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Cited by 30Celiac Disease Research and ManagementBone health and osteoporosis researchNutritional Studies and Diet

Influence of Mediterranean Diet Adherence and Physical Activity on Bone Health in Celiac Children on a Gluten-Free Diet

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Nestares, Teresa, Martín-Masot, Rafael, de Teresa, Carlos, Bonillo, Rocío, Maldonado, José, Flor-Alemany, Marta, Aparicio, Virginia·2021·Nutrients
DOI 10.3390/nu13051636PMC PMC8152289
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Abstract

We aimed to assess the influence of the Mediterranean Diet adherence and physical activity (PA) on body composition, with a particular focus on bone health, in young patients with celiac disease (CD). The CD group (n = 59) included children with CD with a long (>18 months, n = 41) or recent (<18 months, n = 18) adherence to a gluten-free diet (GFD). The non-celiac group (n = 40) included non-celiac children. After adjusting for potential confounders, the CD group showed lower body weight (p = 0.034), lean mass (p = 0.003), bone mineral content (p = 0.006), and bone Z-score (p = 0.036) than non-celiac children, even when the model was further adjusted for adherence to a GFD for at least 18 months. Among CD children, spending greater time in vigorous physical activity was associated with higher lean mass (p = 0.020) and bone mineral density with evidence of statistical significance (p = 0.078) regardless of the time they followed a GFD. In addition, a greater Mediterranean Diet adherence was associated with a higher bone Z-score (p = 0.020). Moreover, lean mass was strongly associated with bone mineral density and independently explained 12% of its variability (p < 0.001). These findings suggest the importance of correctly monitoring lifestyle in children with CD regarding dietary habits and PA levels to improve lean mass and, consequently, bone quality in this population.

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Authors
Nestares, T., Martín-Masot, R., de Teresa, C., Bonillo, R., Maldonado, J., Flor-Alemany, M., & Aparicio, V.
Affiliations
  • Universidad de Granada (ES)
  • Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Malaga, 29010 Málaga, Spain
  • Andalusia Sport Medicine Centre, 18007 Granada, Spain
  • Department of Physiology, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
Corresponding author
Nestares, Teresa
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2021-05-13
Volume
13
Issue
5
Pages
1636
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu13051636
PMC
PMC8152289
OpenAlex
W3163037219
Cited by
30
References
4
Citations by year
2026: 6 · 2025: 7 · 2024: 7 · 2023: 3 · 2022: 6 · 2021: 1
FWCI
3.88
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RISalud Institutional Health Repository of Andalucía (submittedVersion, cc-by)
  • Institutional Repository of the University of Granada (University of Granada) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Regional Goverment of Andalusia (P12-AGR-2581)
  • University of Granada (PP2017-PIP14)
  • Spanish Ministry of Education, Culture, and Sports (FPU17/03715)
Topics
  • Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords
celiac disease, Mediterranean diet adherence, physical activity, bone health, bone mineral density, bone mineral content, lean body mass, body composition, children, gluten-free diet, dietary habits
MeSH terms
Adolescent, Body Composition, Celiac Disease, Child, Cross-Sectional Studies, Female, Humans, Male, Patient Compliance, Prospective Studies, Exercise, Bone Density, Diet, Mediterranean, Diet, Gluten-Free

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