Assessing Nutritional Quality and Adherence to the Gluten-free Diet in Children and Adolescents with Celiac Disease

Publication: Canadian Journal of Dietetic Practice and Research
17 February 2015

Abstract

Purpose: Little is known regarding nutritional adequacy of the gluten free diet (GFD) in children and adolescents with celiac disease (CD). The study aim was to examine macro- and micronutrient intake in children with CD.
Methods: A cross-sectional study was conducted in children and adolescents (4–18 years of age) with CD (n = 32) and healthy controls (n = 32). Macro- and micronutrient intake, and glycemic index (GI) and glycemic load (GL) intake was assessed using validated measures. Diet quality was assessed using the Canadian Healthy Eating Index (HEI-C) and the Alberta Nutrition Guidelines. Values are shown as mean ± SE.
Results: Age (10.4 ± 0.7years vs 8.7 ± 0.7 years; P = 0.06), weight-for-age z score (P = 0.27), and height-for-age z score (P = 0.23) were not different between groups. CD children consumed more fibre (15.9 ± 1.2 g per day(CD) vs 10.8 ± 0.8 g per day (controls); P < 0.001), had higher GI (CD: 54 ± 2 vs 48 ± 1; P < 0.01) and GL (CD: 118 ± 8 vs 93 ± 7; P = 0.02), and lower folate (146.7 ± 15.3 (CD) vs 245.4 ± 21.8 µg per day (controls); P < 0.001) than controls. No differences in HEI-C scores (≤ and > 80) were observed between groups (P > 0.05).
Conclusion: Children with CD had high intakes of fibre, GI, and GL and lower intakes of folate. This has implications for dietary counselling in this population.

Abstract

Objectif. Il existe peu de données sur la suffisance nutritionnelle du régime sans gluten (RSG) chez les enfants et les adolescents atteints de la maladie cæliaque (MC). L'objectif de l’étude était d'examiner l'apport en oligo-éléments et en macronutriments des enfants aux prises avec la MC.
Méthodes. Une étude transversale a été menée auprès d'enfants et d'adolescents (âgés de 4 à 18 ans) atteints de la MC (n = 32) et de témoins en santé (n = 32). L'apport en oligo-éléments et en macronutriments, l'indice glycémique (IG) et la charge glycémique (CG) ont été évalués à l'aide de mesures validées. La qualité du régime a été évaluée en fonction du Canadian-Healthy Eating Index (C-HEI) et des Alberta Nutrition Guidelines. Les valeurs sont présentées sous la forme moyenne ± erreur-type.
Résultats. L’âge (10,4 ± 0,7 années vs 8,7 ± 0,7 années; p = 0,06), l’écart réduit du poids pour l’âge (p = 0,27) et l’écart réduit de la taille pour l’âge (p = 0,23) ne variaient pas beaucoup d'un groupe à l'autre. Les enfants aux prises avec la MC consommaient plus de fibres (15,9 ± 1,2 g par jour [MC] vs 10,8 ± 0,8 g par jour [témoins]; p < 0,001), avaient un IG (MC : 54 ± 2 vs 48 ± 1; p < 0,01) et une CG (MC : 118 ± 8 vs 93 ± 7; p = 0,02) plus élevés et un plus faible apport en acide folique (146,7 ± 15,3 [MC] vs 245,4 ± 21,8 µg par jour [témoins]; p < 0,001) que les témoins. Aucune différence n'a été observée entre les groupes (p > 0,05) relativement aux scores du C-HEI (≤ et > 80).
Conclusion. Les enfants atteints de la MC consommaient plus de fibres et avaient un IG et une CG plus élevés que les témoins en santé, mais leur apport en acide folique était inférieur. Ces résultats ont des répercussions sur le counseling diététique destiné à cette population.

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Information & Authors

Information

Published In

cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 76Number 2June 2015
Pages: 56 - 63

History

Version of record online: 17 February 2015

Authors

Affiliations

Abeer S. Alzaben MSc
Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AB
Justine Turner MD, FRCPC
Department of Pediatrics, University of Alberta, Edmonton, AB
Division of Pediatric Gastroenterology, Stollery Children's Hospital, Edmonton, AB
Leanne Shirton RN
Department of Pediatrics, University of Alberta, Edmonton, AB
Division of Pediatric Gastroenterology, Stollery Children's Hospital, Edmonton, AB
Tarah M. Samuel MN, NP
Department of Pediatrics, University of Alberta, Edmonton, AB
Division of Pediatric Gastroenterology, Stollery Children's Hospital, Edmonton, AB
Rabin Persad MD, FRCPC
Department of Pediatrics, University of Alberta, Edmonton, AB
Division of Pediatric Gastroenterology, Stollery Children's Hospital, Edmonton, AB
Diana Mager PhD, RD
Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AB
Department of Pediatrics, University of Alberta, Edmonton, AB

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Cited by

1. Food Environment and Youth Intake May Influence Uptake of Gluten-Free Food Guide Recommendations in Celiac Disease
2. Dietary Intake and Micronutrient Supplementation in Youth with Celiac Disease with and without Type 1 Diabetes
3. Vitamin D Status and Bone Mineral Density is Influenced by Vitamin D Supplementation and Vitamin K1 Intake in Adults with Diabetes and Chronic Kidney Disease
4. Parental Health Beliefs, Socio-demographics, and Healthcare Recommendations Influence Micronutrient Supplementation in Youth with Celiac Disease

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