Evaluation of nutritional status of children with celiac disease and their mothers

Celiac disease is an autoimmune-mediated disease that affects the intestinal mucosa, triggered by the gluten protein found in barley, rye and wheat in genetically susceptible individuals. The only known effective treatment for celiac disease is a lifelong gluten-free diet. It is important to monitor the diet and nutritional status for the control of the disease. The aim of this study is to evaluate the nutritional status of children with celiac disease and their mothers and to examine the interactions between them. The study included 140 children with celiac disease and 61 mothers aged 2-18 years, diagnosed with celiac disease, on a gluten-free diet and without any other chronic diseases. Information on general health and nutritional habits of all participants was obtained through a face-to-face questionnaire prepared in the light of literature. Children's height, weight and BMI values were evaluated with the WHO AntroPlus program, the Child Eating Behavior Questionnaire (CEBQ) was applied, and daily energy and nutrient consumption was calculated using the BEBIS 8.1 program from three-day food consumption records. Height, weight and BMI of the mothers were also evaluated and three-day food consumption records were taken. Nutritional risk for chronic diseases was measured with the Dietary Quality Index-International (DQI-I). According to the data obtained, the age of diagnosis of children with celiac disease is 6.1 ± 3.83 years, 23.1% of them are very short for age, and 7.5% are very low for age. 68.3% of the children participating in the study did not receive any nutritional counseling, and 41.3% use nutritional support. 18.8% of the children consume foods containing gluten. Gluten-free products consumed in the diet constitute 19.17 ± 6.31% of the total energy intake. This ratio is higher in boys (p <0.05). A positive correlation was found between food enthusiasm, emotional binge eating and food selectivity scores and energy intake, and between food enjoyment score and BMI Z-score value (p <0.05). When the nutritional intake of children was examined, it was observed that the rate of meeting daily protein and calcium needs was low (82.3% ± 15.95%, 69.1 ± 27.07% in girls and 83.5 ± 16.10%, 78 ± 26.67% in boys, respectively) (p> 0.05). 7.4% of the mothers are thin, 39.7% are slightly fat and obese. There was no difference between the DQI-I scores of the mothers according to the gluten-free diet (p> 0.05). Vitamin B1, calcium, magnesium and iron consumption of mothers is below the recommendations (68.5%, 74.2%, 80.3%, 65.9% for those who use gluten-free diet, 67.3%, 67%, 80.9%, 61.5% for those who do not). The total fat and sodium consumption of children and mothers is above the recommendations. 36.2% of the children with celiac disease and their families avoid eating outside due to the risk of gluten contamination. However, high prices, difficulty in accessing gluten-free products and low product variety are the most common difficulties. In addition, 72.4% of the children stated that while applying a diet in the school environment, they suffer from the insensitivity of the environment to diet. As a result of this study, it was revealed that children diagnosed with celiac disease and their mothers were malnourished and had difficulties in adapting to the diet. The energy consumed by the mother and the children and all nutrients were found to be correlated (p <0.05). It is recommended that mothers and children be given nutritional counseling to evaluate and monitor their nutritional status by a dietician specialized in celiac disease.