Celiac.com 12/19/2011 - Very little data has been collected about how body mass relates to celiac disease in children in the United States. Recently, a team of researchers sought to document the way celiac disease presents in children with normal and with elevated body mass index (BMI) for age, and to study BMI changes in those kids following a gluten-free diet.

Photo: CC--dboyThe research team included Norelle Rizkalla Reilly, Kathleen Aguilar, Benjamin G. Hassid, Jianfeng Cheng, Amy R. DeFelice, Philip Kazlow, Govind Bhagat, and Peter H. Green. They are variously affiliate with Columbia University School of Medicine.

The team reviewed data from patients treated at their specialty clinic from 2000 to 2008, for whom follow-up growth data available. In all, they evaluated 142 children from 13 months to 19 years in age, all with biopsy-proven celiac disease.

To compare the results, they assessed patient height, weight, and BMI by age (z score), and grouped results by BMI as underweight, normal, or overweight.

To be certain which of the patients were following a gluten-free diet, the team used results of serological assays, and data of noncompliant patients, which they assessed separately.

Their analysis included only data gathered during the observation period, which they then expressed as change in height, weight, and BMI z score per month of dietary treatment.

They found that almost 1 in 5 (19%) of patients showed an elevated BMI at diagnosis (12.6% were overweight, while 6% obese). Nearly 3 out of 4 patients (74.5%) showed normal BMI.

The team followed each patient for an average of 35.6 months. Three out of four patients (75%) with an elevated BMI at diagnosis showed a substantial decrease in BMI z scores after following a gluten-free diet. Nearly half (44%) of those patients showed a normalized BMI after following a gluten-free diet.

North American children with celiac disease frequently present as either normal weight or overweight. Patients with normal BMI at diagnosis showed sharply higher weight z scores after following a gluten-free diet, and 13% became overweight. This means that normal weight individuals will likely gain weight on a gluten-free diet, and that just over one in ten will become overweight.

However, for overweight and obese children with celiac disease, the results indicate that a gluten-free diet may be helpful in lowering BMI.

Source:
  • JPGN 2011;53: 528–531
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