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Cited by 7Celiac Disease Research and ManagementChild Nutrition and Feeding IssuesClinical Nutrition and Gastroenterology

Nutritional Imbalances in Polish Children with Coeliac Disease on a Strict Gluten-Free Diet

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Szaflarska-Popławska, Anna, Dolińska, Aleksandra, Kuśmierek, Magdalena·2022·Nutrients
DOI 10.3390/nu14193969PMC PMC9572580
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Abstract

Currently, the only treatment for coeliac disease (CD) is a strict, lifelong gluten-free diet (GFD); however, their completeness with regard to energy and macro- and micronutrients remains poorly understood. Paediatric studies are often limited by a low quality and a lack of controls, and their findings should be interpreted with caution. The aim of the present study was to evaluate nutritional imbalances in children with CD on a strict GFD. Methods: A single-centre prospective cohort study was conducted. A total of 48 children with CD (33 girls, mean age 11.8 ± 3.68 years) on a strict GFD (mean duration 5.02 ± 3.87 years) were compared with 50 non-coeliac subjects (26 girls, mean age 10.2 ± 3.97 years). In both groups, anthropometric measurements (body height, weight and BMI) and laboratory tests (haemoglobin level, calcium and magnesium serum concentration, folic acid, vitamin B1, B2, B6 and B12 level) were checked. Additionally, in coeliac subjects, a 3-day food record for energy and macro- and micronutrient intake assessment were determined, and the values were compared to those in non-CD participants and the dietary reference intake (DRI) standards. Results: The CD children were more likely to demonstrate significantly lower serum vitamin B1 and folic acid levels compared to controls (p = 0.01 and p = 0.002, respectively). Although mean serum calcium values were within normal ranges, they were significantly lower in CD subjects than controls (p = 0.01). Mean calcium, folic acid and vitamin D intake was below the dietary recommendations in the CD group (69.9%, 71.2% and 68.9% DRI, respectively) but did not differ significantly between CD and non-coeliac subjects. In turn, the mean supply of proteins and carbohydrates in the CD group substantially exceeded the recommended levels (190.3% and 189.4% DRI, respectively) but was similar to controls. A significantly higher number of CD children were classified as underweight, and a significantly lower number as overweight or obese, compared with controls (p < 0.001). Conclusion: Although children with CD receive nutritional education at diagnosis, a GFD often does not provide a balanced set of macro- and micronutrients. This is mainly due to unhealthy dietary habits, as commonly observed in the general population. Children with CD should be informed that while their diet should be free of gluten, it should nevertheless cover all their nutrition requirements in the long term.

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  • Studies have reported similar nutritional imbalances in children with coeliac disease as healthy controls, with insufficient intakes of several vitamins and minerals, as well as high intakes of saturated fats and low intakes in unsaturated fats.

    “Studies have reported similar nutritional imbalances in children with CD as healthy controls, with insufficient intakes of several vitamins and minerals, as well as high intakes of saturated fats and low intakes in unsaturated fats (98,99).”

    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 [99]

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Cited by

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Authors
Szaflarska-Popławska, A., Dolińska, A., & Kuśmierek, M.
Affiliations
  • Department of Pediatric Endoscopy and Gastrointestinal Function Testing, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, ul. Jagiellonska 13-15, 85-067 Bydgoszcz, Poland
  • Nicolaus Copernicus University (PL)
ORCID
Kuśmierek, Magdalena
Venue
Nutrients
Publisher
MDPI AG
Published
2022-09-24
Volume
14
Issue
19
Pages
3969
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu14193969
PMC
PMC9572580
OpenAlex
W4297238123
Cited by
7
References
2
Citations by year
2026: 1 · 2025: 4 · 2024: 2
FWCI
1.31
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
Keywords
celiac disease, gluten-free diet, paediatric nutrition, micronutrient deficiency, thiamine, folic acid, vitamin D, calcium, energy intake, macronutrient intake, underweight, overweight and obesity, dietary habits, Dietary Reference Intakes, anthropometry, Polish children, food diary, nutrition education, nutrition counseling
MeSH terms
Adolescent, Calcium, Carbohydrates, Celiac Disease, Child, Female, Folic Acid, Hemoglobins, Humans, Magnesium, Male, Poland, Prospective Studies, Vitamin D, Vitamins, Micronutrients, Diet, Gluten-Free

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