Deficiency dilemma: Long-term gluten-free diets for celiac women leads to nutrition shortfall – Study

09-Jun-2022 - Last updated on 09-Jun-2022 at 04:02 GMT

Women with celiac disease and following a strict, long-term gluten-free diet could face major nutrient deficiencies. ©Getty Images

Women with celiac disease following a strict, long-term gluten-free diet could face major deficiencies in major nutrients, including vitamin D, folate, calcium and iron, according to a new study.

Consequently, their quality of life and nutritional status could be adversely affected, according to new research undertaken on Saudi women.

These findings were highlighted in a cross-sectional study titled “Long-Term Effect of Gluten-Free Diets on Nutritional Status, Body Composition, and Associated Factors in Adult Saudi Females with Celiac Disease” published in the journal Nutrients.

“Currently, the prevalence of celiac disease is rapidly increasing worldwide, as well as in the Arabian region, where the Kingdom of Saudi Arabia (KSA) has the highest rate (3.2%). In addition, clinical reports also show that the prevalence of celiac disease is higher in females as compared to males. Yet, the gluten-free diet intake remains the most available therapy to alleviate intestinal damage and reduce nutrient absorption in those patients.

“Unfortunately, nutritional and clinical studies in celiac disease patients have shown that the complete dependence on and long-term intake of gluten-free diet, as a sole source of diet is associated with a reduced energy intake and several adverse health effects, such as deficiencies in essential nutrients, vitamins, and ions, as well as an increased risk of obesity, diabetes mellitus, metabolic disorder and cardiovascular disorder (CVD),” said the researchers.

This cross-sectional study was conducted at Buraidah Central Hospital, KSA, between August and December 2021, on 51 adult Saudi female volunteers who had been previously diagnosed with celiac disease.

The team interviewed the subjects and tracked food intake using questionnaires to retrieve data. Nutritional data was then compared to the recommended dietary intake suggested by the World Health Organization (WHO). Additional measurements such as BMI, body fat, visceral fat, waist-to-hip ratio (WHR) and fasting venous blood sample were taken.

Findings

According to the data retrieved, the actual intake of females with celiac disease did not fulfil the recommended dietary intake of all nutrients; it was significantly lower. For instance, the daily intake of iron, phosphorus, copper, calcium, folate and vitamin A was significantly lower than recommended.

In terms of anthropometric measurements, results showed that 9.8% of the subjects were underweight and had reduced BMI. Around 51% of the patients had a normal BMI, while 27.5% were overweight.

Consuming a gluten-free diet means patients must avoid food containing gluten, which results in poor nutrient intake among women with celiac disease. The subjects also consumed less fibre and micronutrients like iron, calcium and vitamin D. For macros, their intake was significantly low, especially fat, protein and fibre.

Nonetheless, the scientists also observed no sign of abnormality in females with celiac disease on a long-term gluten-free diet, except for the elevated levels during the procalcitonin test, vitamin D deficiency and anaemia.

Another significant factor was the independent variables, such as education levels, which adversely affected the subjects’ nutrition. Perhaps, a less educated female is not aware of proper dietary habits.

The adverse effects were also influenced by depression and anxiety. Past research has shown that celiac disease patients have higher rates of depression than general control groups, which in turn affects nutrition. This decreased health-related quality of life in celiac disease is associated with co-morbid physical and mental illness.

In conclusion, the consumption of a strict gluten-free diet over a long period could create a lot of restrictions that could affect the quality of life and nutritional status among the subjects.

“These findings suggest that psychosocial care, in addition to existing dietary recommendations for people with celiac disease, have the potential to improve patient well-being,” said the researchers.

Source: Nutrients

DOI: 10.3390/nu14102090

“Long-Term Effect of Gluten-Free Diets on Nutritional Status, Body Composition, and Associated Factors in Adult Saudi Females with Celiac Disease”

Authors: Aeshah Ibrahim Alhosain, et al.