Evaluation of diet adherence rates and anthropometric rates in children with celiac disease

Celiac disease is an autoimmune enteropathy caused by ingestion of gluten-containing foods in individuals with genetic predisposition. Adherence to diet in pediatric celiac cases is more challenging than in adult cases and many preventable complications such as short stature, growth retardation, malnutrition and bone disorders may develop. Our study aimed evaluation of diet compliance and anthropometric findings in pediatric celiac cases. The study included 629 children with celiac disease who were diagnosed at the Department of Pediatric Gastroenterology of Fırat University Medical Faculty Hospital and followed up for at least 1 year. 141 patients were excluded from the study because they did not come to our clinic for control. Hb, Hct, Ferritin, Folic acid, B12, Iron and iron binding capacity, transaminase levels, Bone mineral densitometry (BMD) measurements, height and weight measurements were recorded. Informed consent was obtained from their families. In our study, celiac disease was found more frequently in female cases, of which 279 were female (57.2%) and 209 were male (42.8%). In our study, 317 cases (65%) were considered to be "adherent to diet" and 171 cases (35%) were considered as "non-adherent to diet". Diet adherence rates of the patients coming from our province were found to be higher than those of the other provinces (p = 0.007). It was determined that the diet adherence rate of the patients residing in the city centers increased significantly compared to the patients living in rural areas (p <0.001). It was found that folic acid levels were significantly increased with diet in patients who were adherent with the diet, but no increase was observed in non-adherent patients (p <0.001). It was also found that Z score measurements of height and weight values of the cases showed statistically significant improvement in dietary adherence (p <0.001). Significant improvement was found in the Z scores of BMD measurements in the adherent to diet case group (p = 0.003). In conclusion, gluten-free diet is the only known treatment for celiac disease. Many preventable complications such as short stature and growth retardation may develop in children who do not follow the diet. Efforts should be made to raise the awareness of the parents of children with celiac disease, access to specialist physicians should be facilitated and financial difficulties should be mitigated. Keywords: Celiac, child, adherence to diet, anthropometrics.