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Cited by 20Celiac Disease Research and ManagementLiver Disease Diagnosis and TreatmentFood composition and properties

Hepatic Steatosis in Patients with Celiac Disease: The Role of Packaged Gluten-Free Foods

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Raiteri, Alberto, Granito, Alessandro, Faggiano, Chiara, Giamperoli, Alice, Catenaro, Teresa, Negrini, Giulia, Tovoli, Francesco·2022·Nutrients
DOI 10.3390/nu14142942PMC PMC9316041
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Abstract

Background: An increased risk of nonalcoholic fatty liver disease (NAFLD) in patients with celiac disease (CD) adhering to a gluten-free diet (GFD) was recently reported. The nutritional composition of packaged gluten-free foods (PGFF) has been proposed as a possible cause. This hypothesis has not been investigated further, since a systematic structural nutritional interview for all patients would be problematic in clinical practice. Methods: We administered a simple questionnaire based on a Recency, Frequency, and Monetary value (RFM) analysis (a cornerstone of direct marketing segmentation) to consecutive CD patients on a GFD for >6 months and verified its association with NAFLD. Subgroup analyses were performed to understand whether specific patterns of PGFF consumption were significantly associated with NAFLD. Results: Amongst 147 patients (female 82%, median age 42 years), 45 (30.6%) had NAFLD. Total RFM score (adjusted odds ratio = 1.223, 95% CI: 1.059–1.413, p = 0.006), body mass index, and total cholesterol and triglycerides were independently related to NAFLD, and “Bread and bakery” (p = 0.002), “salty convenience” (p = 0.005), and “sweet convenience” (p = 0.049) products were significantly related with NAFLD. Also, questions about the number of purchased PGFF in the last month (monetary value) and different categories of PGFF consumed in the last week (recency) were particularly able to identify NAFLD patients. Conclusions: The specific GFD dietary habits of CD patients were correlated with the degree of risk of NAFLD. Information was obtained through a questionnaire which could be used in clinical practice to favor a patient-tailored approach and in future studies to verify the reproducibility of our results in different geographical areas.

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  • In adolescents, high intakes of gluten-free bread, bakery products as well as sweet and salty convenience foods were associated with non-alcoholic fatty liver disease.

    “In adolescents, high intakes of gluten-free bread, bakery products as well as sweet and salty convenience foods were associated with non-alcoholic fatty liver disease (93).”

    From Gluten-free diet for pediatric patients with coeliac disease: A position paper from the ESPGHAN gastroenterology committee, special interest group in coeliac disease. (2024) · cites this paper as [93]

    Results §3.4 reports that NAFLD was associated with higher consumption scores for gluten-free bread and bakery products and salty convenience foods, with some scores also higher for sweet convenience foods. But Results §3.1 describes a cohort with a median age of 42 years; the paper does not establish this association specifically in adolescents. (LLM, conf=0.90)

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Authors
Raiteri, A., Granito, A., Faggiano, C., Giamperoli, A., Catenaro, T., Negrini, G., & Tovoli, F.
Affiliations
University of Bologna (IT)
Corresponding author
Tovoli, Francesco
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2022-07-18
Volume
14
Issue
14
Pages
2942
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu14142942
PMC
PMC9316041
OpenAlex
W4285802444
Cited by
20
References
1
Citations by year
2026: 3 · 2025: 5 · 2024: 9 · 2023: 3
FWCI
3.72
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
Keywords
celiac disease, non-alcoholic fatty liver disease, hepatic steatosis, gluten-free diet, dietary habits, RFM analysis, convenience foods, bakery products, body mass index, cholesterol, triglycerides
MeSH terms
Adult, Celiac Disease, Female, Humans, Reproducibility of Results, Foods, Specialized, Diet, Gluten-Free, Non-alcoholic Fatty Liver Disease

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