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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.

F1000Research
May 5, 2022
Maha Hoteit et al. (10 authors)
Journal ArticleHuman Study
Study Details

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

Extracted Claims (20)
InterventionDirectionEndpointPopulationDosageImpactClaim #
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
Abstract

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.

Medical Subject Headings (MeSH)
MaleChildAdultAdolescentHumansChild, PreschoolNutritional StatusDiet, Gluten-FreeCross-Sectional StudiesCeliac DiseaseLebanonCalciumDietary SupplementsNutrientsVitamin DVitamin B 12
Study Links
Quality Scores
Safety70
Efficacy65/10
Quality60/10
Citation Metrics
Total Citations4
Citations/Year1.3
Relative Citation Ratio0.81
NIH Percentile42.3%
Research Impact Scores
APT Score0.75
Weight Score2.09
Normalized Score0.66
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