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.

scholarly journals The impact of symptoms on quality of life before and after diagnosis of coeliac disease: the results from a Polish population survey and comparison with the results from the United Kingdom

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emilia Majsiak ◽  
Magdalena Choina ◽  
Dominik Golicki ◽  
Alastair M. Gray ◽  
Bożena Cukrowska
Keyword(s):  
Quality Of Life ◽  
United Kingdom ◽  
Coeliac Disease ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
The United Kingdom ◽  
Before And After ◽  
The Mean ◽  
The Uk

Abstract Background Coeliac disease (CD) is characterised by diverse clinical symptoms, which may cause diagnostic problems and reduce the patients’ quality of life. A study conducted in the United Kingdom (UK) revealed that the mean time between the onset of coeliac symptoms and being diagnosed was above 13 years. This study aimed to analyse the diagnostic process of CD in Poland and evaluate the quality of life of patients before and after CD diagnosis. In addition, results were compared to the results of the original study conducted in the UK. Methods The study included 2500 members of the Polish Coeliac Society. The patients were asked to complete a questionnaire containing questions on socio-demographic factors, clinical aspects and quality of life, using the EQ-5D questionnaire. Questionnaires received from 796 respondents were included in the final analysis. Results The most common symptoms reported by respondents were bloating (75%), abdominal pain (72%), chronic fatigue (63%) and anaemia (58%). Anaemia was the most persistent symptom, with mean duration prior to CD diagnosis of 9.2 years, whereas diarrhoea was observed for the shortest period (4.7 years). The mean duration of any symptom before CD diagnosis was 7.3 years, compared to 13.2 years in the UK. CD diagnosis and the introduction of a gluten-free diet substantially improved the quality of life in each of the five EQ-5D-5L health dimensions: pain and discomfort, anxiety and depression, usual activities, self-care and mobility (p < 0.001), the EQ-Index by 0.149 (SD 0.23) and the EQ-VAS by 30.4 (SD 28.3) points. Conclusions Duration of symptoms prior to the diagnosis of CD in Poland, although shorter than in the UK, was long with an average of 7.3 years from first CD symptoms. Faster CD diagnosis after the onset of symptoms in Polish respondents may be related to a higher percentage of children in the Polish sample. Introduction of a gluten-free diet improves coeliac patients’ quality of life. These results suggest that doctors should be made more aware of CD and its symptoms across all age groups.

scholarly journals Micronutrients Dietary Supplementation Advices for Celiac Patients on Long-Term Gluten-Free Diet with Good Compliance: A Review

Medicina ◽  
2019 ◽  
Vol 55 (7) ◽  
pp. 337 ◽  
Author(s):  
Rondanelli ◽  
Faliva ◽  
Gasparri ◽  
Peroni ◽  
Naso ◽  
...  
Keyword(s):  
Vitamin D ◽  
Folic Acid ◽  
Vitamin B12 ◽  
Dietary Supplementation ◽  
Research Strategy ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Micronutrient Deficiencies ◽  
Good Compliance

Background and objective: Often micronutrient deficiencies cannot be detected when patient is already following a long-term gluten-free diet with good compliance (LTGFDWGC). The aim of this narrative review is to evaluate the most recent literature that considers blood micronutrient deficiencies in LTGFDWGC subjects, in order to prepare dietary supplementation advice (DSA). Materials and methods: A research strategy was planned on PubMed by defining the following keywords: celiac disease, vitamin B12, iron, folic acid, and vitamin D. Results: This review included 73 studies. The few studies on micronutrient circulating levels in long-term gluten-free diet (LTGFD) patients over 2 years with good compliance demonstrated that deficiency was detected in up to: 30% of subjects for vitamin B12 (DSA: 1000 mcg/day until level is normal, then 500 mcg), 40% for iron (325 mg/day), 20% for folic acid (1 mg/day for 3 months, followed by 400–800 mcg/day), 25% for vitamin D (1000 UI/day or more-based serum level or 50,000 UI/week if level is <20 ng/mL), 40% for zinc (25–40 mg/day), 3.6% of children for calcium (1000–1500 mg/day), 20% for magnesium (200–300 mg/day); no data is available in adults for magnesium. Conclusions: If integration with diet is not enough, starting with supplements may be the correct way, after evaluating the initial blood level to determine the right dosage of supplementation.

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 Comparison of Dietary Acid Load Score Between Celiac Patients and healthy Population

2020 ◽  
Author(s):  
Zeinab Nikniaz ◽  
Reza Mahdavi ◽  
Leila Nikniaz ◽  
Masood Shirmohammadi ◽  
Mojgan Akhavan Sabbagh
Keyword(s):  
Celiac Disease ◽  
General Population ◽  
Gluten Free Diet ◽  
Healthy Population ◽  
Gluten Free ◽  
Dietary Acid Load ◽  
Dietary Acid ◽  
Acid Load ◽  
The Mean ◽  
Dietary Data

Abstract Background: Considering the presence of different complications in celiac patients and also limitations of the gluten-free diet (GFD), we intended to assess the diet quality in patients with celiac disease. In this regard, in the present study, we assessed the dietary acid load in adult celiac patients and compare it with that of the healthy population to provide more specific dietary recommendations for celiac patients. Methods: This study was a cross-sectional study that includes 130 celiac patients and 462 Non-celiac population. The 80-item semi-quantitative food frequency questionnaire was used to obtain dietary data. Based on dietary data, the dietary acid load (DAL), Potential renal net acid load (PRAL), and net endogenous acid production (NEAP) were calculated. Results: The mean PRAL value is negative in the celiac group and it was positive in the general population. There was a significant difference in the PRAL score between celiac patients and the general population (p<0.001). The mean NEAP and DAL score were significantly lower in the celiac group compared with the healthy population (P<0.001). There were no significant differences between gluten-free diet adherents and non-adherents regarding the PRAL, NEAP, and DAL values (P>0.05). Conclusion: We showed that the patients with celiac disease had significantly less acidogenic diet compared with that of the general population. Considering the health benefits of a less acidogenic diet, following a gluten-free diet, could have added value to celiac patients and besides the elimination of symptoms, it could also prevent other complications in these patients.

scholarly journals NUTRITIONAL STATUS AND MICRONUTRIENT LEVELS OF CHILDREN WITH CELIAC DISEASE BEFORE AND AFTER GLUTEN FREE DIET

2006 ◽  
Vol 13 (01) ◽  
pp. 145-150
Author(s):  
HINA AYESHA ◽  
Muhammed Asghar Butt ◽  
MUHAMMED SHAMOON ◽  
Maqbool Ahmed ◽  
BUSHRA NAZIR ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Nutritional Status ◽  
Serum Zinc ◽  
Gluten Free Diet ◽  
Control Group ◽  
Inflammatory Disorder ◽  
Healthy Children ◽  
Gluten Free ◽  
Trace Mineral ◽  
Before And After

Introduction: Celiac disease is an autoimmune inflammatory disorder ofsmall intestine precipitated by ingestion of gluten. Clinical and histological improvement occurs on withdrawal of glutenfrom the diet. Objectives: The present study were to identify the trace mineral deficiency in newly diagnosed celiacchildren and to assess how far these deficiencies are corrected after strict gluten free diet. The study also assessedthe nutritional status of celiac children compared to the healthy controls before and after Gluten Free Diet. Setting:Department of Pediatrics Punjab Medical College Faisalabad. Duration: January 2004 to March 2005. Study Design:Interventional case control study. Patients and Methods: 22 children aged 2 to 14 years diagnosed as Celiac diseaseon the basis of typical intestinal biopsy findings were included. 15 healthy children served as controls. Anthropometricmeasurements and serum Zinc Copper Magnesium and Iron along with albumin were done for both patients andcontrols initially and repeated after 6 months while patients were receiving strict GFD and controls receiving normaldiet. The general linear model was used for the analysis of variance using SPSS (2004). Results: Serum Zinc wasbelow the reference range in 68%. Serum copper and Magnesium in 31%, Iron in 95%and albumin in 59% of thepatients. There was a statistically significant increase in serum zinc, iron and magnesium levels (p value, < 0 05) whileserum copper and albumin did not show any significant rise after Gluten free diet. Control group did not show any significant change in their trace mineral levels .Celiac patients gained more weight (mean 4.47 versus 2.91 cm) andheight (3.34cm versus 1.022 cm) as compared to the control group. Conclusion: Celiac children receiving strict Glutenfree diet and showing good clinical response probably do not need mineral supplementation.

P0428 CARDIAC SYMPATHETIC AND PARASYMPATHETIC BALANCE BEFORE AND AFTER GLUTEN FREE DIET IN CHILDREN WITH CELIAC DISEASE

2004 ◽  
Vol 39 (Supplement 1) ◽  
pp. S218 ◽  
Author(s):  
M. Barbato ◽  
F. Viola ◽  
M. Curione ◽  
S. Di Bona ◽  
A. Ambrosini ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Before And After

Role of Dietary Gluten in Development of Celiac Disease and Type I Diabetes: Management Beyond Gluten-Free Diet

2020 ◽  
Vol 27 (21) ◽  
pp. 3555-3576
Author(s):  
Jinli Pei ◽  
Shuangshuang Wei ◽  
Yechun Pei ◽  
Hao Wu ◽  
Dayong Wang
Keyword(s):  
Celiac Disease ◽  
Diabetes Management ◽  
Type I Diabetes ◽  
Human Leukocyte ◽  
Gluten Free Diet ◽  
Type I ◽  
Gluten Free ◽  
Micronutrient Deficiencies ◽  
Wheat Varieties ◽  
Nonalcoholic Fatty Liver

Gluten triggers Celiac Disease (CD) and type I diabetes in genetically predisposed population of human leukocyte antigen DQ2/DQ8+ and associates with disorders such as schizophrenia and autism. Application of a strict gluten-free diet is the only well-established treatment for patients with CD, whereas the treatment for patients with celiac type I diabetes may be depend on the timing and frequency of the diet. The application of a gluten-free diet in patients with CD may contribute to the development of metabolic syndrome and nonalcoholic fatty liver disease and may also lead to a high glycemic index, low fiber diet and micronutrient deficiencies. The alteration of copper bioavailability (deficient, excess or aberrant coordination) may contribute to the onset and progress of related pathologies. Therefore, nutrient intake of patients on a gluten-free diet should be the focus of future researches. Other gluten-based therapies have been rising with interest such as enzymatic pretreatment of gluten, oral enzyme supplements to digest dietary gluten, gluten removal by breeding wheat varieties with reduced or deleted gluten toxicity, the development of polymeric binders to suppress gluten induced pathology.

The impact of a gluten-free diet on the growth pattern of Saudi children with celiac disease

2021 ◽  
pp. 1-17
Author(s):  
Omar Ibrahim Saadah
Keyword(s):  
Celiac Disease ◽  
Growth Pattern ◽  
Laboratory Data ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Z Score ◽  
The Mean ◽  
The Impact ◽  
Igfbp 3

Objective: To describe the growth pattern of children with celiac disease (CD) after introduction of a gluten-free diet (GFD). Methods: In this retrospective, children 2–16 years old with biopsy-proven CD in 2015–2018 were included in the study conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Serial measurements of height-for-age z-score (HAZ) and weight-for-age z-score (WAZ), were recorded at 0, 4, 8, 12, and 16 months. Data on insulin-like growth hormone-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) obtained at diagnosis and during follow-up were retrieved. Clinical, demographic, and laboratory data were extracted from patients' medical files. Results: The median age for the patients was 8.9 years (range, 2.4–16 years). Males constituted 53.2%. The mean WAZ at diagnosis was -2.8±1.9 and the mean HAZ was -3±0.99. Trend analysis indicated a significant time effect for WAZ (p<0.001) and for HAZ (p<0.001). The mean IGF-1 was 133.4±96.8 ng/ml and the mean IGFBP-3 was 3174±1081 ng/ml. There was significant increase in the secretion of IGF-1 (p=0.01) and IGFBP-3 (p=0.004) during the first 8 months of a GFD. Conclusion: The administration of a GFD for Saudi children with CD normalizes their growth parameters within 16 months of follow-up and improves the endogenous secretion of growth factors. Keywords: Celiac disease, growth, child, Continuous...

Serodiagnosis of Celiac Disease in Children Referred for Evaluation of Anemia: A Pediatric Hematology Unit’s Experience.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1665-1665
Author(s):  
R.K. Marwaha ◽  
Deepak Bansal ◽  
Amita Trehan ◽  
Akash Patel
Keyword(s):  
Celiac Disease ◽  
Small Bowel ◽  
Tissue Transglutaminase ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Indian States ◽  
Duration Of Symptoms ◽  
Pulmonary Hemosiderosis ◽  
Proximal Small Bowel ◽  
The Mean

Abstract Celiac disease (CD) is a malabsorptive disorder wherein the proximal small bowel mucosa is damaged as a result of dietary exposure to gluten. Children with intractable diarrhea and failure to thrive are diagnosed with relative ease. Diagnosis can however be challenging and is often delayed when children present with ‘difficult to treat anemia’, without overt gastrointestinal manifestations. The case records of 77 patients with CD were scrutinized retrospectively. Diagnosis was established with serology (tissue transglutaminase-IgA assay) in 46 (59.7%), serology along with small bowel mucosal biopsy in 23 (29.9%) and with biopsy alone in the remaining 8 (10.4%). All children belonged to the predominantly wheat consuming northern Indian states. The mean age at presentation was 99.1±34.8 months (median: 102, range: 22–168). Males outnumbered females in a ratio of 1.96:1. The mean duration of symptoms was 41±31.2 months (median: 36, range: 1–132). The overwhelming majority, i.e., 75 (97.4%) children had anemia (Hemoglobin <11 g/dL). Mean hemoglobin (Hb) was 7.0±2.2 g/dL (median: 7.2, range: 2.3–12.5). 52 (67.5%) had received iron supplements for sufficient lengths, without benefit. The red cell morphology was microcytic hypochromic in 37 (48%) and dimorphic in 33 (42.9%). A history of diarrhea was not forthcoming in 32 (41.6%) cases. 59 (76.6%) were malnourished, with a weight less than 80 % of expected for the age and 30 (39 %) were stunted, with a height falling below the 90% of expected. Two children had skin bleeds secondary to coagulopathy, due to Vitamin K malabsorption. In another 2, recurrent anemia was attributed to pulmonary hemosiderosis; further investigations for secondary causes unearthed CD. All children were initiated on an austere gluten free diet, along with iron and folic acid supplements for the initial 6–9 months. Mean duration of follow was 17.7±20.9 months. Improvement was perceptible within days of initiating gluten free diet. Of the 38 (49.4%) children who had a follow up of a year or longer, the mean Hb at the last visit had risen to 12.9±1.2 g/dL. Conclusions: Hematologists need to be aware of the mono-symptomatic presentation of CD with anemia. The typical period of presentation of CD is described to be between 6 mo and 2 yr of age. Prolonged duration of symptoms and a diagnosis at a relatively older age is striking in the index study. In a suggestive clinical background, identification of CD with serodiagnosis alone, without resorting to small bowel biopsy is increasingly gaining acceptance, as the specificity of newer serological assays is 95–98%. This is particularly true in tropical countries, where some degree of flattening of villi may be attributed to malnutrition and or infections, such as rotavirus enteritis, Giardia lamblia, or tropical sprue. A biopsy may be misleading in such cases. Heightened awareness is essential to identify CD at an early age, especially, in children in whom anemia is the dominant manifestation. The benefits of gluten free diet are apparent with the rise in hemoglobin and the improvement in growth parameters are gratifying both for physicians and the caretakers.

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