Nutritional status, nutrient imbalances, food-related behaviors and dietary supplements use among patients with celiac disease on a gluten free diet in Lebanon: a national cross-sectional study.
Study Goal
The researchers aimed to assess diet quality, nutritional imbalances, and nutritional status among individuals with celiac disease following a gluten-free diet in Lebanon.
Results Summary
The study found nutritional deficiencies (iron, vitamin B12, calcium, vitamin D) and low muscle mass in participants, with barriers like expensive gluten-free products limiting adherence. Despite these issues, most participants followed gluten-free diets and read nutrition labels.
Population
50 individuals (31.74 ± 15.64 years) with celiac disease in Lebanon, including children, adolescents, and adults.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
gluten free diet | increase | nutritional deficiencies | susceptible individuals | - | associated with | #1 |
- | decrease | iron | participants | 38% | presenting low serum levels | #2 |
- | decrease | vitamin B12 | participants | 16% | presenting low serum levels | #3 |
- | decrease | muscle mass | participants | 40% | had low | #4 |
- | decrease | mild to moderate malnutrition | individuals | 14% | weight loss | #5 |
- | no change | nutrition labels | participants | 80% | were reading | #6 |
- | no change | gluten-free diets | participants | 96% | were following | #7 |
gluten free diet | decrease | daily energy intake | individuals with CD | - | inadequacy | #8 |
gluten free diet | decrease | calcium | individuals with CD | - | insufficient intakes | #9 |
gluten free diet | decrease | vitamin D | individuals with CD | - | insufficient intakes | #10 |
gluten free diet | increase | protein intake | all age groups | - | exceeding the recommendations | #11 |
gluten free diet | increase | iron intake | all age groups | - | exceeding the recommendations | #12 |
dietary supplements | no change | vitamin D | study participants | 38% | used | #13 |
dietary supplements | no change | vitamin B12 | study participants | 10% | used | #14 |
dietary supplements | no change | iron | study participants | 46% | used | #15 |
dietary supplements | no change | calcium | study participants | 18% | used | #16 |
dietary supplements | no change | folate | study participants | 16% | used | #17 |
dietary supplements | no change | probiotics | study participants | 4% | used | #18 |
gluten free diet | increase | deficiencies | - | - | may cause | #19 |
gluten free diet | decrease | bone density | - | - | leading to reduced | #20 |
Background: Celiac disease is an autoimmune disorder triggered by gluten, that occurs in susceptible individuals and is associated with dietary restriction and subsequent nutritional deficiencies. This study investigated the diet quality, nutrition imbalances and nutrition status among young children,adolescents and adults with CD who were referred to several hospitals in Lebanon. Methods: A cross-sectional study in 50 individuals (31.74 ± 15.64 years) with CD who follow a gluten free diet was conducted, using biochemical parameters, anthropometric measurements, dietary and physical activity assessments. Results: Of the 50 participants, 38% and 16% were presenting low serum levels of iron and vitamin B12, respectively. The majority of participants were physically inactive and around 40% of them had low muscle mass. A weight loss of 10% to 30% indicating mild to moderate malnutrition was shown in 14% of individuals. The assessment of food-related behaviors shows that 80% of participants were reading nutrition labels and 96% of them were following gluten-free diets (GFD). Some barriers including family ignorance (6%), language of the nutrition labels (20%) and expensive GF products (78%) were limiting the adherence to GFD. The inadequacy of the daily energy intake along with insufficient intakes of calcium and vitamin D were remarked among individuals with CD. However, protein and iron intake were exceeding the recommendations among all age groups, except in males aged 4-8 years and 19-30 years. Half the study participants were using dietary supplements where 38%, 10%, 46%, 18%, 16% and 4% used vitamin D, vitamin B12, iron, calcium, folate and probiotics, respectively. Conclusion: GFD is the key treatment for CD. However, it is not without inadequacies and may cause certain deficiencies such as calcium and vitamin D leading to reduced bone density. This underlines the critical role of dietitians in education and maintenance of healthy GFD among individuals with CD.