scholarly journals Knowledge of Medical Students and Medical Professionals Regarding Nutritional Deficiencies in Patients with Celiac Disease

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1771
Author(s):  
Łukasz Dembiński ◽  
Artur Mazur ◽  
Mariusz Dąbrowski ◽  
Teresa Jackowska ◽  
Aleksandra Banaszkiewicz
Keyword(s):  
Vitamin D ◽  
Celiac Disease ◽  
Medical Students ◽  
Healthcare Professionals ◽  
Gluten Free Diet ◽  
Acceptable Level ◽  
Excessive Amount ◽  
Nutritional Deficiencies ◽  
Medical Professionals ◽  
Gluten Free

A gluten-free diet provides relief from symptoms for patients with celiac disease, although there is still a risk of nutritional deficiencies. These patients can potentially consume an excessive amount of fat and insufficient amounts of fiber, iron, vitamin D, and calcium. This study aimed to assess the knowledge of medical students and healthcare professionals in Poland regarding nutritional deficiencies and the prevention of such deficiencies in patients with celiac disease who are on a gluten-free diet. Of the 430 survey participants, 46% did not realize the risk of nutritional deficiencies in patients with celiac disease. The knowledge of the participants was lowest regarding the risk of being overweight or obese. Among the healthcare professionals, an acceptable level of correct answers was provided by only 37% of individuals and was highest for the dietitians’ group. Our results demonstrate the need to improve the education of healthcare professionals concerning nutrition in patients with celiac disease.

scholarly journals Nutritional Deficiencies in Children with Celiac Disease Resulting from a Gluten-Free Diet: A Systematic Review

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1588 ◽  
Author(s):  
Giovanni Di Nardo ◽  
Maria Pia Villa ◽  
Laura Conti ◽  
Giusy Ranucci ◽  
Claudia Pacchiarotti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Celiac Disease ◽  
Gluten Free Diet ◽  
Nutritional Deficiencies ◽  
Gluten Free ◽  
Clinical Consequences ◽  
Macro And Micronutrients ◽  
High Glycemic Index ◽  
Therapeutic Protocols ◽  
Not At Risk

Background: A strictly gluten-free diet (GFD) is the basis for managing celiac disease (CD). Numerous studies have reported nutritional deficiencies/imbalances ascribable to a GFD. The aim of this review is to describe nutritional deficiencies observed in children with celiac disease on a GFD, to discuss the clinical consequences related to these nutritional imbalances, and to identify strategies that may be adopted to treat them. Methods: We reviewed the MEDLINE and EMBASE databases between January 1998 and January 2019. Results: Children are, regardless of whether they are on a gluten-free diet or not, at risk of consuming too much fat and insufficient fiber, iron, vitamin D, and calcium. These imbalances may be exacerbated when children are on a gluten-free diet. In particular, the intake of folate, magnesium, zinc, and foods with a high glycemic index in children with CD who are on a GFD is significantly altered. Conclusions: Therapeutic protocols should include nutritional education to help teach subjects affected by disorders such as CD the importance of labels, the choice of foods, and the combination of macro- and micronutrients. Children with CD on a GFD should be encouraged to rotate pseudo-cereals, consume gluten-free commercial products that have been fortified or enriched, and use foods that are local and naturally gluten-free.

scholarly journals 25-Hydroxyvitamin D, 1,25-Dihydroxyvitamin D, and Peripheral Bone Densitometry in Adults with Celiac Disease

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 929 ◽  
Author(s):  
Carolina Ciacci ◽  
Giancarlo Bilancio ◽  
Ilaria Russo ◽  
Paola Iovino ◽  
Pierpaolo Cavallo ◽  
...  
Keyword(s):  
Vitamin D ◽  
Celiac Disease ◽  
Serum Calcium ◽  
Calcium Supplementation ◽  
Quantitative Computed Tomography ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Mineral Density ◽  
High Fracture ◽  
Calcium And Phosphorus

Background: Adults with celiac disease (CeD) show low bone mineral density (BMD) and high fracture risk. CeD guidelines suggest measurements of serum minerals and vitamin D. However, studies on vitamin levels in CeD patients are contradictory. Aim: To investigate in CeD, 25-hydroxy-vitamin D [25(OH)D], 1,25-dihydroxy-vitamin D [1,25(OH)2D], and related analytes and to evaluate their relationships to peripheral BMD as assessed by peripheral quantitative computed tomography (pQCT). Methods: Gluten-free diet (GFD)-treated, and untreated adult CeD patients naïve to vitamin D and calcium supplementation underwent measurements of serum 25(OH)D, 1,25(OH)2D, parathyroid hormone (PTH), total calcium, phosphate, and of radius BMD by pQCT. Results: Complete data were collected in 105 patients for lab tests and 87 patients for BMD. For lab tests, untreated CeD differed from treated CeD for 22.0% lower serum 25(OH)D (p = 0.023), 42.5% higher serum PTH (p < 0.001), and 13.0% higher serum 1,25(OH)2D (p = 0.029) in the presence of similar serum calcium and phosphorus (p > 0.35). For BMD, untreated CeD differed from treated CeD for lower diaphyseal cortical BMD (1133 and 1157 mg/cm3, p = 0.004) but not for distal BMD (total, trabecular, and subcortical, p > 0.13). Independent correlates of diaphyseal cortical BMD were GFD treatment and body mass index (p < 0.05). Conclusions: Data indicated that, compared to CeD patients on a gluten-free diet, untreated adult CeD patients at diagnosis had lower 25(OH)D, higher PTH, and higher 1,25(OH)2D in the absence of difference in serum calcium and phosphorus. 25(OH)D and 1,25(OH)2D, even below the normal range, were not associated with BMD. Our findings do not support the use of vitamin D supplementation for all CeD adults.

scholarly journals A266 IS A MULTIVITAMIN SUFFICIENT TO MEET NUTRITIOAL REQUIREMENTS IN CANADIAN ADULTS FOLLOWING A GLUTEN-FREE DIET?

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 143-144
Author(s):  
R Chibbar ◽  
D Weiten ◽  
K H Green ◽  
L Rigaux ◽  
C N Bernstein ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Calcium Supplementation ◽  
Gluten Free Diet ◽  
Nutritional Deficiencies ◽  
Gluten Free ◽  
Food Record ◽  
Time Points ◽  
Supplement Use ◽  
Funding Agencies ◽  
Dietary Supplement Use

Abstract Background Concerns exist regarding nutritional deficiencies and risk of metabolic syndrome in patients with celiac disease (CD) on a gluten-free diet (GFD). Aims This study assessed if patients with CD trying to follow a GFD meet Recommended Dietary Allowance (RDA) targets for macro- and micronutrients and the effect of supplement use in reaching RDA targets. Methods Adults (&gt;16 years) with biopsy confirmed CD (Marsh 3) were recruited within 6 weeks of starting a GFD. Participants prospectively completed a 3-day food record, including dietary supplement use, at 6, 12, and 24 months after study entry. Macro- and micronutrient consumption was determined using the Nutrition Coordinating Center Food & Nutrient Database (NCCDB), USDA National Nutrient Database for Standard Reference (USDA SR28), and CRON-O-Meter Community Database (CCDB). RDA targets were analyzed using a paired t-test and logistic regression, adjusted for age and sex. Results Forty-nine participants (71% female; mean age 49 years) completed interpretable food records at all time points. Most (59%) used supplements and supplement use was highest at 6 months (51%). Considering macronutrients, ≥88% met the RDA for carbohydrates and protein at each time point; however, only 44% met the target for fibre. Participants who took a supplement plus a multivitamin were significantly more likely than those who took only a multivitamin to meet the RDA for vitamins B12 and D. Fewer than 20% of those who took neither a multivitamin nor an iron supplement met the RDA, whereas ≥70% of those taking a multivitamin had adequate iron intake. Participants were significantly more likely to meet RDA targets for calcium with a supplement than with a multivitamin only. Even with supplementation, ≤55% met the RDA for folate. Conclusions There is a need for ongoing monitoring and dietician support for GFD treatment in CD. Adults with celiac disease met RDA targets for protein and carbohydrate, but not fibre. While specific calcium supplementation was required to meet RDA targets for calcium, a multivitamin was generally sufficient to meet RDA targets for iron, Vitamin B12 and D. Folate was below target at all time points even with supplementation. Funding Agencies CAG, CIHRNIH

scholarly journals Dermatomyositis Associated with Celiac Disease: Response to a Gluten-Free Diet

2006 ◽  
Vol 20 (6) ◽  
pp. 433-435 ◽  
Author(s):  
Min Soo Song ◽  
David Farber ◽  
Alain Bitton ◽  
Jeremy Jass ◽  
Michael Singer ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Adult Population ◽  
Gastrointestinal Symptoms ◽  
Human Leukocyte ◽  
Gluten Free Diet ◽  
Nutritional Deficiencies ◽  
Deficiency Anemia ◽  
Gluten Free ◽  
Disease Response ◽  
Vitamin Deficiencies

The association between dermatomyositis and celiac disease in children has been well documented. In the adult population, however, the association has not been clearly established. A rare case of concomitant dermatomyositis and celiac disease in a 40-year-old woman is presented. After having been diagnosed with dermatomyositis and iron deficiency anemia, this patient was referred to the gastroenterology clinic to exclude a gastrointestinal malignancy. Blood tests revealed various vitamin deficiencies consistent with malabsorption. The results of gastroscopy with duodenal biopsy were consistent with celiac disease. After she was put on a strict gluten-free diet, both nutritional deficiencies and the dermatomyositis resolved. The patient’s human leukocyte antigen haplotype study was positive for DR3 and DQ2, which have been shown to be associated with both juvenile dermatomyositis and celiac disease. It is suggested that patients with newly diagnosed dermatomyositis be investigated for concomitant celiac disease even in the absence of gastrointestinal symptoms.

Celiac Disease and the Gluten-Free Diet: Consequences and Recommendations for Improvement

2015 ◽  
Vol 33 (2) ◽  
pp. 175-182 ◽  
Author(s):  
Thimmaiah G. Theethira ◽  
Melinda Dennis
Keyword(s):  
Celiac Disease ◽  
Critical Role ◽  
Nutrition Therapy ◽  
Gluten Free Diet ◽  
Nutritional Deficiencies ◽  
Gluten Free ◽  
Immune Mediated ◽  
Macro And Micronutrients ◽  
Medical Nutrition

Background: Celiac disease (CD) is a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically susceptible individuals. CD-related enteropathy leads to multiple nutritional deficiencies involving macro- and micronutrients. Currently, medical nutrition therapy consisting of the gluten-free diet (GFD) is the only accepted treatment for CD. Key Messages: The GFD is the cornerstone of treatment for CD. Prior published studies have concluded that maintenance of the GFD results in improvement of the majority of nutritional deficiencies. In the past, counseling for CD focused mainly on the elimination of gluten in the diet. However, the GFD is not without its inadequacies; compliance to the GFD may result in certain deficiencies such as fiber, B vitamins, iron, and trace minerals. Paucity of fortified gluten-free foods may be responsible for certain deficiencies which develop on the GFD. Weight gain and obesity have been added to the list of nutritional consequences while on the GFD and have been partially attributed to hypercaloric content of commercially available gluten-free foods. Follow-up of patients diagnosed with CD after starting the GFD has been reported to be irregular and, hence, less than ideal. Conclusions: Monitoring of the nutritional status using blood tests and use of appropriate gluten-free supplementation are integral components in the management of CD. The ideal GFD should be nutrient-dense with naturally gluten-free foods, balanced with macro- and micronutrients, reasonably priced, and easily accessible. Rotation of the pseudo-cereals provides a good source of complex carbohydrates, protein, fiber, fatty acids, vitamins and minerals. Fortification/enrichment of commonly consumed gluten-free commercial grain products should be encouraged. Dietitians specializing in CD play a critical role in the education and maintenance of the GFD for patients with CD.

scholarly journals CELIAC DISEASE;

2017 ◽  
Vol 24 (08) ◽  
pp. 1253-1255
Author(s):  
Edip Erkus ◽  
Mehmet Zahid Kocak ◽  
Gulali Aktas ◽  
Haluk Savli
Keyword(s):  
Vitamin D ◽  
Immune Response ◽  
Celiac Disease ◽  
Vitamin D Deficiency ◽  
Elderly Woman ◽  
Autoimmune Disorder ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Latent Disease ◽  
Definition Of

Celiac Disease (CD) is an autoimmune disorder based on immune response togluten in genetically predisposed subjects. Five subtypes of CD has been described; classicaldisease, atypical disease, silent disease, latent disease, potential disease. Literature consistsat least five different definition of latent CD. We aimed to present a unique latent CD case inan elderly woman, who referred with anemia, hypoalbuminemia and vitamin D deficiency. Sheresponded well to initiation of gluten free diet.

scholarly journals The Gluten-Free Diet for Celiac Disease and Beyond

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3993
Author(s):  
Bara Aljada ◽  
Ahmed Zohni ◽  
Wael El-Matary
Keyword(s):  
Celiac Disease ◽  
Dermatitis Herpetiformis ◽  
Cognitive Disorders ◽  
Gluten Free Diet ◽  
Nutritional Deficiencies ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Immune Mediated ◽  
The Brain

The gluten-free diet (GFD) has gained popularity beyond its main medical indication as the treatment for gluten-induced immune-mediated disorders such as celiac disease (CD), dermatitis herpetiformis, gluten ataxia, wheat allergy, and non-celiac gluten sensitivity. However, the diet carries some disadvantages such as elevated costs, nutritional deficiencies, and social and psychological barriers. The present work aims to review indications, proven benefits, and adverse events of a gluten-free diet. Close follow-up with patients following the diet is recommended. More data is needed to assess the effectiveness of the diet in managing mental and cognitive disorders and to establish a connection between the brain and gluten.

The effect of celiac disease and gluten-free diet on pubertal development: a two-center study

2020 ◽  
Vol 33 (3) ◽  
pp. 409-415
Author(s):  
Nevzat Aykut Bayrak ◽  
Burcu Volkan ◽  
Belma Haliloglu ◽  
Soner Sertan Kara ◽  
Atilla Cayir
Keyword(s):  
Vitamin D ◽  
Celiac Disease ◽  
Pubertal Development ◽  
Tanner Stage ◽  
Gonadal Hormones ◽  
Gluten Free Diet ◽  
Age At Menarche ◽  
Gluten Free ◽  
Vitamin D Status ◽  
Healthy Individuals

AbstractObjectivesWe aimed to assess whether age at menarche and pubertal development (Tanner stage) are related to gluten-free diet (GFD) adherence, hormonal status, micro-nutrient levels and body mass index (BMI) in children with celiac disease (CD).MethodsIn this two-center, cross-sectional study, CD patients and healthy individuals were studied. CD patients were re-evaluated after 1 year of follow-up. Height, weight, Tanner stage, age at menarche and diet compliance were recorded. Blood samples for anti-tissue transglutaminase IgA (TTG), pituitary gonadotropins, gonadal hormones, prolactin and micronutrients (folate, vitamin B12, vitamin D, ferritin, iron and, iron-binding capacity [IBC]) were assayed.ResultsConsecutive age- and sex-matched 228 celiac patients (12.92 ± 2.35 years; 67.9% female) and 135 non-celiac healthy individuals (12.77 ± 2.25 years; 65.2% female) were studied. Tanner stage was significantly higher in the control group for both girls and boys (p < 0.05). The mean age at menarche was significantly lower in healthy individuals (13.13 ± 1.01 vs. 12.15 ± 0.97, p < 0.001). By multivariate analysis, GFD adherence, transferrin saturation (sTrf), total IBC (TIBC) and vitamin D status were found to be positively correlated with Tanner stage (p < 0.05). After 1 year, 192 of the CD patients were re-evaluated. GFD compliance was better (TTG levels: 135.59 ± 73.88 vs. 71.53 ± 69.40, p < 0.001) and it was correlated with Tanner stage (r = 0.49, p < 0.01), sTrf (r = 0.66, p < 0.01) and IBC (r = 0.23, p < 0.05).ConclusionsOur data show that adequate weight gain, adherence to GFD, sufficient iron and vitamin D status are essential factors for salubrious puberty in CD patients.

scholarly journals Beneficial Effect of Oligofructose-Enriched Inulin on Vitamin D and E Status in Children with Celiac Disease on a Long-Term Gluten-Free Diet: A Preliminary Randomized, Placebo-Controlled Nutritional Intervention Study

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1768 ◽  
Author(s):  
Natalia Drabińska ◽  
Urszula Krupa-Kozak ◽  
Paweł Abramowicz ◽  
Elżbieta Jarocka-Cyrta
Keyword(s):  
Vitamin D ◽  
Celiac Disease ◽  
Vitamin E ◽  
Nutritional Intervention ◽  
Optimal Level ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Complementary Method ◽  
Significant Difference ◽  
Fat Soluble Vitamins

Prebiotics have been shown to improve absorption of some nutrients, including vitamins. This pilot study evaluated the effect of the prebiotic oligofructose-enriched inulin (Synergy 1) on fat-soluble vitamins status, parathormone, and calcium-related elements in pediatric celiac disease (CD) patients (n = 34) on a strict gluten-free diet (GFD). Participants were randomized into a group receiving 10 g of Synergy 1 or placebo (maltodextrin) together with a GFD. At baseline and after 3 months of intervention, 25-hydroxyvitamin D [25(OH)D], parathormone, vitamin E and A, calcium, phosphate, magnesium, total protein, and albumin were determined. Concentration of 25(OH)D increased significantly (p < 0.05) by 42% in CD patients receiving Synergy 1 in GFD, whereas no change was observed in placebo. Vitamin D status reached an optimal level in 46% of patients receiving Synergy 1. No significant difference in parathormone, calcium, and phosphate levels was observed. Concentration of vitamin E increased significantly (p < 0.05) by 19% in patients receiving Synergy 1, but not in the placebo. Vitamin A levels were not changed. Supplementation of GFD with Synergy 1 improved vitamin D and vitamin E status in children and adolescents with CD and could be considered a novel complementary method of management of fat-soluble vitamins deficiency in pediatric CD patients.

scholarly journals The Role of Gluten-Free Diet in Rebalancing Micronutrient Deficiencies in Children With Celiac Disease

2020 ◽  
Vol 5 (1) ◽  
pp. 22-27
Author(s):  
Seyed Mohsen Dehghani ◽  
Anis Amirhakimi ◽  
Iraj Shahramian ◽  
Najmeh Rahanjam ◽  
Fatemeh Fazeli ◽  
...  
Keyword(s):  
Vitamin D ◽  
Celiac Disease ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Micronutrient Deficiencies ◽  
Medical Sciences ◽  
Normal Range ◽  
Before And After ◽  
The Status ◽  
The Mean

Introduction: Celiac disease (CD) is one of the most common reasons for malnutrition. This study aimed to determine the status of the micronutrients, including vitamins and minerals in children with CD. Methods: The participants of this study included children <18 years old newly diagnosed with CD from January 2016 to December 2017 in the Clinic of Gastrointestinal and Digestive Diseases affiliated with Shiraz University of Medical Sciences. The diagnosis of CD was based on serological and pathologic findings. Finally, the data was analyzed using SPSS 22. Results: In the present study, 78 children with CD were evaluated, including 30 (38.5%) males and 48 (61.5%) females. The levels of hemoglobin and iron significantly improved after 6 months of treatment (P=0.001). In the present study, the level of calcium was below the normal range in 5 (6.4%) patients at diagnosis. However, its level was within a normal range in all patients 6 months after the treatment. Based on the results, the level of phosphorus was low in 24 (30.7%) and 5 (6.4%) patients before and after the treatment, respectively (P=0.001). Further, the vitamin D level was below a normal range in 66 (84.6%) and 15 (19.2%) patients at diagnosis and 6 months after the treatment, respectively (P=0.001). On the other hand, the mean level of folic acid increased from 16.5 at diagnosis to 22.39 after 6 months of treatment (P=0.001). Finally, the mean level of zinc also increased from 73.3 at diagnosis to 81.6 after 6 months of treatment (P=0.001). Conclusion: In general, the levels of iron, folate, vitamin D, and zinc reduced in patients with CD. In most patients, these deficiencies improved by receiving a gluten-free diet (GFD). Monitoring patients with CD is recommended for the diagnosis of micronutrient deficiencies.

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