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  • Jefferson Adams
    Jefferson Adams

    Higher Body Mass Index and Lower Risk of Obesity in Celiac Disease Patients on a Gluten-free Diet

    Reviewed and edited by a celiac disease expert.

    Celiac.com 05/25/2012 - A team of researchers recently set out to examine body mass and obesity risk in a large population of people with celiac disease who are following a gluten-free diet.

    Photo:CC-FBellonThe research team included T. A. Kabbani, A. Goldberg, C. P. Kelly, K. Pallav, S. Tariq, A. Peer, J. Hansen, M. Dennis & D. A. Leffler. They are affiliated with the Department of Medicine and Division of Gastroenterology at Beth Israel Deaconess Medical Center in Boston, Massachusetts.

    Diagnosis for celiac disease is on the rise, and many people who are diagnosed experience weight changes once they adopt a gluten-free diet. There's a pretty good amount of study data on weight change on a gluten-free diet, but a very limited amount of data regarding changes in body mass.

    The researchers wanted to look at a large population of people with celiac disease, who followed a gluten-free diet to better understand changes in body mass index (BMI) following celiac diagnosis.

    To do this, they looked at a total of 1018 patients with biopsy confirmed celiac disease. The patients had all previously visited the Beth Israel gastroenterology clinic in Boston.

    The team recorded data for initial and follow-up BMIs, and used an expert dietitian to assess patient compliance with a gluten-free diet. They found a total of 679 patients with at least two recorded BMIs and GFD adherence data, and used data from those patients in their study. The average amount of time from first BMI measurement to follow-up measurement was 39.5 months.

    When they compared the results against data for the general population, they found that celiac disease patients on a gluten-free diet were significantly less likely to be overweight or obese (32% vs. 59%, P < 0.0001).

    They also found that average body mass increased significantly after patients adopted a gluten-free diet (24.0 to 24.6; P < 0.001). Overall, 21.8% of patients with normal or high BMI at study entry increased their BMI by more than two points.

    The results of this study show that celiac disease patients on a gluten-free diet have lower BMI than the regional population at diagnosis, but that BMI increases with a gluten-free diet, especially in those who follow the diet closely.

    Still, even though overall risk of obesity is lower than the regular population, once celiac patients adopt a gluten-free diet, 15.8% of patients move from a normal or low BMI class into an overweight BMI class, and 22% of patients overweight at diagnosis gain weight.

    As a result, the study team feels that weight maintenance counseling should be an integral part of celiac dietary education.

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    For those who haven't lost any weight, maybe you aren't eating enough food? It's important to fill your diet with healthy proteins and those grains that you are able to eat. For me, I eat a jumbo egg and veggie omelet with one corn tortilla, sprinkling of cheese, and salsa in the morning. Lunch is usually chicken with a green salad with some sort of nut and olives and a healthy dressing. Dinner is about the same: a healthy protein, lots of veggies, and a carb that I can handle. I've also done the 4-6 small meals a day when I have time. Gluten-free doesn't necessarily mean diet food. You still have to eat wisely and think portion-control. Which is why the eating small meals every 3 hours really is best.

    I totally agree with you, Renee.

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    BMI is a defunct concept devised in the early 1800's. I am 5' 8". At the peak of my season my senior year in high school, I did three workouts per day 5 days a week and one long workout on Saturdays, swimming over 11,000 yards a day. I had a 29-30 inch waist, weighed between 165 and 170 lbs and had a body fat level of about 4% (too low really). I was not a runner but I could run for 7 miles non-stop, take a short break and then run 7 miles back home. You could not pinch any fat on my abdomen. It was skin over muscle. At age 45 I turned to lifting. I worked out 4-5 days a week, could bench press 325 lbs and squat 465 lbs. I had a 31-32 inch waist, weighed between 185 and 190 lbs and a body fat level of less than 10%. I could probably run about 5-6 miles one way. You could pinch a little bit more than skin on my abdomen, but I looked "cut" all over.

     

    According to the BMI chart, at 190 lbs, I was officially obese. Nonsense! I was in excellent condition. (I wish I was back there now.) If I followed their suggested weight level for a "normal" person, I would only weigh about 140 (or even less); that's Auschwitz material. The only proper way to determine a healthy weight for any given person is according to their LBM - lean body mass. Lean Body Mass is a component of your body composition, calculated by subtracting your body fat weight from your total body weight: total body weight is lean plus fat. Lean Body Mass equals Body Weight minus Body Fat. The correct rule should be: It's not how much you weigh, its how lean or fat you are. If you weigh 200 lbs and are 5' 8" but are only 10% body fat and you can jog/run 5+ miles without straining, chances are you're in great shape and great overall cardiovascular health.

     

    A toned and/or muscular body is both healthy and attractive. Being an emaciated scarecrow is not. And for the record, I have celiac disease. Watching what and when you eat certainly helps, but nothing can take the place of a proper exercise/workout regimen. No diet in the world can make you look tone or muscular, only exercise can do that.

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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