Nutritional Deficiencies in Children with Celiac Disease Resulting from a Gluten-Free Diet: A Systematic Review

Giovanni Di Nardo, Maria Pia Villa, Laura Conti, Giusy Ranucci, Claudia Pacchiarotti, Luigi Principessa, Umberto Raucci, Pasquale Parisi

Research output: Contribution to journalArticle

Abstract

BACKGROUND: A strictly gluten-free diet (GFD) is the basis for managing celiac disease (CD). Numerous studies have reported nutritional deficiencies/imbalances ascribable to a GFD. The aim of this review is to describe nutritional deficiencies observed in children with celiac disease on a GFD, to discuss the clinical consequences related to these nutritional imbalances, and to identify strategies that may be adopted to treat them.

METHODS: We reviewed the MEDLINE and EMBASE databases between January 1998 and January 2019.

RESULTS: Children are, regardless of whether they are on a gluten-free diet or not, at risk of consuming too much fat and insufficient fiber, iron, vitamin D, and calcium. These imbalances may be exacerbated when children are on a gluten-free diet. In particular, the intake of folate, magnesium, zinc, and foods with a high glycemic index in children with CD who are on a GFD is significantly altered.

CONCLUSIONS: Therapeutic protocols should include nutritional education to help teach subjects affected by disorders such as CD the importance of labels, the choice of foods, and the combination of macro- and micronutrients. Children with CD on a GFD should be encouraged to rotate pseudo-cereals, consume gluten-free commercial products that have been fortified or enriched, and use foods that are local and naturally gluten-free.

Original languageEnglish
JournalNutrients
Volume11
Issue number7
DOIs
Publication statusPublished - Jul 13 2019

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gluten-free diet
Gluten-Free Diet
celiac disease
systematic review
Celiac Disease
nutrient deficiencies
Malnutrition
Glutens
gluten
Fortified Food
Glycemic Index
Food
glycemic index
Micronutrients
nutrition education
vitamin D
dietary minerals
Folic Acid
food choices
Vitamin D

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Nutritional Deficiencies in Children with Celiac Disease Resulting from a Gluten-Free Diet : A Systematic Review. / Di Nardo, Giovanni; Villa, Maria Pia; Conti, Laura; Ranucci, Giusy; Pacchiarotti, Claudia; Principessa, Luigi; Raucci, Umberto; Parisi, Pasquale.

In: Nutrients, Vol. 11, No. 7, 13.07.2019.

Research output: Contribution to journalArticle

Di Nardo, Giovanni ; Villa, Maria Pia ; Conti, Laura ; Ranucci, Giusy ; Pacchiarotti, Claudia ; Principessa, Luigi ; Raucci, Umberto ; Parisi, Pasquale. / Nutritional Deficiencies in Children with Celiac Disease Resulting from a Gluten-Free Diet : A Systematic Review. In: Nutrients. 2019 ; Vol. 11, No. 7.
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title = "Nutritional Deficiencies in Children with Celiac Disease Resulting from a Gluten-Free Diet: A Systematic Review",
abstract = "BACKGROUND: A strictly gluten-free diet (GFD) is the basis for managing celiac disease (CD). Numerous studies have reported nutritional deficiencies/imbalances ascribable to a GFD. The aim of this review is to describe nutritional deficiencies observed in children with celiac disease on a GFD, to discuss the clinical consequences related to these nutritional imbalances, and to identify strategies that may be adopted to treat them.METHODS: We reviewed the MEDLINE and EMBASE databases between January 1998 and January 2019.RESULTS: Children are, regardless of whether they are on a gluten-free diet or not, at risk of consuming too much fat and insufficient fiber, iron, vitamin D, and calcium. These imbalances may be exacerbated when children are on a gluten-free diet. In particular, the intake of folate, magnesium, zinc, and foods with a high glycemic index in children with CD who are on a GFD is significantly altered.CONCLUSIONS: Therapeutic protocols should include nutritional education to help teach subjects affected by disorders such as CD the importance of labels, the choice of foods, and the combination of macro- and micronutrients. Children with CD on a GFD should be encouraged to rotate pseudo-cereals, consume gluten-free commercial products that have been fortified or enriched, and use foods that are local and naturally gluten-free.",
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AU - Di Nardo, Giovanni

AU - Villa, Maria Pia

AU - Conti, Laura

AU - Ranucci, Giusy

AU - Pacchiarotti, Claudia

AU - Principessa, Luigi

AU - Raucci, Umberto

AU - Parisi, Pasquale

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N2 - BACKGROUND: A strictly gluten-free diet (GFD) is the basis for managing celiac disease (CD). Numerous studies have reported nutritional deficiencies/imbalances ascribable to a GFD. The aim of this review is to describe nutritional deficiencies observed in children with celiac disease on a GFD, to discuss the clinical consequences related to these nutritional imbalances, and to identify strategies that may be adopted to treat them.METHODS: We reviewed the MEDLINE and EMBASE databases between January 1998 and January 2019.RESULTS: Children are, regardless of whether they are on a gluten-free diet or not, at risk of consuming too much fat and insufficient fiber, iron, vitamin D, and calcium. These imbalances may be exacerbated when children are on a gluten-free diet. In particular, the intake of folate, magnesium, zinc, and foods with a high glycemic index in children with CD who are on a GFD is significantly altered.CONCLUSIONS: Therapeutic protocols should include nutritional education to help teach subjects affected by disorders such as CD the importance of labels, the choice of foods, and the combination of macro- and micronutrients. Children with CD on a GFD should be encouraged to rotate pseudo-cereals, consume gluten-free commercial products that have been fortified or enriched, and use foods that are local and naturally gluten-free.

AB - BACKGROUND: A strictly gluten-free diet (GFD) is the basis for managing celiac disease (CD). Numerous studies have reported nutritional deficiencies/imbalances ascribable to a GFD. The aim of this review is to describe nutritional deficiencies observed in children with celiac disease on a GFD, to discuss the clinical consequences related to these nutritional imbalances, and to identify strategies that may be adopted to treat them.METHODS: We reviewed the MEDLINE and EMBASE databases between January 1998 and January 2019.RESULTS: Children are, regardless of whether they are on a gluten-free diet or not, at risk of consuming too much fat and insufficient fiber, iron, vitamin D, and calcium. These imbalances may be exacerbated when children are on a gluten-free diet. In particular, the intake of folate, magnesium, zinc, and foods with a high glycemic index in children with CD who are on a GFD is significantly altered.CONCLUSIONS: Therapeutic protocols should include nutritional education to help teach subjects affected by disorders such as CD the importance of labels, the choice of foods, and the combination of macro- and micronutrients. Children with CD on a GFD should be encouraged to rotate pseudo-cereals, consume gluten-free commercial products that have been fortified or enriched, and use foods that are local and naturally gluten-free.

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