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Screening Versus Symptoms: Does Detection Method Affect Body Mass for Celiacs on a Gluten-free Diet?

Celiac.com 08/27/2012 - Because so many patients are now overweight upon diagnosis for celiac disease, and so fee present as classically underweight, doctors are revising the clinical presentation guidelines for celiac disease diagnosis.

Photo: CC--fbellon1That being said, some researchers have voiced concern that some patients might gain further weight while on a gluten-free diet.

Recently, a team of researchers conducted a study to assess the impact of a gluten-free diet on body mass index (BMI) in a nationwide group of celiac patients and to isolate any variables that might help to predict favorable or unfavorable BMI changes.

The research team included Anniina Ukkola, Markku Mäki, Kalle Kurppa, Pekka Collin, Heini Huhtala, Leila Kekkonen, and Katri Kaukinen. They are affiliated variously with the School of Medicine, University of Tampere, and the Department of Gastroenterology and Alimentary Tract Surgery at Tampere University Hospital, both in Tampere, Finland.

To assess weight and disease-related issues, the researchers looked at 698 newly detected adults who were diagnosed with celiac disease by classical or extra-intestinal symptoms or by screening.

The researchers measured BMI upon celiac diagnosis and after one year on a gluten-free diet. They then compared the results against data for the general population.

Study data showed that 4% of patients were underweight at celiac diagnosis, 57% were normal weight, 28% were overweight and 11% were obese.

On a gluten-free diet, 69% of underweight patients gained weight, while 18% of overweight and 42% of obese patients lost weight. BMI remained stable for the other patients.

Both symptom- and screen-detected celiac patients showed similar results. The patients with celiac disease showed a more favorable BMI pattern than the general population.

The most favorable BMI changes were seen in patients with self-rated gluten-free diet expertise, along with those who were younger upon diagnosis. Dietary counseling did not seem to impact .

The initial method of detection does not seem to matter for people with celiac disease who are following a gluten-free diet. Both screen-detected and symptom-detected celiac disease patients who followed a gluten-free diet showed similar improvements in body mass index (BMI).

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6 Responses:

 
Kelly Shuman
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said this on
27 Aug 2012 7:00:51 AM PST
I was diagnosed 21 years ago and am still overweight. (obese). I would love to see just what the diet consisted of exactly, because nothing I have tried has helped me to lose weight - I have gained more, if anything. If anyone is doing research please contact me, my daughter, my sister, and nephew.
We would love to have more information and help others with this disease.

 
Heather Twist
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said this on
28 Aug 2012 12:57:01 AM PST
That is pretty much what I've seen in the community. Some people with celiac ... don't lose weight when they lose the gluten. When food absorption is better, celiac people eat less, but don't lose weight.

I kind of think the research by Dr. Richard Johnson is on the right track. Some combination of too much fructose, and too much iron, is triggering the weight gain. Wheat might trigger too much iron absorption also. But the American diet, in particular, is really high in fructose (not just HFCS, but also sucrose and OJ) and iron (not just meat, but also iron-enriched foods).

In terms of the article though, about "detection methods" ... my first thought was about waist circumference. Anyone with "bloating" can gain a few inches just from gas, and THAT I think, is a big flaw in the waist-measurement statistics.

 
KarenB
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said this on
03 Sep 2012 9:49:28 AM PST
Kelly, I don't know if my answer will be yours but I have finally been able to lose weight for the first time in 30 years. I was diagnosed with celiac disease nearly 10 years ago. I was overweight then and it's gone up slowly since then until this year. I've been watching my blood glucose levels and a friend recommended a book called The Diabetes Solution by Dr. Bernstein. I don't follow his instructions exactly but I am restricting my carbs to fewer than 100 grams daily and losing weight. I've been eating 1600 calories a day for a while but weight loss didn't begin until I restricted carbs to fewer than 100.

One other thing that makes a difference for me that I haven't heard mentioned much for weight loss is sleep. In the past, I've always gone on about 6 hours of sleep or less. Now, if I get less than 8 hours of sleep per night, after a couple of days the weight loss stops. I have been on different diets many times and they didn't work. The carb restriction and sleep is working and I've lost 30 pounds. That's the first time I've been able to make the scale go the other direction in 30 years.

I have to mention a food logging program called DietPower is helping me keep track of the food but I find it's wildly optimistic on how many calories I burn in any activity so I ignore the "calories earned by activity" section. Hope this helps.

 
Cristie Kalish
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said this on
05 Sep 2012 2:57:53 PM PST
I feel you! We (my mom and I, both celiacs) have the same experience. It seems impossible to lose weight, we just gain. That said, having tried every diet, my mom finally seems to have found a holistic doctor who is helping her. He put her on a grain-free, dairy-free, sugar-free diet. I put my family of 5 on it and everyone has lost weight (me the least, sigh). Nonetheless, it's working for us 5 and my mom. My mom was diagnosed with candida in her intestine; you might want to look it up.

 
amy
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said this on
10 Sep 2012 5:23:17 PM PST
H! For the first time in 10 years, I've had good success quickly dropping the pounds with very low carb, gluten-free fresh foods - nothing processed. Low carb is key!! Keep lowering the daily amount of carbs until you have the rate of weight loss you want - it varies for everyone. Look up primal blueprint's website and get on their email list - they have great free advice/emailed tips and recipes. They is very filling and easy recipes - you won't be hungry at all. My sister had similar success and we're now working on other family members!

 
KarenB
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said this on
03 Sep 2012 9:32:06 AM PST
I'm thrilled to see that doctors are recognizing celiac disease in overweight people more often. Ten years ago, when I was diagnosed, several doctors had a difficult time believing that I was biopsy diagnosed because I was (and am) overweight.




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