Gluten‐Free Diet and Lipid Profile in Children With Celiac Disease

Forchielli, Maria Luisa; Fernicola, Paola; Diani, Lucia; Scrivo, Barbara; Salfi, Nunzio; Pessina, Achille C.; Lima, Mario; Conti, Veronica; Pession, Andrea

doi:10.1097/mpg.0000000000000785

Cited by 24 publications

(24 citation statements)

References 30 publications

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“…Another important, yet controversial issue, is the effect of a GFD in anthropometric parameters, in particular, the value of weight and BMI. Dyspepsia and malabsorption associated with progressing CD lead to malnutrition in quantitative and qualitative terms [ 32 , 33 ], which results, e.g., in both delayed growth and puberty [ 34 ]. Due to this, until recently, these patients were identified exclusively with low BMI.…”

Section: Discussionmentioning

confidence: 99%

“…Due to this, until recently, these patients were identified exclusively with low BMI. Currently, we know that over time CD may be accompanied by normal as well as excessive body mass, or even by obesity [ 35 , 36 , 37 ], because a GFD may contain both a high energy and high fat load [ 32 ]. The effects of a GFD, related to BMI vary greatly.…”

Section: Discussionmentioning

confidence: 99%

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The Relationship between Body Composition and a Gluten Free Diet in Children with Celiac Disease

et al. 2018

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The primary and proven therapy, in cases of celiac disease (CD), is a rigorous gluten-free diet (GFD). However, there are reports of its negative effects in the form of nutritional deficiencies, obesity, and adverse changes in body composition. The study aimed to assess the impact of a GFD on the body composition of children with CD. In a case-controlled study (n = 41; mean age 10.81 y; SD = 3.96) children with CD, in various stages of treatment, underwent medical assessment. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. More than half of the examined children (n = 26) followed a GFD. CD children had significantly higher mean values of the fat free mass (FFM% = 80.68 vs. 76.66, p = 0.015), and total body water (TBW% = 65.22 vs. 60.47, p = 0.012), and lower mean values of the fat mass (FM% = 19.32 vs. 23.34, p = 0.015). Children who were on a GFD presented slightly higher, but not statistically significant, mean values of FM and FFM, than children who did not follow dietary recommendations (FM [kg] = 7.48 vs. 5.24, p = 0.064; FM% = 20.81 vs. 16.73, p = 0.087; FFM [kg] = 28.19 vs. 22.62, p = 0.110). After minimum one year of a GFD, CD children showed significantly higher values of FFM [kg] (p = 0.001), muscle mass (MM) [kg] (p < 0.001), TBW [L] (p < 0.001) and body cell mass (BCM) [kg] (p < 0.001). Furthermore, CD children who were on a GFD presented a significantly higher increase in weight (p = 0.034) and body mass index (BMI) (p = 0.021). The children adhering to a GFD demonstrate a tendency towards higher indices of selected body composition components.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Relationship between Body Composition and a Gluten Free Diet in Children with Celiac Disease

et al. 2018

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“…They found that mean total cholesterol and LDL-C did not significantly change, while mean HDL-C significantly rose and mean triglyceride levels significantly decreased after the diet, suggesting that GFD may positively influence lipid profile. Recently, in a cross-sectional prospective study, Forchielli et al[ 31 ] analyzed the impact of GFD on serum lipid concentrations in children with CD compared with the general pediatric population. They studied 235 CD children and adolescents: In 205 patients the lipid profile was available only after diagnosis (group 1), whereas in 30 patients it was available both before and after GFD (group 2).…”

Section: Serum Lipidsmentioning

confidence: 99%

“…In group 2, total cholesterol did not change over time, triglycerides diminished, and HDL-C increased. They therefore suggested that GFD, being appropriate in terms of fibers and unsatured fats[ 31 ], may have a positive influence on lipid profiles, determining higher HDL-C in CD children than in the reference population.…”

Section: Serum Lipidsmentioning

confidence: 99%

Cardiometabolic risk factors in children with celiac disease on a gluten-free diet

Anania¹,

Pacifico²,

Olivero³

et al. 2017

WJCP

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Celiac disease (CD) is an immune-mediated systemic condition evoked by gluten and related prolamines in genetically predisposed subjects. It is characterised by a variable combination of gluten-dependent clinical symptoms, CD-specific antibodies, HLA-DQ2 and HLA-DQ8 haplotypes, and enteropathy. The only therapy of CD consists of a life-long gluten free diet (GFD). Strict GFD adherence results in full clinical, serological and histological remission, avoiding long-term complications in CD patients. However, this diet is not without problems. Gluten free products have high levels of lipids, sugar and salt to improve food palatability and consistency, and subjects with CD show an excessive consumption of hypercaloric and hyperlipidic foods to compensate dietetic restriction. GFD may therefore have a negative impact on cardiometabolic risk factors such as obesity, serum lipid levels, insulin resistance, metabolic syndrome, and atherosclerosis. In adults, some studies have suggested that GFD have a beneficial effect on cardiovascular profile, whereas others have shown an atherogenic effect of GFD. In children, very few studies are available on the issue. Thus, the aim of the present narrative review was to analyze the current clinical evidence on the impact of GFD on cardiometabolic risk factors in children with CD.

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“…However, it has been described as potentially unhealthy due to the extensive presence of fat and calories [1][2][3][4][5][6][7][8]. This extensive intake can change body mass index (BMI) and modify lipid profiles, with mixed results indicating potential early atherosclerosis development in adults and children, but also improvements in high-density lipoprotein (HDL) levels [9][10][11][12][13][14][15][16][17][18]. Little is known about changes in dietary habits before and during GFD.…”

Section: Introductionmentioning

confidence: 99%

Gluten Deprivation: What Nutritional Changes Are Found During the First Year in Newly Diagnosed Coeliac Children?

et al. 2019

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Aim: A gluten-free diet (GFD) can expose children to excessive calories and fat intake. The study is intended to verify whether and how food intake, laboratory parameters, and growth are modified by a year of GFD. Methods: In 79 CD (coeliac disease) children (mean age 7.9 ± 3.8 years, 52 females, 27 males) diagnosed over 24 months, 24-h food diaries, food-frequency patterns, anthropometric and laboratory parameters (mainly blood sugar, insulin, lipid profile, and homocysteine) were prospectively collected before and during the first year of GFD. Nutrient intakes were compared over time and with recommendations. They were also used as regressors to explain the levels and changes of metabolic and growth variables. p-values < 0.05 were considered statistically significant. Results: Average macronutrient intake did not change during the year. Caloric intake remained below 90% (p ≤ 0.0001) and protein intake above 200% (p ≤ 0.0001) of recommendations. Lipid intake was stable at 34% of overall energy intake. Unsaturated fats increased (less omega-6 and more omega-3 with a ratio improvement from 13.3 ± 5.5 to 8.8 ± 3.1) and so did fibers, while folate decreased. The children who experienced a containment in their caloric intake during the year, presented a slower catch-up growth. Some differences were found across gender and age groups. In particular, adolescents consumed less calories, and females more omega-3. Fiber and simple sugar intakes emerged as implicated in lipid profile shift: fibers negatively with triglycerides (TG) (p = 0.033), simple sugars negatively with high-density lipoprotein (HDL) (p = 0.056) and positively with TG (p = 0.004). Waist-to-height ratio was positively associated with homocysteine (p = 0.018) and Homeostasis Model Assessment (p = 0.001), negatively with fibers (p = 0.004). Conclusion: In the short run, GFD is nutritionally very similar to any diet with gluten, with some improvements in unsaturated fats and fiber intake. Along with simple sugars containment, this may offer CD patients the opportunity for a fresh start. Caloric intakes may shift and should be monitored, especially in adolescents.

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Gluten‐Free Diet and Lipid Profile in Children With Celiac Disease

Abstract: Lipid profiles of children with CD differ across sexes and from reference population. GFD, being unexpectedly appropriate in fibers and fat proportion, may be a contributor.

Cited by 24 publications

References 30 publications

The Relationship between Body Composition and a Gluten Free Diet in Children with Celiac Disease

The Relationship between Body Composition and a Gluten Free Diet in Children with Celiac Disease

Cardiometabolic risk factors in children with celiac disease on a gluten-free diet

Gluten Deprivation: What Nutritional Changes Are Found During the First Year in Newly Diagnosed Coeliac Children?

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