Contact Us

2637 E Atlantic Blvd #43110
Pompano Beach, FL 33062
USA
Email: editor@conscientiabeam.com
Tel. +15184073707
Fax: +1-877-881-2035

Conference List

48th International Scientific Conference on Sport, Medical and Health Sciences
Vennue: Holiday Inn Bangkok Silom 981 Silom Road, Bangrak, Bangkok 10500, Thailand
Date: 28-Mar-2018
More Details

4th International Academic Conference on Medical and Health Sciences
Vennue: Hotel Grand Flora Dubai, UAE Al- Rigga Road Deira , Near Al-Rigga Metro station , Deira Dubai UAE
Date: 09-Apr-2018
More Details

5th International Academic Conference on Medical and Health Sciences
Vennue: Patra Jasa Bali Resort & Villas Jl.Ir. H Juanda, South Kuta Beach, Kuta 80361, Bali-Indonesia
Date: 07-Jul-2018
More Details

Journal of Nutrients

March 2014, Volume 1, 1, pp 7-18

Update on Nutritional Aspects of Gluten-Free Diet in Celiac Patients

Maria de Lourdes Moreno, Isabel Comino, Carolina Sousa

Maria de Lourdes Moreno 1 ,

Isabel Comino 1 Carolina Sousa 1 
  1. Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad de Sevilla, C/ Profesor García González S/N, Sevilla, Spain 1


Abstract:

A strict gluten-free diet is the only currently available therapeutic treatment for patients with celiac disease, an autoimmune disorder of the small intestine associated with a permanent intolerance to gluten proteins. In recent years, the dramatically prompted changes in the dietary habit of an increasingly large population (celiac disease, non-celiac gluten sensitivity and gluten allergy) has resulted in rising demands for gluten-free products. Before starting gluten-free diet, alteration in intestinal absorption capacity of celiac patients involves deficiencies of nutrients, vitamins and dietary minerals. The habitual poor gluten-free food choices in addition to inherent deficiencies in the gluten-free diet of diagnosed celiac patients may relate with dietary inadequacies. Therefore dietary assessment and counseling at the time of celiac disease diagnosis and ongoing care are crucial as well as fortification of gluten-free foods also need to be considered. This article reviews the nutritional aspects of gluten-free diet in celiac patients and provides an up-date of dietetic recommendations to correct these deficiencies and to ensure optimum gluten-free diet compliance.
Contribution/ Originality
This study documents the nutritional aspects of gluten-free diet in celiac patients, with special highlight on the assessment of the nutritional status of the patient prior to withdrawal of gluten from the diet.

Keywords:


Video:

Reference:

  1. A. A. Fasano, "Novel therapeutic/integrative approaches for celiac disease and dermatitis herpetiformis," Clin Dev Immunol, Article ID 959061, vol. 2012, p. 7, 2012.
  2. J. Miranda, A. Lasa, M. A. Bustamante, I. Churruca, and E. Simon, "Nutritional differences between a gluten-free diet and a diet containing equivalent products with gluten," Plant Foods Hum Nutr., vol. 69, pp. 182-187, 2014.
  3. A. Rubio-Tapia, R. A. Kyle, E. L. Kaplan, D. R. Johnson, W. Page, F. Erdtmann, T. L. Brantner, W. R. Kim, T. K. Phelps, B. D. Lahr, A. R. Zinsmeister, L. J. Melton, and J.-A. Murray, "Increased prevalence and mortality in undiagnosed celiac disease," Gastroenterology, vol. 137, pp. 88-93, 2009.
  4. E. Lionetti and C. Catassi, "New clues in celiac disease epidemiology, pathogenesis, clinical manifestations, and treatment," Int Rev Immunol., vol. 30, pp. 219-31, 2011.
  5. D. Bernardo and A. S. Pea, "Developing strategies to improve the quality of life of patients with gluten intolerance in patients with and without coeliac disease," Eur J Intern Med., vol. 23, pp. 6-8, 2012.
  6. A. Sapone, J. C. Bai, C. Ciacci, J. Dolinsek, P. H. Green, M. Hadjivassiliou, K. Kaukinen, K. Rostami, D. S. Sanders, M. Schumann, R. Ullrich, D. Villalta, U. Volta, C. Catassi, and A. Fasano, "Spectrum of gluten-related disorders: Consensus on new nomenclature and classi?cation," BMC Med., vol. 10, p. 13, 2012.
  7. L. Hernandez and P. H. Green, "Extraintestinal manifestations of celiac disease," Curr Gastroenterol Rep., vol. 8, pp. 383-389, 2006.
  8. S. Husby, S. Koletzko, I. R. Korponay-Szab, M. L. Mearin, A. Phillips, R. Shamir, R. Troncone, K. Giersiepen, D. Branski, C. Catassi, M. Lelgeman, M. Mki, C. Ribes-Koninckx, A. Ventura, and K. P. Zimmer, "European society for pediatric gastroenterology, hepatology, and nutrition guidelines for the diagnosis of coeliac disease," J Pediatr Gastroenterol Nutr., vol. 54, pp. 136-160, 2012.
  9. J. See and J. A. Murray, "Gluten-free diet: The medical and nutrition management of celiac disease," Nutr Clin Pract., vol. 21, pp. 1-15, 2006.
  10. L. M. Sollid, "Coeliac disease: Dissecting a complex inflammatory disorder," Nat Rev Immunol., vol. 2, pp. 647-655, 2002.
  11. G. Corrao, G. R. Corazza, V. Bagnardi, G. Brusco, C. Ciacci, M. Cottone, C. Sategna Guidetti, P. Usai, P. Cesari, M. A. Pelli, S. Loperfido, U. Volta, A. Calabr, and M. Certo, "Mortality in patients with celiac disease and their relatives: A cohort study," Lancet, vol. 357, pp. 356-361, 2001.
  12. M. Rashid, A. Cranney, M. Zarkadas, I. D. Graham, C. Switzer, S. Case, M. Molloy, R. E. Warren, V. Burrows, and J. D. Butzner, "Celiac disease: Evaluation of the diagnosis and dietary compliance in Canadian children," Pediatrics, vol. 116, pp. e754-759, 2005.
  13. A. Lanzini, F. Lanzarotto, V. Villanacci, A. Mora, S. Bertolazzi, D. Turini, G. Carella, A. Malagoli, G. Ferrante, B. M. Cesana, and C. Ricci, "Complete recovery of intestinal mucosa occurs very rarely in adult coeliac patients despite adherence to gluten-free diet," Aliment Pharmacol Ther., vol. 29, pp. 1299-1308, 2009.
  14. M. L. Moreno, I. Comino, and C. Sousa, "Alternative grains as potential raw material for gluten-free food development in the diet of celiac and gluten-sensitive patients," Austin J Nutri Food Sci., vol. 2, pp. 9-18, 2014.
  15. M. Dennis and S. Case, "Going gluten-free: A primer for clinicians," Pract Gastroenterol., vol. 28, pp. 86-104 2004.
  16. S. Case, Gluten-free diet: A comprehensive resource guide. Regina, Saskatchewan, Canada: Case Nutrition Consulting, 2006.
  17. A. Garca-Manzanares and A. J. Lucendo, "Nutritional and dietary aspects of celiac disease," Nutr Clin Pract., vol. 26, pp. 163-173, 2011.
  18. P. H. R. Green, S. N. Stavropoulos, S. G. Panagi, S. L. Goldstein, D. J. McMahon, H. Absan, and A. I. Neugut, "Characteristics of adult celiac disease in the USA: Results of a national survey," Am J Gastroenterol, vol. 96, pp. 126-131, 2001.
  19. R. J. Farrell and C. P. Kelly, "Celiac sprue," N Engl J Med., vol. 346, pp. 180-188, 2002.
  20. J. A. Murray, T. Watson, B. Clearman, and F. Mitros, "Effect of a gluten-free diet on gastrointestinal symptoms in celiac disease," Am J Clin Nutr., vol. 79, pp. 669-673, 2004.
  21. P. Garca, M. Camblor, and R. De la Cuerda, Recomendaciones nutricionales en la enfermedad celiaca. In: M. Len, S. Celaya, eds. Manual de recomendaciones nutricionales al alta hospitalaria. Basel, Switzerland: Novartis Consumer Health, 2001.
  22. P. Ferrara, M. Cicala, E. Tiberi, C. Spadaccio, L. Marcella, A. Gatto, P. Calzolari, and G. Castellucci, "High fat consumption in children with celiac disease," Acta Gastroenterol Belg., vol. 72, pp. 296-300, 2009.
  23. M. Rewers, "Epidemiology of celiac disease: What are the prevalence, incidence, and progression of celiac disease?," Gastroenterology, vol. 128, pp. 47-51, 2005.
  24. A. V. Hoffbrand, "Anaemia in adult coeliac disease," Clin Gastroenterol, vol. 3, pp. 71-89, 1974.
  25. F. Bottaro, F. Cataldo, N. Rotolo, M. Spina, and G. R. Corazza, "The clinical pattern of subclinical/silent celiac disease: An analysis on 1026 consecutive cases," Am J Gastroenterol., vol. 94, pp. 691-696, 1999.
  26. S. Jones, C. D'Souza, and N. Y. Haboubi, "Patterns of clinical presentation of adult coeliac disease in a rural setting," Nutr J., vol. 5, p. 24, 2006.
  27. R. Caruso, F. Pallone, E. Stasi, S. Romeo, and G. Monteleone, "Appropriate nutrient supplementation in celiac disease," Ann Med., vol. 45, pp. 522-531, 2013.
  28. T. R. Halfdanarson, M. R. Litzow, and J. A. Murray, "Hematologic manifestations of celiac disease," Blood, vol. 109, pp. 412-421, 2007.
  29. C. Hershko and J. Patz, "Ironing out the mechanism of anemia in celiac disease," Haematologica, vol. 93, pp. 1761- 1765, 2008.
  30. M. R. Howard, A. J. Turnbull, P. Morley, P. Hollier, R. Webb, and A. Clarke, "A prospective study of the prevalence of undiagnosed coeliac disease in laboratory defined iron and folate deficiency " J Clin Pathol., vol. 55, pp. 754-757, 2002.
  31. M. A. DAmico, J. Holmes, S. N. Stavropoulos, M. Frederick, J. Levy, A. R. DeFelice, P. G. Kazlow, and P. H. Green, "Presentation of pediatric celiac disease in the United States: Prominent effect of breastfeeding," Clin Pediatr., vol. 44, pp. 249-258, 2005.
  32. G. Kapur, A. K. Patwari, S. Narayan, and V. K. Anand, "Iron supplementation in children with celiac disease," Indian J Pediatr., vol. 70, pp. 955-958, 2003.
  33. A. Tursi and G. Brandimarte, "The symptomatic and histologic response to a gluten-free diet in patient with borderline enteropathy," J Clin Gastroenterol, vol. 36, pp. 13-17, 2003.
  34. T. Fisgin, N. Yarali, F. Duru, B. Usta, and A. Kara, "Hematologic manifestiton of childhood celiac disease," Acta Haematol., vol. 111, pp. 211-214, 2004.
  35. T. Thompson, "Thiamin, riboflavin, and niacin contents of the gluten-free diet: Is there cause for concern?," J Am Diet Assoc., vol. 99, pp. 858-862, 1999.
  36. T. Thompson, "Folate, iron, and dietary fiber contents of the gluten-free diet," J Am Diet Assoc., vol. 1000, pp. 1389-1396, 2000.
  37. E. Pagano, "Whole grains and the gluten-free diet," Pract Gastroenterol, vol. 29, pp. 66-78, 2006.
  38. T. A. Kemppainen, M. T. Heikkinen, M. K. Ristikankare, V. M. Kosma, and R. J. Julkunen, "Nutrient intakes during diets including unkilned and large amounts of oats in celiac disease," Eur J Clin Nutr., vol. 64, pp. 62-67, 2010.
  39. J. D. Cook, S. A. Dassenko, and P. Whittaker, "Calcium supplementation: Effect on iron absorption," Am J Clin Nutr., vol. 53, pp. 106-111, 1991.
  40. P. Kruzliak, Hematologic manifestations of celiac disease. In: P. Kruzliak, ed. Celiac disease- From pathophysiology to advanced therapies, in tech, 2012.
  41. A. Dahele and S. Ghosh, "Vitamin B12 deficiency in untreated celiac disease," Am J Gastroenterol., vol. 96, pp. 745-750, 2001.
  42. T. R. Halfdanarson, N. Kumar, W. J. Hogan, and J. A. Murray, "Copper deficiency in celiac disease," J Clin Gastroenterol, vol. 43, pp. 162-164, 2009.
  43. S. Tikkakoski, E. Savilahti, and K. Kolho, "Undiagnosed coeliac disease and nutritional deficiencies in adults screened in primary health care," Scand J Gastroenterol, vol. 42, pp. 60-65, 2007.
  44. A. I. Rogers and R. D. Madanick, Maldigestion and malabsorption. In: W.M. .Weinstein, C.J. Hawkey, J. Bosch, eds. Clinical gastroenterology and hepatology. Philadelphia: Elsevier, 2005.
  45. F. Fernndez-Baares, H. Monzn, and M. Forn, "A short review of malabsorption and anemia," World J Gastroenterol., vol. 15, pp. 4644-4652, 2009.
  46. A. Ross, C. Taylor, A. Yaktine, and H. Del Valle, Dietary reference intakes for calcium and vitamin D, institute of medicine report. Washington DC: The National Academies Press, 2011.
  47. B. R. Javorsky, N. Maybee, S. H. Padia, and A. C. Dalkin, "Vitamin d deficiency in gastrointestinal disease," Practical Gastroenterology, pp. 52-72, 2006.
  48. T. Kemppainen, H. Kroger, E. Janatuinen, E. I. Arnala, V. M. Kosma, P. Pikkarainen, R. Julkunen, J. Jurvelin, E. Alhava, and M. Uusitupa, "Osteoporosis in adult patients with celiac disease," Bone, vol. 24, pp. 249-255, 1999.
  49. A. Tavakkoli, D. DiGiacomo, P. H. Green, and B. Lebwohl, "Vitamin D status and concomitant autoimmunity in celiac disease," J Clin Gastroenterol, vol. 47, pp. 515-519, 2013.
  50. W. E. Fickling, X. A. McFarlane, A. K. Bhalla, and D. Robertson, "The clinical impact of metabolic bone disease in celiac disease " Postgrad Med J., vol. 77, pp. 33-36, 2001.
  51. J. F. Gregory, "In vivo kinetics of folate metabolism," Rev Nutr., vol. 22, pp. 199-200, 2002.
  52. R. Pawson and A. Mehta, "Review article: The diagnosis and treatment of haematinic deficiency in gastrointestinal disease," Aliment Pharmacol Ther., vol. 12, pp. 687-698, 1998.
  53. R. Carmel, Megaloblastic anemias: Disorders of impaired DNA synthesis. In: J.P. Greer, J. Foerster, J.N. Lukens, G.M. Rodgers, F. Paraskevas, B. Glader, eds. Wintrobes clin hematol vol. 1. Philadelphia, PA: Lippincott Williams & Wilkins, 2004.
  54. S. Bode and E. Gudmand-Hoyer, "Symptoms and haematologic features in consecutive adult celiac patients," Scand J Gastroenterol., vol. 31, pp. 54-60, 1996.
  55. D. Stevens, "Nutritional anaemia in childhood celiac disease," Proc Nutr Soc., vol. 38, p. 102, 1979.
  56. K. Pittschieler, "Folic acid concentration in the serum and erythrocytes of patients with celiac disease," Padiatr Padol., vol. 21, pp. 363-366, 1986.
  57. T. A. Kemppainen, V. M. Kosma, E. K. Janatuinen, R. J. Julkunen, P. H. Pikkarainen, and M. I. Uusitupa, "Nutritional status of newly diagnosed celiac disease patients before and after the institution of a celiac disease diet: Association with the grade of mucosal villous atrophy," Am J Clin Nutr., vol. 67, pp. 482-487, 1998.
  58. M. Haapalahti, P. Kulmala, and T. J. Karttunen, "Nutritional status in adolescents and young adults with screen-detected celiac disease," J Pediatr Gastroenterol Nutr., vol. 40, pp. 566-570, 2005.
  59. J. E. Botero-Lpez, M. Araya, A. Parada, M. A. Mndez, F. Pizarro, N. Espinosa, P. Canales, and T. Alarcn, "Micronutrient deficiencies in patients with typical and atypical celiac disease," J Pediatr Gastroenterol Nutr., vol. 53, pp. 265-270, 2011.
  60. C. Lamacchia, A. Camarca, S. Picascia, A. Di Luccia, and C. Gianfrani, "Cereal-based gluten-free food: How to reconcile nutritional and technological properties of wheat proteins with safety for celiac disease patients," Nutrients, vol. 6, pp. 575-590, 2014.
  61. E. Gallagher, T. R. Gormley, and E. K. Arendt, "Recent advances in the formulation of gluten-free cereal-based products," Trends Food Sci Tech., vol. 15, pp. 143-152, 2004.
  62. E. Zannini, J. M. Jones, S. Renzetti, and E. K. Arendt, "Functional replacements for gluten," Annu Rev Food Sci Technol., vol. 3, pp. 227-245, 2012.
  63. E. K. Arendt, C. M. OBrien, T. Schober, T. R. Gormley, and E. Gallagher, "Development of gluten-free cereal products," Farm Food, vol. 12, pp. 21-27, 2002.
  64. C. G. Rizzello, M. De Angelis, R. Di Cagno, A. Camarca, M. Silano, I. Losito, M. De Vincenzi, M. D. De Bari, F. Palmisano, F. Maurano, C. Gianfrani, and M. Gobbetti, "Highly efficient gluten degradation by lactobacilli and fungal proteases during food processing: New perspectives for celiac disease," Appl Environ Microbiol., vol. 73, pp. 4499-4507, 2007.
  65. I. Caputo, M. Lepretti, S. Martucciello, and C. Esposito, "Enzymatic strategies to detoxify gluten: Implications for celiac disease," Enzyme Res., vol. 7, p. e174354, 2010.
  66. C. Hallert, C. Grant, S. Grehn, C. Grnn, S. Hultn, G. Midhagen, M. Strm, H. Svensson, and T. Valdimarsson, "Evidence of poor vitamin status in coeliac patients on a gluten-free diet for 10 years," Aliment Pharmacol Ther., vol. 16, pp. 1333-1339, 2002.
  67. S. J. Shepherd and P. R. Gibson, "Nutritional inadequacies of the gluten-free diet in both recently-diagnosed and long-term patients with celiac disease," J Hum Nutr Diet., vol. 26, pp. 349-358, 2013.
  68. N. J. Wierdsma, M. A. Van Bokhorst-De Van Der Schueren, M. Berkenpas, C. J. Mulder, and A. A. Van Bodegraven, "Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients," Nutrients, vol. 5, pp. 3975-3992, 2013.
  69. T. Thompson, M. Dennis, L. A. Higgins, A. R. Lee, and M. K. Sharrett, "Gluten-free diet survey: Are Americans with coeliac disease consuming recommended amounts of fibre, iron, calcium and grain foods?," J Hum Nutr Diet., vol. 18, pp. 163-169, 2005.
  70. A. Eliasson and K. Larsson, Cereals in breadmaking. NY, USA: Marcel Dekker, 1993.
  71. C. Berti, P. Riso, L. D. Monti, and M. Porrini, "In vitro starch digestibility and in vivo glucose response of gluten free foods and their counterparts," Eur J Nutr., vol. 43, pp. 198-204, 2004.
  72. A. E. Scaramuzza, C. Mantegazza, A. Bosetti, and G. V. Zuccotti, "Type 1 diabetes and celiac disease: The effects of gluten free diet on metabolic control," World J. Diabetes, vol. 4, pp. 130-134, 2013.
  73. L. Norsa, R. Shamir, N. Zevit, E. Verduci, C. Hartman, D. Ghisleni, E. Riva, and M. Giovannini, "Cardiovascular disease risk factor profiles in children with celiac disease on gluten free diets," World J Gastroenterol, vol. 19, pp. 5658-5664, 2013.
  74. National Research Council, Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (Macronutrients). Washington, DC: The National Academies Press, 2005.
  75. M. E. Segura and C. M. Rosell, "Chemical composition and starch digestibility of different gluten-free breads," Plant Foods Hum Nutr., vol. 66, pp. 224-230, 2011.
  76. L. Alvarez-Jubete, M. Auty, E. K. Arendt, and E. Gallagher, "Baking properties and microstructure of pseudocereal flours in gluten-free bread formulations," Eur Food Res Technol., vol. 230, pp. 437-445, 2010.
  77. A. M. De la Barca, M. E. Rojas-Martnez, A. R. Islas-Rubio, and F. Cabrera-Chvez, "Gluten-free breads and cookies of raw and popped amaranth flours with attractive technological and nutritional qualities," Plant Foods Hum Nutr., vol. 65, pp. 241-246, 2010.
  78. J. Martin, T. Geisel, C. Maresch, K. Krieger, and J. Stein, "Inadequate nutrient intake in patients with celiac disease: Results from a German dietary survey," Digestion, vol. 87, pp. 240-246, 2013.
  79. B. Jasthi, J. Stevenson, and L. Harnack, "Comparison of nutrient composition of gluten-containing and gluten-free sliced breads and spaghetti noodles," presented at the 38th National Nutrient Databank Conference, Portland (USA), 2014.

Statistics:

Google Scholor ideas Microsoft Academic Search bing Google Scholor

Funding:

Competing Interests:

Acknowledgement:


Related Article

( 1 ) Update on Nutritional Aspects of Gluten-Free Diet in Celiac Patients
( 3 ) Contribution of Meat towards Nutritional Security - An Analysis through Consumption of Different Food Items among Meat and Non-Meat Consumers in Karnataka
( 4 ) Protective Effect of L-Ascorbic Acid (Vitamin C) On Mercury Detoxication and Physiological Aspects of Albino Rats
( 5 ) Impact of Ramadan Fasting on Some Biochemical Aspects in Healthy Subjects
( 9 ) Effect of Dietary Supplementation with Cyphostemma Digitatum on Serum Lipid Profile and Liver Enzymes in Hyperlipidemic Subjects
( 10 ) Dietary Polyamines and Diseases: Reducing Polyamine Intake Can Be Beneficial In Cancer Treatment
( 12 ) Ultrasound Guided Axillary Node Sampling in Patients of Carcinoma Breast with Clinically Negative Axilla: A Pilot Study
( 13 ) Prognostic Factors in Patients with Squamous Cell Carcinoma of the Oral Tongue Treated With Adjuvant Therapy Following Surgery
( 15 ) Role of Iron Metabolism in Breast Cancer Patients
( 16 ) Prosthodontic Rehabilitatative Therapy through Surgical Obturator for Maxillectomy Patients: A Review
( 17 ) Correlation between Her2/Neu and Histopatholoical Finding among Sudanese Female Breast Cancer Patients
( 18 ) Impaired Immune Phenotype of Circulating Endothelial-Derived Microparticles in None-Diabetic Patients with Chronic Heart Failure: Impact on Insulin Resistance
( 19 ) Evaluation of Techniques for the Diagnosis of Rotavirus Gastroenteritis in Paediatric Patients
( 20 ) Spectrum of Morphological Changes and Prevalence of P53 Signatures In Tubal Fimbrial Epithelium in General Population and In Patients with Pelvic Serous Carcinomas
( 21 ) The Importance of Clinical Genotype in Patients with Klinefelter Syndrome. A Genetic Disorder Asociated to Taurodontism
( 22 ) Correlation between Certain Complications and Health Education Program among Non-Insulin Dependent Diabetes Miletus Patients
( 23 ) Epidemiological and Clinical Characteristics of Egyptian Patients with Hepatocellular Carcinoma: A Single Center Study