Multidimensional Disadvantages of a Gluten-Free Diet in Celiac Disease: A Narrative Review

Marciniak, Martyna; Szymczak-Tomczak, Aleksandra; Mahadea, Dagmara; Eder, Piotr; Dobrowolska, Agnieszka; Krela‐Kaźmierczak, Iwona

doi:10.3390/nu13020643

Cited by 21 publications

(9 citation statements)

References 100 publications

(118 reference statements)

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“…Imbalanced GFDs can be connected with dysbiosis [ 45 ], which could be harmful for our patients and decrease intestinal absorption. Research on the composition of gut microflora in people on a GFD suggests its reduced biodiversity and reduced concentrations of short-chain fatty acids such as acetic and propionic butyric acid [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Whether a Gluten-Free Diet Should Be Recommended in Chronic Autoimmune Thyroiditis or Not?—A 12-Month Follow-Up

Pobłocki

Pańka

Telesiński

et al. 2021

JCM

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Elimination diets have recently become extremely popular among people with autoimmune diseases. A gluten-free diet is indicated in celiac disease (CD), but some studies show its effectiveness in cases of autoimmunity. The aim of this study was to assess whether the use of a gluten-free diet is also effective in patients with chronic autoimmune thyroid disease (cAITD), which is the most common thyroid autoimmune pathology associated with chronic inflammation, over-reactivity of the immune system, auto-destruction of thyrocytes and hypothyroidism. The final analysis of the study included 62 Caucasian women randomized into a control group (CG: n = 31) and an experimental group on a gluten-free diet (GFDG: n = 31), were subject to a 12-month follow-up, during which the concentrations of thyrotropin (TSH), free triiodothyronine (fT3), free thyroxine (fT4), anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies were assessed at baseline and after 3, 6 and 12 months. During the 12-month follow-up between the CG and the GFDG, no differences were found in anti-TPO and anti-TG antibodies, fT3 or fT4 levels, except a significant reduction in TSH levels in the GFDG. Additionally, performed analysis between individual appointments presented no significant differences in changes in the median concentrations of anti-TPO, anti-TG or fT3, but confirmed a significant decrease in TSH and showed accessory an increase in fT4 after 12 months in GFDG. Statistical analyses performed separately for both groups indicated a constant reduction of anti-TG concentrations in the GFDG. In conclusion, a GFD may be administered in cAITD after ruling out celiac disease, but it is necessary to perform more studies to assess if cAITD patients achieve the benefits of following a GFD. Patients with cAITD should be offered proper nutrition education combined with a healthy lifestyle promotion.

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Section: Discussionmentioning

confidence: 99%

Whether a Gluten-Free Diet Should Be Recommended in Chronic Autoimmune Thyroiditis or Not?—A 12-Month Follow-Up

Pobłocki

Pańka

Telesiński

et al. 2021

JCM

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“…The nutritional status of CeD populations has shifted over time, with classic clinical presentations marked by malabsorption and weight loss replaced by a pattern of weight gain and obesity [ 78 , 79 ]. In a recent systematic review and meta-analysis [ 80 ], only 6% of CeD patients are undernourished, while 20% are overweight or obese.…”

Section: Nutritional Status Of Ced and Ncgws Patientsmentioning

confidence: 99%

“…In addition, even those adhering strictly to a GFD will often consume a nutritionally inadequate GFD, rich in sugar and fat and deficient in fiber [ 98 ]. A nutritionally inadequate GFD can lead to malnutrition, overweight, and obesity, with poor outcomes in patients adopting a GFD [ 78 , 79 , 80 ]. Therefore, a registered dietitian (RD) who is experienced in the management of CeD is crucial for nutritional assessment and management, including monitoring of dietary adherence, when treating patients who adopt a GFD.…”

Section: Role Of An Experienced Registered Dietitian As Part Of Multi...mentioning

confidence: 99%

Nutritional Considerations in Celiac Disease and Non-Celiac Gluten/Wheat Sensitivity

et al. 2023

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A gluten-free diet (GFD) is the only available treatment for celiac disease (CeD), and it may also improve symptoms in non-celiac gluten/wheat sensitivity (NCGWS). In CeD, gluten triggers an immune reaction leading to enteropathy, malabsorption, and symptoms; in NCGWS, the mechanism leading to symptoms is unknown, and neither wheat nor gluten triggers enteropathy or malabsorption. A strict GFD is, therefore, necessary for CeD, but a gluten-restricted diet (GRD) may suffice to achieve symptom control for NCGWS. Regardless of this distinction, the risk of malnutrition and macro- and micronutrient deficiencies is increased by the adoption of a GFD or GRD. Thus, patients with CeD or NCGWS should undergo nutritional assessment and subsequent monitoring, based on evidence-based tools, under the care of a multidisciplinary team involving physicians and dietitians, for the long-term management of their nutrition. This review gives an overview of available nutrition assessment tools and considerations for the nutritional management of CeD and NCGWS populations.

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“…In most cases aligned with a well-managed diet, symptoms resolve, mucosa regenerates, celiac-specific antibodies normalize, and deficiency states are resolved [ 9 ]. Once absorption improves with diet, a CD patient’s body weight and body mass index (BMI) typically increase [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Body Mass Index during Gluten-Free Diet in Patients with Celiac Disease

et al. 2023

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The association of clinical variables with body mass index (BMI) and changes experienced during a gluten-free diet (GFD) in celiac disease (CD) is not well established. In this retrospective cohort study, we aimed to investigate factors aligned with baseline and a follow-up regarding BMI in CD cases diagnosed at the University of Pécs (Hungary). Data were collected regarding gender, age, clinical presentation, histology, serology, extraintestinal manifestations, and BMI upon diagnosis and during follow-up. To compare variables with baseline BMI and BMI changes in short-, intermediate-, and long-term periods, we applied univariate analyses. A total of 192 CD patients were included. Males had significantly higher mean BMI when compared with females at diagnosis (22.9 ± 4.1 vs. 21.4 ± 4.3 kg/m2, p = 0.041) and during follow-up (p = 0.031, p = 0.029, and p = 0.033 for short-, intermediate-, and long-term follow-ups, respectively). Non-classical CD patients experienced higher mean BMI at diagnosis (22.9 ± 4.0 vs. 20.7 ± 4.4 kg/m2, p < 0.001) and following long-term follow-up (24.5 ± 3.2 vs. 22.6 ± 3.4 kg/m2, p = 0.039) than classical patients. In conclusion, although the mean BMI remained in the normal range, it increased significantly during follow-up, even at the short-term follow-up. This change was characteristic for non-classical cases and males on the long-term follow-ups.

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Multidimensional Disadvantages of a Gluten-Free Diet in Celiac Disease: A Narrative Review

Cited by 21 publications

References 100 publications

Whether a Gluten-Free Diet Should Be Recommended in Chronic Autoimmune Thyroiditis or Not?—A 12-Month Follow-Up

Whether a Gluten-Free Diet Should Be Recommended in Chronic Autoimmune Thyroiditis or Not?—A 12-Month Follow-Up

Nutritional Considerations in Celiac Disease and Non-Celiac Gluten/Wheat Sensitivity

Body Mass Index during Gluten-Free Diet in Patients with Celiac Disease

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