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  • Jefferson Adams
    Jefferson Adams

    Malnutrition Risk Remains Higher in Celiacs Disease Patients on a Gluten-Free Diet

    Reviewed and edited by a celiac disease expert.

    Celiac.com 06/27/2007 - It is well known that following a gluten-free diet brings about a remission in celiac disease. But what are the true physiological effects of such remission? A study published recently in the American Journal of Clinical Nutrition shows that even when people with celiac disease follow strict gluten-free diets, they frequently have inferior body composition and nutritional uptake compared to healthy people without celiac disease.

    Faced with a shortage of solid data on the long-term benefits of a gluten-free diet for celiac patients, a team of Italian doctors conducted a study to determine body composition and nutritional status. They looked at data for patients with celiac disease who are following a strict gluten-free diet, and who were in full clinical, biochemical, and histological remission.

    The research team was made up of Maria Teresa Bardella, Clara Fredella, Luigia Prampolini, Nicoletta Molteni, Anna Maria Giunta and Paolo A Bianchi. They looked at data from 71 patients. Subjects included 51 women and 20 men. Subjects ranged from 17 to 58 years of age. The average age of test subjects was 27 years. Subjects were assessed for the following factors: body mass index; bone mineral content (as measured by dual-energy X-ray absorptiometry); fat and lean mass; height and weight. The team conducted a 3-d dietary questionnaire. They also measured total daily energy, fat, carbohydrate, and protein intakes.

    Important for Celiacs to Follow Strict Gluten-Free Diet to Avoid Malnutrition - Lower Weight and Body Mass Index for Celiac Patients

    Compared to control subjects, celiac patients had a lower intake of total energy (9686 ± 1569 and 11297 ± 1318 kJ/d in males and 6736 ± 1318 and 7740 ± 1715 kJ/d in females). The male celiacs showed lower weight, height, and body mass index than their control counterparts. Female celiac patients showed substantially lower weight and body mass index. For both male and female celiac patients, fat and lean mass differed dramatically from the control group.

    Female celiac patients diagnosed as adults showed a markedly higher lower bone mineral content compared to the control group. Males showed no such disparity. In general and celiac patients ate an unbalanced diet that contained higher amounts of energy from fat and lower amounts of energy from carbohydrates.

    Researchers Recommend Strict Follow-ups and Nutritional Advice for Celiac Patients

    The study showed that even when celiacs faithfully follow a gluten-free diet and their celiac disease is in total remission; their body composition and nutritional uptake differ substantially from healthy non-celiacs. For that reason, and in order to prevent malnutrition, the researchers recommend that all celiacs receive strict follow-ups and dietary evaluations regarding the nutritional composition of their food choices.

    American Journal of Clinical Nutrition, Vol. 72, No. 4, 937-939, October 2000

    health writer who lives in San Francisco and is a frequent author of articles for Celiac.com.

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    Very interesting. This article confirms why I was anemic for many years. Guess I didn't absorb the nutrition from my foods as it was impossible. Gluten free sometimes leaves me hungry for other foods, perhaps it is a missing nutrient or a missing taste.

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    Thanks for the article, but while helpful, it fails to note the reason why there is malnutrition. AFAIK, celiacs have damaged villi that do not recover (because the villi are absent if enough damage has been done). If that's the case, then I would guess treatment wouldn't be with diet. It would be with multivitamins and mineral supplements, just like bariatric patients who can't absorb well because of a physical issue. And cutting more fat out of the diet would simply make the absorption of minerals worse. Sure some people overdo the fats, but not everyone, and they are needed for bad absorbers. Bad dietary advice must also be avoided.

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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 biology, anatomy, medicine, science, and advanced research, and scientific methods. 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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