Abstract
The primary and proven therapy, in cases of celiac disease (CD), is a rigorous gluten-free diet (GFD). However, there are reports of its negative effects in the form of nutritional deficiencies, obesity, and adverse changes in body composition. The study aimed to assess the impact of a GFD on the body composition of children with CD. In a case-controlled study (n = 41; mean age 10.81 y; SD = 3.96) children with CD, in various stages of treatment, underwent medical assessment. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. More than half of the examined children (n = 26) followed a GFD. CD children had significantly higher mean values of the fat free mass (FFM% = 80.68 vs. 76.66, p = 0.015), and total body water (TBW% = 65.22 vs. 60.47, p = 0.012), and lower mean values of the fat mass (FM% = 19.32 vs. 23.34, p = 0.015). Children who were on a GFD presented slightly higher, but not statistically significant, mean values of FM and FFM, than children who did not follow dietary recommendations (FM [kg] = 7.48 vs. 5.24, p = 0.064; FM% = 20.81 vs. 16.73, p = 0.087; FFM [kg] = 28.19 vs. 22.62, p = 0.110). After minimum one year of a GFD, CD children showed significantly higher values of FFM [kg] (p = 0.001), muscle mass (MM) [kg] (p < 0.001), TBW [L] (p < 0.001) and body cell mass (BCM) [kg] (p < 0.001). Furthermore, CD children who were on a GFD presented a significantly higher increase in weight (p = 0.034) and body mass index (BMI) (p = 0.021). The children adhering to a GFD demonstrate a tendency towards higher indices of selected body composition components.
Highlights
Celiac disease (CD) is a diet-dependent disease and one of the most common food intolerances in Europe posing significant health-related problems [1]
In the present case-controlled study, we observed that selected body composition parameters and nutritional indicators in children with CD are significantly different than in healthy controls
The results of the present study showed that children with CD had significantly lower mean values of the fat mass (FM) expressed both in kg and as percentage of body mass (p = 0.007 and p = 0.015, respectively), and higher mean percentage values of the fat free mass (FFM) (p = 0.015), and total body water (TBW) (p = 0.012)
Summary
Celiac disease (CD) is a diet-dependent disease and one of the most common food intolerances in Europe posing significant health-related problems [1]. The disease may manifest itself at any age, yet it is frequently diagnosed in children up to 5 years of age, three in four cases being identified in female subjects. It is estimated that for each case diagnosed, there are 5 undetected cases [2], which is partly linked to the high prevalence of subclinical CD [3]. The expected global prevalence of CD is in the range from 0.2% to 5.6% [4]. In Europe, the relevant rate generally varies from 0.5% to 1%. In the age group of 2.5–15 years, the condition affects 1 in 80 to 1 in 300 children [5,6]
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