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

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.

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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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3 Responses:

 
Eileen
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said this on
07 Jul 2008 9:36:44 PM PDT
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.

 
amy
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said this on
07 May 2012 12:56:08 PM PDT
Thank you this article has been insightful.

 
Jane
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said this on
15 Dec 2013 2:33:04 PM PDT
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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Celiac.com Celiac Disease & Gluten-Free Diet Forum - All Activity

Hey All, I was wondering if anyone has tried gluten free pizza? I'm specifically talking about the store bought kind. I'm looking for a cheat meal - I've been eating mainly non processed fresh food but I need a little something to stay sane every now and then. I'm from New York so i'd say I have a pretty high standard of pizza lol. Are there any good frozen ones that are worth eating? I don't think i've ever eaten a frozen pizza in my life but I don't particularly have the time right now to make my own. Also while I'm posting I figure i'll ask. I'm going to this event with my friend at her work. It's like a dinner party. How do I navigate this situation food wise? Should I just eat at home and get drinks there or plan to eat there but take snacks just in case nothing seems safe? Thanks guys!

Hi Dalek, JMG has it right, any food with wheat, rye or barley is a gluten containing food. In addition, watch out for malt, which is sometimes made from barley. That includes the malt in beers.

Interesting!! I'm going to share that with her dr. I'll have to look into the gluten sensitivity more myself, the main reason we started testing is due to poor growth. As I learned more, I've seen several symptoms that could be explained by celiac. I like feeling informed so I'll know what to talk to the dr about or ask about. I think those are the results we are waiting for still, I couldn't remember the name.

Call your doctor's office and ask them to relay your request to the doctor to amend the test request, they should be able to sort it without an additional meeting and delay. Worth a try anyway I think the Biocard tests TTG IGA and it may give you an indication. Do post your results here as I'm sure others will be interested in its effectiveness. If it's negative however remember that there are several celiac tests for a reason. Some test on one, some on another etc... However my guess is your doctor will dismiss them and want their own testing. That's the usual experience.

Waiting for the EMA, I bet. Keep advocating! this is interesting. If celiac disease is excluded, she might still have a gluten sensitivity. There just is not specific test for that. http://theglutensummittranscripts.s3.amazonaws.com/Dr_Umberto_Volta.pdf