Comparative Study of Nutrition and Quality of Life in Children with Celiac Disease and Their Healthy Siblings (+Video)

Celiac.com 11/24/2025 - Celiac disease is a lifelong condition in which eating gluten damages the small intestine and can interfere with growth and daily comfort. A strict gluten-free diet is the accepted treatment, but life with this diet can influence more than just physical health. It can touch family routines, social experiences, and how children feel about themselves. This study set out to look not only at children who have celiac disease, but also at their healthy brothers and sisters, and to compare both groups with unrelated healthy children of similar ages. The goal was to understand two things at the same time: whether children are getting the nutrients they need, and how they are doing in day-to-day life at home, with friends, and at school.

Who Took Part and How the Study Worked

The researchers included three groups of children: those diagnosed with celiac disease, their healthy siblings living in the same household, and a control group of healthy peers. The final numbers were eighty-one children with celiac disease, seventy-eight healthy siblings, and one hundred six healthy peers. The groups were balanced by age and gender so that comparisons would be fair. Families answered questions about background and daily life. The children’s eating patterns and nutrient intake were recorded, and simple body measurements such as height and weight were taken to check growth. To understand day-to-day well-being, the team used a widely accepted child quality of life scale that asks about feelings, friendships, school life, family life, and self-image.

What the Study Found About Food and Growth

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First, the good news: when the researchers looked at whether children were meeting general nutrient needs, the three groups were broadly similar. Children with celiac disease even took in a little more protein than the other groups. This suggests that, with care and planning, a gluten-free diet can supply the essential nutrients children require.

However, the body measurements told a more nuanced story. Heights were similar across the groups, but children with celiac disease tended to have lower body weight and a lower body mass index than both their siblings and the unrelated healthy children. This pattern can mean that even when children are eating an appropriate gluten-free diet, they may still face hurdles achieving the same growth status as their peers. These hurdles could come from earlier periods of intestinal damage before diagnosis, the ongoing strictness of the diet, accidental exposure to gluten, or the social and practical challenges of finding safe foods in every setting.

How Children Felt and Functioned Day to Day

When the researchers looked at the total score for quality of life, the groups did not show major differences. But when they examined specific parts of the scale, clear gaps appeared. Children with celiac disease had lower scores in the areas of self-esteem, friendships, and school life. Notably, four in ten children with celiac disease were categorized as having a low overall quality of life. That is a large share, and it points to needs that go beyond nutrition alone.

An especially important result was that healthy siblings also showed lower self-esteem than the unrelated healthy peers. This means that the experience of a chronic condition in one child can ripple outward through the family. Healthy siblings may share some of the daily restrictions, may worry about cross-contact at home or at social events, or may feel that family attention is heavily focused on the child with the diagnosis. Over time, these realities can shape how a child sees themself and how comfortable they feel with friends and at school.

Why Similar Nutrient Intake Does Not Guarantee Equal Well-Being

At first glance, the results about nutrient adequacy might seem to settle the question: if children with celiac disease are getting enough nutrients, then all is well. This study shows that real life is not that simple. A gluten-free diet demands constant label reading, careful planning, and saying no to common foods at parties, cafeterias, and restaurants. Even when families succeed at meeting nutrient needs, the effort itself can be tiring and socially isolating. Children can feel different, and they can be left out when food is central to shared experiences. These pressures can affect self-esteem, friendships, and school participation in ways that do not show up on a simple nutrient checklist.

What Families and Health Professionals Can Do

The study’s message is clear: medical treatment and nutrition guidance are necessary, but they are not enough by themselves. Children with celiac disease benefit when care also addresses feelings, friendships, and school challenges. Family-centered support can include counseling, child-friendly education about the condition, practice with self-advocacy in social settings, and help for parents to balance attention across siblings. Schools can play a role by normalizing safe options at events, training staff in cross-contact prevention, and ensuring that children who must avoid gluten are not singled out or excluded.

Healthy siblings should not be overlooked. They can be invited into age-appropriate education about the condition, encouraged to voice concerns, and supported in having their own food choices and social plans where possible. When families make space for every child’s needs, the household burden eases and children’s confidence can grow.

Strengths and Limits to Keep in Mind

This study brings value by examining children with celiac disease alongside their own healthy siblings and a group of healthy peers. That design helps separate the effects of the gluten-free lifestyle and the family environment from general childhood experiences. As with most cross-sectional research, the study gives a snapshot in time rather than a picture of change over months or years. It also relies on reported food intake and standardized questionnaires, which can never capture every detail of daily life. Even so, the consistent differences in self-esteem, friendships, and school experiences are signals that deserve attention.

What This Means for People Who Live with Celiac Disease

For families, the findings underscore a practical truth. Success with celiac disease is not only about avoiding gluten. It is also about helping children feel capable, included, and understood. Families can celebrate small wins, build routines that reduce stress, and ask schools, coaches, and community groups for simple accommodations that make participation easier. Health professionals can support this by pairing nutrition counseling with emotional and social guidance, and by checking in regularly about friendships, school experiences, and sibling well-being.

Conclusion: Why the Study Matters

This study shows that children with celiac disease can meet nutrient needs on a gluten-free diet, yet still carry a heavier load in areas that are not measured on a food label or a growth chart. Lower body weight and lower body mass index point to lingering growth challenges, and lower scores for self-esteem, friendships, and school life point to invisible costs that affect confidence and everyday joy. Healthy siblings can also feel these effects, especially in self-esteem. For people who live with celiac disease, the message is hopeful and practical: when nutrition support is combined with family-centered emotional and social care, children are better positioned to thrive. In short, nourishing the body is essential, and nourishing the whole child and the whole family is just as important.

Read more at: link.springer.com

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