases the disease is asymptomatic [1].Nowadays, CD is considered a frequent worldwide disease that affects both pediatric and adult patients
Folate and calcium blood concentrations were within normality, and no differences between celiac and non-celiac children and adolescents were detected, even though intakes for theses nutrients were low
We found a lower level of plasmatic concentration of 25-OH vitamin D in celiac children and adolescents, and the intake of vitamin D and calcium in the diet was lower than recommendations, we did not find a correlation between plasmatic concentrations of vitamin D and bone mineral density (BMD)
Summary
CD is considered a frequent worldwide disease that affects both pediatric and adult patients. Recent epidemiological studies have estimated a CD prevalence of 1:100, with a range between. In Spain, studies conducted in the Community of Madrid, Asturias and The Basque Country provide prevalence data of 1:370 in the adult population and 1:118 to 1:220 in children [5]. In Madrid, 1 in every 79 children suffers CD [6]. The most frequent clinical presentation of CD is the classical form, mainly diagnosed during the first two years of life [7]. The incidence of CD in Spain has increased notably compared with previous studies, and it is much higher than that observed in other European countries [7]
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