Gluten-Free Product Contribution to Energy and Macronutrient Intakes in Spanish Children and Adolescents with Celiac Disease

Abstract

Gluten-free products (GFP) are a good choice for the replacement of cereals when following a gluten-free diet due to celiac disease (CD). However, commercial GFP are made with highly refined flours and may contain more fat, sugar, and salt, and less fiber and micronutrients than gluten-containing analogues, thus challenging the nutritional adequacy of the diet. The aim of this study is to assess the contribution of GFP to the diets of children and adolescents with CD. Food intakes were assessed in a cross-sectional study on 70 children and adolescents with CD (aged four to 18, 50% females), using three 24-h dietary records. GFP consumption reached 165 g a day and comprised mostly bread and fine bakery ware, followed by pasta. GFP contributed with a high percentage (>25%) to total energy, carbohydrates, fiber, and salt daily intakes and, to a lesser extent (<20%), to fat (including saturated fat), sugars and protein. Contribution of homemade products was testimonial. GFP contribution to total energy intake is significant and, consequently, relevant to the nutritional adequacy of the diet. Children and adolescents with CD could benefit from fat, saturated fat, and salt reduction, and fiber enrichment of processed GFP.

Glutensiz Diyetin Çölyak Hastalığı Olan Çocukların Beslenme Durumuna Etkisi

“…In most studies, it was reported that there were significant increases in total fat and saturated fatty acid intake of children with celiac disease than the control group (Babio et al, 2017;Balamtekin et al, 2015;Ferrara et al, 2009;Kautto et al, 2014;Zuccotti et al, 2013). In a Spanish study, gluten-free diet contributed with a high percentage (>25%) to total energy, carbohydrates, fiber, and salt intakes (González et al, 2022). Moreover, ultra-processed food consumption was shown to increase in diet (Martín-Masot et al, 2022).…”

Nutritional Composition of Breakfast in Children and Adolescents with and without Celiac Disease in Spain—Role of Gluten-Free Commercial Products

“…Pseudo-cereals such as amaranth, buckwheat, and quinoa, but also milled legumes, seeds, and nuts, are optional ingredients increasingly used for the preparation of gluten-free baked goods compared to GCCs [ 54 , 56 , 64 ], which enlarge the quantity of fibre of the GFPs. Nevertheless, despite the higher fibre content of GFPs, people following a strict GFD have a lower fibre intake than the rest of the population if the intake of the whole day, not only for breakfast, is assessed [ 27 , 36 , 45 , 65 ].…”

“…An analysis of products marketed as gluten-free indicates that most of them have a higher salt content, especially breads, pastries, and cakes, compared to GCCs [ 44 , 71 , 72 ]. Salt reduction in cereal-based products for celiacs is another important issue to be addressed by the food industry, as we have previously proposed [ 27 ].…”

“…Due to the limitations of a GFD, children and adolescents particularly consume many processed products made specifically for them [ 27 ]. According to some authors, abusive use of these products can have long-term consequences, including systemic inflammation or intestinal microbiota alteration, that appear to contribute to the persistence of nutritional deficiencies [ 28 ] and cardiometabolic-related pathologies, such as obesity [ 29 , 30 ] or cardiovascular disease [ 31 ].…”