Journal ArticleDOI
Nutritional inadequacies of the gluten-free diet in both recently-diagnosed and long-term patients with coeliac disease
TLDR
Dietary inadequacies are common and may relate to habitual poor food choices in addition to inherent deficiencies in the GFD, and dietary education should also address the achievement of adequate micronutrient intake.Abstract:
Background
Life-long gluten-free diet (GFD) is the only recognised treatment for coeliac disease (CD). The present study aimed to determine the nutritional adequacy of the ‘no detectable gluten’ diet.
Methods
Seven-day prospective food intake was assessed in 55 patients who were adherent to a GFD for more than 2 years and in 50 newly-diagnosed age- and sex-matched patients (18–71 years, 24% male) studied prospectively over 12 months on GFD. Historical precoeliac intake was also assessed in the latter group. Intake was compared with Australian Nutritional Recommendations and the Australian population data.
Results
Nutritional intake was similar between groups. Of macronutrients, only starch intake fell over 12 months (26% to 23%, P = 0.04). Fibre intake was inadequate for all except in diet-experienced men. More than one in 10 of both newly-diagnosed and experienced women had inadequate thiamin, folate, vitamin A, magnesium, calcium and iron intakes. More than one in 10 newly-diagnosed men had inadequate thiamin, folate, magnesium, calcium and zinc intakes. Inadequate intake did not relate to nutrient density of the GFD. Inadequacies of folate, calcium, iron and zinc occurred more frequently than in the Australian population. The frequency of inadequacies was similar pre- and post-diagnosis, except for thiamin and vitamin A, where inadequacies were more common after GFD implementation.
Conclusions
Dietary intake patterns at 12 months on a GFD are similar to longer-term intake. Dietary inadequacies are common and may relate to habitual poor food choices in addition to inherent deficiencies in the GFD. Dietary education should also address the achievement of adequate micronutrient intake. Fortification of GF foods also need to be considered.read more
Citations
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Journal ArticleDOI
Gluten free diet and nutrient deficiencies: A review
TL;DR: GF-diet was found to be poor in alimentary fiber due in particular to the necessary avoidance of several kinds of foods naturally rich in fiber and the low content of fiber of GF product that are usually made with starches and/or refined flours.
Journal ArticleDOI
Nutritional differences between a gluten-free diet and a diet containing equivalent products with gluten.
TL;DR: Calorie and nutrient intake in a GF diet is different when compared to its equivalent diet with gluten, and differences in calorie, macronutrient, fiber, sodium, salt and cholesterol content between GF rendered and gluten-containing foodstuffs are pointed out.
Journal ArticleDOI
Maternal Diet and Nutrient Requirements in Pregnancy and Breastfeeding. An Italian Consensus Document
Franca Marangoni,Irene Cetin,Elvira Verduci,Giuseppe Canzone,Marcello Giovannini,Paolo Scollo,Giovanni Corsello,Andrea Poli +7 more
TL;DR: The risk of not reaching the adequate nutrient supply is increased for selected groups of women of childbearing age: those following exclusion diets, underweight or overweight/obese, smokers, adolescents, mothers who have had multiple or close pregnancies, and those with previous unfavorable pregnancy outcomes.
Journal ArticleDOI
Gluten-Free Diet: Gaps and Needs for a Healthier Diet.
TL;DR: The nutritional profile of gluten-free-rendered products currently available on the market is reviewed, and the possible relationship thereof with the nutritional status of coeliac patients on a GFD is discussed.
Journal ArticleDOI
NASPGHAN Clinical Report on the Diagnosis and Treatment of Gluten-related Disorders.
Ivor D. Hill,Alessio Fasano,Stefano Guandalini,Edward J. Hoffenberg,Joseph Levy,Norelle R. Reilly,Ritu Verma +6 more
TL;DR: This clinical report will compare and contrast the manifestations of gluten-related disorders, emphasize the importance of differentiating between these conditions, discuss initial and subsequent tests needed to confirm the diagnosis, and provide recommendations on treatment and follow-up for each condition.
References
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Gluten, major histocompatibility complex, and the small intestine: A molecular and immunobiologic approach to the spectrum of gluten sensitivity (‘celiac sprue’)
TL;DR: The nature and basis of nonresponsive celiac sprue require more thoughtful initiatives to elucidate the immunologic mechanism(s) of unresponsiveness and evaluate possible means of reversal.
Journal ArticleDOI
Current approaches to diagnosis and treatment of celiac disease: An evolving spectrum☆
Alessio Fasano,Carlo Catassi +1 more
TL;DR: The current gold standard for the diagnosis of CD remains histologic confirmation of the intestinal damage in serologically positive individuals, and the keystone treatment of CD patients is a lifelong elimination diet in which food products containing gluten are avoided.
Journal ArticleDOI
Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition.
Ivor D. Hill,Martha H. Dirks,Gregory S. Liptak,Richard B. Colletti,Alessio Fasano,Stefano Guandalini,Edward J. Hoffenberg,Karoly Horvath,Joseph A. Murray,Mitchell Pivor,Ernest G. Seidman +10 more
TL;DR: It is recommended that children and adolescents with symptoms of celiac disease or an increased risk for Celiac disease have a blood test for antibody to tissue transglutaminase (TTG), and that those with an elevated TTG be referred to a pediatric gastroenterologist for an intestinal biopsy and treated with a strict gluten-free diet.