Update on nutritional aspects of gluten-free diet in celiac patients

A strict gluten - free diet is the only currently available therapeutic treatment for patients with celiac disease, an autoimmune disorder of the small intestine associated with a permanent intolerance to gluten proteins. In recent years, the dramatically prompted changes in the dietary habit of an increasingly large population (celiac disease, non - celiac gluten sensitivit y and gluten allergy) has resulted in rising demands for gluten - free products. Before starting gluten - free diet, alteration in intestinal absorption capacity of celiac patients involves deficiencies of nutrients, vitamins and dietary minerals. The habitual poor gluten - free food choices in addition to inherent deficiencies in the gluten - free diet of diagnosed celiac patients may relate with dietary inadequacies. Therefore dietary assessment and counseling at the time of celiac disease diagnosis and ongoing c are are crucial as well as fortification of gluten - free foods also need to be considered. This article reviews the nutritional aspects of gluten - free diet in celiac patients and provides an up - date of dietetic recommendations to correct these deficiencies and to ensure optimum gluten - free diet compliance

Celiac Disease and Migraine Headaches: Current Knowledge and Future Directions

Background: Migraine headaches and celiac disease are widespread problems affecting millions of patients worldwide.  Celiac disease is an autoimmune disease in which the consumption of gluten leads to the development of an abnormal immune response in the intestines and the atrophy of intestinal villi. The most characteristic clinical symptoms of celiac disease are gastrointestinal symptoms. Nevertheless, manifestations of the nervous system, including migraines, are also sometimes noted. A gluten-free diet is the only effective therapeutic approach for patients with celiac disease. It reduces symptoms and halts the progression of the disease. Neurological symptoms, including migraines, are frequent extraintestinal manifestations. In this study we aim to elaborate on current knowledge concerning both coexisting of migraines and celiac disease as well as effect of gluten free diet on headaches in patients with celiac disease, gluten intolerance and healthy individuals   Results: Headaches, especially migraines, are more common in patients suffering from celiac disease. Numerous studies indicate that a gluten-free diet may help in the treatment of headaches and is also an effective way to stop the progression of celiac disease. Conclusion: Migraine headaches are quite common in patients with celiac disease, and a gluten-free diet may help alleviate them. The findings suggest the need for increased awareness of the co-occurrence of these two conditions. A gluten-free diet is the only effective treatment for celiac disease and can stop progression of the disease. Further research is needed to determine the potential benefits of such a diet in patients with gluten intolerance or healthy individuals

The differences between the quality of life and personal health profile between individuals diagnosed with celiac disease and those who follow a gluten-free diet for non-celiac reasons

Background: Celiac disease is an autoimmune disorder triggered by gluten proteins in wheat, barley, and rye, necessitating a strict gluten-free diet. However, many individuals without celiac disease are adopting gluten-free diets for various health reasons. Purpose: This study compares the quality of life and health profile of individuals with celiac disease and those following a gluten-free diet for non-celiac reasons. Methods: A survey was conducted and distributed via social media to people diagnosed with celiac disease and those adhering to a gluten-free diet non-celiac. The results were analyzed via Google Forms and Excel to better interpret the data for visualization. Results: According to the survey, celiac disease patients experienced a lower quality of life, had strict dietary restrictions, and were better informed and less anxious. In contrast, non-celiac gluten/wheat-sensitive individuals reported a better quality of life, fewer diet restrictions, and improved overall health. Both groups faced micronutrient deficiencies, raising concerns about the nutritional value of gluten-free products. Conclusion: Understanding these differences is crucial for providing better healthcare and nutritional support for individuals adhering to gluten-free diets. However, the study has limitations due to self-reporting bias and small sample size, requiring further investigation to establish causative relationships

A Gluten-Free Diet, Not an Appropriate Choice without a Medical Diagnosis

In the past, only people diagnosed with celiac disease, approximately 1% of the population, avoided gluten consumption through all their meals. However, popular media often now mistakenly present gluten-free foods as being a healthier choice, and more people have now concluded that gluten is a harmful part of the diet. A review of literature on gluten-free diets, gluten sensitivity, celiac disease, and attitudes toward gluten consumption was undertaken to examine the prevalence and consequences of adopting a gluten-free diet and to provide guidance to healthcare practitioners whose patients are now often adopting this diet without medical input. Aside from celiac disease, nonceliac gluten sensitivity (NCGS) occurs in those persons in which gluten ingestion leads to symptomatic manifestations in the absence of celiac disease or wheat allergy but who report a remission of certain symptoms after removing gluten from their diet. However, it was been shown that a large percentage of people who claim NCGS do not feel those manifestations under a double-blind challenge to gluten. Moreover, some parents, believing that ingesting gluten is detrimental for their health, adopt gluten-free diets for their children. A review of existing data shows that there are detrimental effects to going gluten free, including loss of the dietary fiber, deficiencies in dietary minerals and vitamins, and potential heavy metal exposure. Healthcare practitioners should query patients about their dietary choices, and in cases of questionable adoption of gluten-free diet, patients and parents are educated about the detriments of a gluten-free diet, and in cases where patients continue to insist on gluten-free foods, referrals to nutritional counseling are warranted in order to minimize potential harm

Celiac disease and non-celiac gluten sensitivity – characteristics and differences

Introduction Celiac disease is a quite common condition resulting from the interaction of genetic, immunological, and environmental factors, with the main environmental factor being exposure to gluten. Non-celiac gluten sensitivity (NCGS) affects individuals without celiac disease or wheat allergy and is characterized by intestinal and extraintestinal symptoms related to the consumption of grain products, without accompanying damage to the intestinal mucosa. Discussion Gluten is a grain protein that is resistant to digestive enzymes and accumulates in the intestines, leading to tissue damage and the release of tissue transglutaminase 2 (tTG2) enzyme, which increases gluten immunogenicity. The presence of HLA-DQ2 or HLA-DQ8 gene variants in the genome is a necessary condition for the development of the disease, but it does not always lead to celiac disease. The pathomechanism of non-celiac gluten sensitivity is not yet fully understood. Diagnosis of celiac disease involves serological tests, genetic tests, and histological examination. Conclusions The only effective treatment for celiac disease is a strict gluten-free diet, which involves eliminating wheat, rye, barley, and triticale from one's diet. Further research is necessary to search for effective therapies. The approach for NCGS involves introducing an appropriate diet - either low FODMAP or gluten-free

Role of oats in celiac disease

A gluten-free diet is currently the only effective means of treating individuals with celiac disease. Such a diet enables celiac patients to control their symptoms and avoid various complications associated with this condition. However, while the quality of gluten-free foods has significantly improved during recent decades, maintenance of a gluten-free diet does not necessarily ensure adequate nutritional intake. Because oats are an important source of proteins, lipids, vitamins, minerals, and fibre, their inclusion in a gluten-free diet might improve the nutritional status of a celiac patient. Although oats are included in the list of gluten-free ingredients specified in European regulations, their safety when consumed by celiac patients remains debatable. Some studies claim that pure oats are safe for most celiac people, and contamination with other cereal sources is the main problem facing people with this disease. However, it is necessary to consider that oats include many varieties, containing various amino acid sequences and showing different immunoreactivities associated with toxic prolamins. As a result, several studies have shown that the immunogenicity of oats varies depending on the cultivar consumed. Thus, it is essential to thoroughly study the variety of oats used in a food ingredient before including it in a gluten-free diet

A Randomized Controlled Trial of an Online Intervention to Improve Gluten-Free Diet Adherence in Celiac Disease

Objectives: To test the effectiveness of an interactive online intervention to improve gluten free diet adherence in adults with celiac disease. Methods: A Randomized controlled trial was conducted. A total of 189 adults with biopsy-confirmed celiac disease were recruited and randomized to receive the intervention (n=101) or to a waitlist control condition (n=88). Post-intervention data was available for 70 intervention and 64 waitlist participants. Three month follow-up data was obtained for 46/50 completers from the intervention group. The primary outcome measure was gluten-free diet adherence. Secondary outcomes were gluten-free diet knowledge, quality of life and psychological symptoms. Results: Results were based on intention-to-treat analyses. The intervention group evidenced significantly improved gluten-free diet adherence, and gluten-free diet knowledge following the treatment period relative to the waitlist control group. The change in knowledge did not contribute to the change in adherence. These improvements were maintained at 3-month’ follow-up. Conclusions: The online program was effective in improving adherence and represents a promising resource for individuals with celiac disease who are struggling to achieve or maintain adequate gluten free diet adherence

Anthropometric Parameters in Celiac Disease: A Review on the Different Evaluation Methods and Disease Effects

Artigo completo publicado em periódicoThis review compiled anthropometric data from 29 original articles, published between 1995 and 2015, corresponding to a total sample of 6368 celiac disease subjects. Body mass index was the main parameter for measuring anthropometry (82.1%), followed by body mass (78.6%), body fat (51.7%), bone mineral density and bone mineral content (46.4%), and fat-free mass (44.8%). The main evaluation method was dual x-ray absorptiometry (83.3%), followed by bioimpedance (16.6%), skinfold thickness (16.6%), and isotope dilution (5.5%). This compilation suggests that celiac disease patients without a gluten-free diet (WGFD) and celiac disease patients with a gluten-free diet (GFD) show a lower body mass than the control group, with inconclusive data about WGFD versus GFD. Body mass index is lower in WGFD and GFD compared to control group, and is lower in WGFD compared to GFD. We observed lower values of FM and FFM in WGFD and GFD versus the control group. No difference was found between WGFD versus GFD. BMD and BMC are lower in WGFD versus GFD and GFD versus the control group, with inconclusive data about WGFD versus GFD. The findings of this review suggest that celiac disease patients must be periodically evaluated through anthropometric parameters, since the pathology has the potential to modulate such values even in a gluten-free diet, with these variables reflecting their healthy status. In parallel, the screening of different anthropometric assessment methodologies can provide support for more accurate evaluations by scientists and clinical professionals who work with celiac disease patients

The role of nutrtion in children with celiac disease

Celiac disease, a permanent, irreversible but treatable disease  is an autoimmune disease triggered by gluten ingestion in genetically predisposed individuals, also known as celiac sprue and gluten sensitive enteropathy.  Recent findingsIntestinal inflammation and villous atrophy in small intestines by permanent intolerance to gluten in celiac disesea leads to seveare malabsorption. About 20%-38%  patients were basically nutritionally imbalance secondary malabsorption due to mucosal damage. Nutrition plays a very important role in the management of celiac disease. Gluten free diet must be balanced to cover nutrient requirements to prevent deficiencies and ensure children’s health, growth and development.Conclusion Gluten-free diet is the only accepted and available treatment in CD. It was a life-long treatment, if not carried out with attention, it may lead to nutritional imbalance which can affect children’s growth and development

Exploring Factors of Non-Compliance for Adolescents with Celiac Disease

Individuals with celiac disease face many challenges when navigating the world around them. Adolescents with celiac disease must face the challenge of standing out in a world that is heavily influenced by peers and the pressure to fit in. The purpose of this project was to explore factors of non-compliance for adolescents with celiac disease. Using a qualitative design, two adolescent female volunteers participated in a focus group regarding factors in their lives that led them to not comply with the gluten-free diet. Data were analyzed and the focus group responses were then linked to previous related literature. The findings indicated that the respondents were in fact able to comply with the gluten-free diet based on the severity of their symptoms, support from others, knowledge of others about the gluten-free diet, and their own knowledge. These findings highlight the importance of support and knowledge and point out the need for a greater effort to offer continued support and research for celiac disease