Cereal Consumption among Subjects with Celiac Disease: A Snapshot for Nutritional Considerations

Abstract

Background: To our knowledge no study has focused on the pattern of cereal-based products (CBP) consumption among people with celiac disease (CD). Our study aimed at evaluating the dietary intake of CBP among patients with CD and comparing it with a control population. Methods: Eighty-two volunteers with CD and 77 non-CD volunteers enrolled throughout Italy were asked to register their consumption of CBP on specific diaries for three days. Results: CD patients’ median three-day intake of biscuits and crackers was higher compared to controls (65.8 g vs. 22.7 g and 44.7 g vs. 10.6 g, p < 0.05 respectively, Mann–Whitney test). A significant difference was observed also comparing the two groups for median three-day bread consumption, with the CD group consuming less bread than controls (109.5 g vs. 150.7 g, p < 0.05, Mann–Whitney test). When assessing regional and gender-related CBP consumption patterns, significantly higher rice consumption was found among CD women from Northern Italy compared to CD women from Central and Southern Italy (p = 0.006 and p = 0.002 respectively, Fisher’s exact test). No other significant differences were observed. Conclusions: Our results provide a snapshot of the overall consumption of CBP among Italian subjects with CD. Altogether, these data show that, despite minor differences, dietary consumption of CBP among CD patients is similar to the general population.

A Review on the Gluten-Free Diet: Technological and Nutritional Challenges

“…Similar findings were reported by other researchers reporting food-record and questionnaire-based data from adults and children [ 125 , 126 , 127 , 128 ]. However, it is being questioned whether this trend is reflective of overall dietary habits rather than the gluten-free diet alone [ 125 , 129 ]. For example, while CD patients have been shown to share similar intake patterns of cereal-based products in general with the total population, biscuits and crackers are consumed more frequently among individuals with CD [ 129 ].…”

“…However, it is being questioned whether this trend is reflective of overall dietary habits rather than the gluten-free diet alone [ 125 , 129 ]. For example, while CD patients have been shown to share similar intake patterns of cereal-based products in general with the total population, biscuits and crackers are consumed more frequently among individuals with CD [ 129 ]. According to Valitutti et al [ 129 ], the popularity of these high GI products may also reflect consumer dissatisfaction with the palatability and availability of other gluten-free carbohydrate options, such as bread.…”

“…For example, while CD patients have been shown to share similar intake patterns of cereal-based products in general with the total population, biscuits and crackers are consumed more frequently among individuals with CD [ 129 ]. According to Valitutti et al [ 129 ], the popularity of these high GI products may also reflect consumer dissatisfaction with the palatability and availability of other gluten-free carbohydrate options, such as bread. Finally, inadequate intakes of iron, folate, calcium, selenium, magnesium, zinc, niacin, thiamine and riboflavin, as well as vitamins A and D were reported in CD patients following a gluten-free diet [ 125 , 126 , 127 , 130 , 131 , 132 ].…”

Association between Elevated TGA-IgA Titers and Older Age at Diagnosis with Absence of HBV Seroconversion in Celiac Children

“…On the other hand, pure oats [ 11 ] have been considered safe for celiac patients, both in children and adults, and also rice, corn, buckwheat, amaranth, millet, sorghum, and quinoa can be introduced in GFD as gluten-free cereals and pseudocereals. A strict GFD is often difficult to follow due to the risk of contamination—additionally, gravies and coatings used in food processing can often contain traces of gluten [ 12 ]. Nevertheless, such diets have often also been promoted by certain media in a sort of “celiac craze” in healthy subjects [ 13 ], following the wrong conception that removing gluten from any diet would yield positive effects on health.…”

Gluten Free Diet for the Management of Non Celiac Diseases: The Two Sides of the Coin

“…The glycemic index of GF products changes according to the type and quality of contained ingredients and to the procedures used to obtain them [ 42 ]. In addition, GF products have generally lower amounts of folate, iron, riboflavin, niacin and thiamine [ 43 ] and researchers in this field work to overcome these limits without altering their taste [ 44 ]. Therefore, as reported by Barone and colleagues [ 45 ], CD patients compared to healthy individuals, assume higher amounts of sugar and fat and lower quantities of fibers when they are on a GF diet, but this may depend on their different habits.…”