Effects of 12 Weeks of Strength Training and Gluten-Free Diet on Quality of Life, Body Composition and Strength in Women with Celiac Disease: A Randomized Controlled Trial

Abstract

Celiac disease (CD) is an autoimmune disease characterized by gluten-induced intestinal inflammation. Dietary restrictions and symptoms may have a significant impact on the patient’s quality of life, body composition (BC), and strength. This study was designed to assess the impact of an isocaloric gluten free diet and resistance exercise in women. A total of 28 Spanish women, aged 40 years old or more, took part in a randomized controlled trial. Each group received a different intervention: group 1, gluten-free nutrition plan + exercise (GFD + E); group 2, gluten-free nutrition plan (GFD); group 3, celiac controls (NO-GFD); and group 4, non-celiac controls (CONTROL). The variables studied were quality of life, BC and isometric hand strength. After 12 weeks of intervention, celiac women that followed a gluten-free diet and exercise showed higher scores on the psychological health scale than celiac women without intervention. The women in group 1 were the only ones who presented improvements in BC variables; fat mass, BMI, and fat-free mass. Negative correlations were found between the perception of quality of life and age, however a positive correlation between quality of life and isometric strength test results was found. In addition to a gluten-free diet, resistance training is essential to improve BC, strength, and gastrointestinal symptoms.

The effectiveness of gluten-free dietary interventions: A systematic review

“…The participants were invited to participate in the studies through hospitals, local gastrointestinal physician referrals, local celiac support groups and posters in public centers, social media and news advertisements, emails, and word of mouth. In most of the studies, the researchers utilized a waitlist control group, where the participants in the control group were not given any treatment during the study, but they were on a list to receive treatment after the study without any concrete specification of when that treatment would occur ( Sainsbury et al, 2015 ; Haas et al, 2017 ; Dowd et al, 2019 ; Muhammad et al, 2020 ; Martínez-Rodríguez et al, 2021 ; Akbari Namvar et al, 2022 ). Only a study by Haas et al (2017) focused on the younger population, with a mean age of 16.4 (+/− 2.4), while in other studies, the average age of the participants ranged between 30 and 55 years of age Table 3 .…”

“…Two of the studies focused not only on celiac disease and a gluten-free diet but also on physical exercise as part of an overall healthy lifestyle and to increase their overall quality of life ( Dowd et al, 2019 ; Martínez-Rodríguez et al, 2021 ). In the study by Dowd et al (2019) , the participants attended 12 weeks of high-intensity interval training (HIIT) with a professional HIIT trainer.…”

“…( Dowd et al, 2019 ). The participants in the study by Martínez-Rodríguez et al (2021) also engaged in group physical training for a period of 12 weeks, but the sessions were scheduled 3 times a week for 60 min each. Contrary to the approaches cited above, Martínez-Rodriguez and his colleagues (2021) did not use any education intervention but provided the participants with an individualized prescription diet which was prescribed by a professional dietitian ( Martínez-Rodríguez et al, 2021 ).…”

“…The participants in the study by Martínez-Rodríguez et al (2021) also engaged in group physical training for a period of 12 weeks, but the sessions were scheduled 3 times a week for 60 min each. Contrary to the approaches cited above, Martínez-Rodriguez and his colleagues (2021) did not use any education intervention but provided the participants with an individualized prescription diet which was prescribed by a professional dietitian ( Martínez-Rodríguez et al, 2021 ). The prescribed gluten-free diet contained 5 meals a day for each day in a week for the whole period of 12 weeks and was based on diet recommendations for the Spanish population ( Martínez-Rodríguez et al, 2021 ).…”

“…The quality-of-life score in two studies was observed immediately postintervention and 3 months postintervention ( Martínez-Rodríguez et al, 2021 ; Akbari Namvar et al, 2022 ). In another study, the intervention group reported significant improvements in the quality of life and gastrointestinal symptoms immediately postintervention, and these improvements were sustained even after 3 months postintervention, although there was no effect on adherence levels to a gluten-free diet ( Dowd et al, 2022 ).…”