Assessment of nutritional status in children with celiac disease

Celiac disease (CD) is an autoimmune inflammatory condition of the small intestinal, triggered by ingestion of gluten in susceptible individuals. The only treatment for celiac disease (CD) is a lifelong gluten free diet. Wheat, rye, and barley are the major sources of gluten. The aim of this study was to evaluate the nutritional status, anthropometric measurements and preferred gluten free cereals in children with CD. One hundred twenty patients with CD no additional health problems, aged between 6 to 18 years attending Hacettepe University, Faculty of Medicine, Department of Pediatric Gastroenterology Hepatology and Nutrition were included. A questionnaire was applied to evaluate the general characteristics, anthropometric measurements of the individuals, a-24-hour dietary recall, food consumption frequency of gluten free products. Energy, macronutrient, micronutrient intakes were calculated using a-24-hour dietary recall method and compared according to nutritional guidelines. A-24-hour dietary recall was evaluated using BEBİS 7.2, anthropometric measurement was evaluated using WHO AntroPlus and statistical analysis were done using SPSS 22.0 software. The mean age of the patients was 11.49±3.76 years. There were 30% boys and 70% girls. The most common reasons for diagnosis the patients are growth and developmental retardation (37.5%), diarrhea (30.8%) and constipation (8.3%). The patients average age of diagnosis is 7.3±4.2 years. According to weight-for-age Z score values, 29.5% of patients were underweight (<-2SD). According to height-for-age Z score values, it was found that 15.8% of the patients were stunted (<-2SD). The percentage of patients meeting their energy needs was 77.9±26.7%. According to the food consumption record of the patients, it was shown that the intake of fiber, vitamin B1, calcium and iron was insufficient. The mean daily amount for gluten free bread was 108.6±110.5 g/day, rice 34.3±27.3 g/day, potato 102.6±79.2 g/day, gluten free flour 12.6±2.5 g/day, low protein bread 67.4±65.5 g/day. But Amaranth, quinoa and bean flour were not been consumed. Approximately 24.8±14.8% of total daily energy intake came from gluten free products. These products were obtained from supermarket (95.8%), internet shopping (3.3%), or patient foundation (0.9%). As a result of this study, it was shown that the importance of nutritional status of patients with celiac diseases was emphasized. Dietitian specialized in CD should give detailed dietary education to prevent the patients from nutritent deficiencies. Instead of low protein gluten free products, alternative cereals (buckwheat, amaranth or quinoa), a good source of carbohydrates, protein, fiber, fatty acids, vitamins and minerals, should be used. Nutritional therapy and education are important in the prevention and treatment of complications such as vitamin- mineral deficiency, anemia, malnutrition, and obesity in celiac diseases.