Study of adherence to the gluten-free diet in coeliac patients

Miaja, María Fernández; Martín, Juan José Díaz; Treviño, Santiago Jiménez; González, Maraelys Morales; García, Carlos Bousoño

doi:10.1016/j.anpede.2020.06.012

Cited by 12 publications

(9 citation statements)

References 29 publications

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“…Before generalizing this hypothesis to the whole CD population, some limitations of this study should be discussed. First, the proportion of non-adherent patients was similar to that previously reported [ 30 , 31 ] but still too low to analyze the relationship between adherence and densitometry modifications properly. Therefore, no inferences should be drawn from the apparent lack of correlation between non-adherence DXA parameters.…”

Section: Discussionsupporting

confidence: 70%

Evolution of bone densitometry parameters and risk of fracture in coeliac disease: a 10-year perspective

et al. 2023

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Background Metabolic bone disease is frequently found in patients with coeliac disease (CD). Despite its high prevalence, international guidelines are partially discordant about its management due to the lack of long-term data. Methods We retrospectively evaluated a large dataset of prospectively collected data of CD patients assessing the variation of DXA parameters and estimated fracture risk according to the FRAX® score in a 10-year follow-up. Incident fractures are reported, and the predictive ability of the FRAX® score is verified. Results We identified 107 patients with low bone density (BMD) at the diagnosis of CD and a 10-year follow-up. After improving at the first follow-up, T-scores slowly reduced over time but with no clinically relevant differences between the first and last examination (lumbar spine: from − 2.07 to − 2.07, p = 1.000; femoral neck: from − 1.37 to − 1.55, p = 0.006). Patients with osteoporosis at the index measurement had more marked fluctuations than those with osteopenia; the latter group also showed minimal modifications of the FRAX® score over time. Six incident major fragility fractures occurred, with a good predictive ability of the FRAX® (AUC 0.826). Conclusion Adult CD patients with osteopenia and no risk factors had substantially stable DXA parameters and fracture risk during a 10-year follow-up. A dilated interval between follow-up DXA for these patients could be considered to reduce diagnosis-related time and costs, maintaining a 2-year interval for patients with osteoporosis or risk factors.

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Section: Discussionsupporting

confidence: 70%

Evolution of bone densitometry parameters and risk of fracture in coeliac disease: a 10-year perspective

et al. 2023

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“…While compliance with a GFD tended to be high when initiated in childhood, the percentage of adolescents with CD who strictly adhered to a GFD varies widely, ranging from 40% to 81% [ 76 , 107 , 164 ]. Higher adherence rates were typically observed among patients diagnosed in childhood and those presenting with severe gastrointestinal symptoms [ 165 , 166 ]. However, studies have noted a decrease in dietary compliance among children above 9 years of age, with compliance rates dropping from 75.92% in children aged >2–5 years to 41.37% in those above 9 years [ 158 ].…”

Section: Discussionmentioning

confidence: 99%

“…Regarding disease-related factors, some studies found no association between adherence to the GFD and age at diagnosis [ 80 , 166 ]. However, others observed that at least 80% of patients diagnosed with CD before the age of 4 years adhere to the GFD, compared to only 36% of those diagnosed after 4 years of age [ 82 ].…”

Section: Discussionmentioning

confidence: 99%

Vulnerability in Children with Celiac Disease: Findings from a Scoping Review

Macedo,

Catarino,

Festas

et al. 2024

Children

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(1) Background: The scientific literature highlights that children diagnosed with celiac disease (CD) are at a heightened risk of experiencing physical, psychological, and social challenges, impacting their overall healthy childhood development. However, there remains a lack of a clear understanding regarding the factors that contribute to this vulnerability. The purpose of this study is to analyze and map the evidence on the sociopsychosomatic vulnerability of these children and identify gaps in this topic. (2) Methods: Following Joanna Briggs Institute’s guidelines for scoping reviews, we executed a detailed search of key electronic databases and explored the grey literature to capture a broad spectrum of studies. Our focus was on identifying research that looked into the multiple dimensions of vulnerability—physical, psychological, and social—in children with CD. We included a diverse range of study designs as well as systematic reviews, ensuring a comprehensive analysis. The selection process was stringent, utilizing clearly defined inclusion and exclusion criteria. (3) Results: We identified 61 studies that met our inclusion criteria. The review highlighted significant adverse health outcomes in children with CD and elucidated various individual and environmental determinants that influenced these vulnerabilities. It also underscored the lack of assessment tools to evaluate the risk of health problems in this population. (4) Conclusions: The findings underscore a critical need for further research to deepen our understanding of the vulnerabilities associated with CD in children. Developing targeted assessment tools will be crucial in stratifying health risks and enhancing care strategies for this vulnerable population.

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“…This finding was consistent with a study conducted in individuals with CD in Spain (92.5%). 48 According to a Spanish study, 72% of individuals with CD showed acceptable adherence which was associated with higher levels of self-efficacy. 49 Three studies from the UK showed that white patients were adhering to GFD in a range from 53 to 81%.…”

Section: Dietary Supplements Use and Typementioning

confidence: 99%

Nutritional status, nutrient imbalances, food-related behaviors and dietary supplements use among patients with celiac disease on a gluten free diet in Lebanon: a national cross-sectional study

et al. 2023

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Background: Celiac disease is an autoimmune disorder triggered by gluten, that occurs in susceptible individuals and is associated with dietary restriction and subsequent nutritional deficiencies. This study investigated the diet quality, nutrition imbalances and nutrition status among young children,adolescents and adults with CD who were referred to several hospitals in Lebanon. Methods: A cross-sectional study in 50 individuals (31.74 ± 15.64 years) with CD who follow a gluten free diet was conducted, using biochemical parameters, anthropometric measurements, dietary and physical activity assessments. Results: Of the 50 participants, 38% and 16% were presenting low serum levels of iron and vitamin B12, respectively. The majority of participants were physically inactive and around 40% of them had low muscle mass. A weight loss of 10% to 30% indicating mild to moderate malnutrition was shown in 14% of individuals. The assessment of food-related behaviors shows that 80% of participants were reading nutrition labels and 96% of them were following gluten-free diets (GFD). Some barriers including family ignorance (6%), language of the nutrition labels (20%) and expensive GF products (78%) were limiting the adherence to GFD. The inadequacy of the daily energy intake along with insufficient intakes of calcium and vitamin D were remarked among individuals with CD. However, protein and iron intake were exceeding the recommendations among all age groups, except in males aged 4-8 years and 19-30 years. Half the study participants were using dietary supplements where 38%, 10%, 46%, 18%, 16% and 4% used vitamin D, vitamin B12, iron, calcium, folate and probiotics, respectively. Conclusion: GFD is the key treatment for CD. However, it is not without inadequacies and may cause certain deficiencies such as calcium and vitamin D leading to reduced bone density. This underlines the critical role of dietitians in education and maintenance of healthy GFD among individuals with CD.

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Study of adherence to the gluten-free diet in coeliac patients

Cited by 12 publications

References 29 publications

Evolution of bone densitometry parameters and risk of fracture in coeliac disease: a 10-year perspective

Evolution of bone densitometry parameters and risk of fracture in coeliac disease: a 10-year perspective

Vulnerability in Children with Celiac Disease: Findings from a Scoping Review

Nutritional status, nutrient imbalances, food-related behaviors and dietary supplements use among patients with celiac disease on a gluten free diet in Lebanon: a national cross-sectional study

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