The Gluten Free Diet’s Impact on Growth in Children with Celiac Disease in Two Different Countries

Abstract

The effects of gluten free diet (GFD) on body mass index (BMI) and growth parameters in pediatric patients with celiac disease (CD) and their dependence on different socio-cultural environments are poorly known. We conducted an international retrospective study on celiac patients diagnosed at the University of Verona, Italy, and at the University of Chicago, Chicago, IL, USA, as underweight. A total of 140 celiac children and 140 controls (mean age 8.4 years) were enrolled in Chicago; 125 celiac children and 125 controls (mean age 7.3 years, NS) in Verona. At time of diagnosis, Italian celiac children had a weight slightly lower (p = 0.060) and a BMI z-score significantly (p < 0.001) lower than their American counterparts. On GFD, Italian celiac children showed an increased prevalence of both underweight (19%) as well as overweight (9%), while American children showed a decrease prevalence of overweight/obese. We concluded that while the GFD had a similar impact on growth of celiac children in both countries, the BMI z-score rose more in American than in Italian celiac children. Additionally, in Italy, there was an alarming increase in the proportion of celiac children becoming underweight. We speculate that lifestyle and cultural differences may explain the observed variations.

Nutritional Status of Saudi Children with Celiac Disease Following the Ministry of Health’s Gluten-Free Diet Program

“…These findings are consistent with those reported by Fernández et al [ 4 ], who found that the majority of the children had normal BMI, with only a small percentage being overweight or obese. Sansotta et al [ 32 ] also conducted a study in two countries that included 125 Italian and 140 American children with CD who followed a GFD for more than 6 months and observed an evaluated BMI-for-age z-score and percentiles for Italian and American children. In contrast, Moya et al [ 33 ] found that BMI z-score and height z-score did not change significantly after one year of diagnosis, which could be attributed to poor adherence to the GFD.…”

The Effect of Gluten-Free Diet Duration on Body Mass Index of Iranian Patients with Celiac Disease

“…[15][16][17][18] It has been shown that the first year of following this diet is accompanied by significant improvement in the histological and clinical conditions of patients; although, some experts believe that complete histological recovery may achieve after more than one year of dieting. [15][16][17][18][19] Studies have shown that GFD adherence is associated with significant changes in the BMI of patients with CD. 20 Little is known about the effect of different durations of compliance to GFD on weight and BMI changes in patients with CD.…”

Nutrition in Pediatric Gastroenterology

“…Two papers focus on celiac disease (CD) [4,5]. The international retrospective study conducted by Sansotta et al [4] investigated the effects of a gluten-free diet on body mass index (BMI) and growth parameters in pediatric patients with CD. The different impacts of a gluten-free diet are described in two groups of CD children followed in two different countries, i.e., Italy and the USA.…”