Body composition in children with celiac disease and the effects of a gluten-free diet: a prospective case-control study

Abstract

Background: Celiac disease is the most common cause of malnutrition in children of Western countries. Objective: The objective was to measure body composition in children at the time celiac disease was diagnosed and after consumption of a gluten-free diet (GFD). Design: We assessed body composition by dual-energy X-ray absorptiometry in 29 children and adolescents with a mean (± SD) age of 9.5 ± 3.4 y at the time celiac disease was diagnosed and in a subset of 20 patients after 1.2 ± 0.2 y of a GFD. We also studied 23 patients aged 21.2 ± 4.6 y who consumed a GFD for 10.6 ± 4.5 y. Each patient was matched with a healthy control subject of the same age and sex. Results: Untreated patients weighed less than control subjects (P = 0.04). Fat mass and bone mineral content were lower in the patients than in the control subjects (P < 0.01), as was lean mass of the limbs (P = 0.0013). After Ϸ1 y of the GFD, there were no significant differences in body-composition values between patients and control subjects. Similarly, body-composition values of celiac disease patients who consumed the GFD long term were comparable with those of healthy subjects. Conclusions: Remarkable abnormalities in body composition were found in children at the time of diagnosis of celiac disease. Appropriate dietary treatment reverses body-composition abnormalities quickly and the beneficial effects of gluten withdrawal are persistent. Because these results are harder to achieve if celiac disease is first diagnosed in adulthood, efforts to encourage early diagnosis of celiac disease should be made.Am J Clin Nutr 2000;72:71-5.

Screening for Celiac Disease in Children With Type 1 Diabetes

“…However, the authors did not characterize the symptoms of their patients, and the celiac and control groups were not matched for age, sex, or pubertal status. A follow-up study (21) by the same investigative group found a 19% decrease in total body bone mineral content (assessed by dual-energy X-ray absorptiometry) in a heterogeneous group of celiac children and adolescents that included patients with symptomatic disease.…”

Prevalence of low bone mineral density in children and adolescents with celiac disease under treatment

“…20 In general, patients who follow a gluten-free diet without straying from it recover their BMD more rapidly, but simply complying with the diet does not ensure normalization, even after years. 2,5,8,[19][20][21]25,[30][31][32][33] As is seen among chronic diseases in which dietary treatment is required, there is no guarantee that a gluten-free diet will be followed strictly over the long term, and failure to adhere to the diet was confirmed in 13 of our patients. 30 Serological tests for celiac disease have been recommended as an indirect measurement for monitoring the compliance with the diet.…”

Gluten and the Gut: A Brief Review of Gluten-Related Gastrointestinal Disorders

“…GFD improves symptomology, reduces mucosal damage and eliminates risks for osteoporosis and bowel cancers associated with long term active CD [50][51][52][53][54][55][56]. All newly diagnosed patients should undergo a formal investigation for micronutrient deficiencies including serum iron, folic acid, vitamin D and vitamin B12 [40].…”