Effect of Gluten-Free Diets on Nutritional Status in celiac patients: a systematic review

Abstract

Introduction: Celiac disease (CD) is an autoimmune disease of the small intestine in which ingestion of gluten leads to destruction of intestinal areas in affected patients. Lifelong adherence to a gluten-free diet (GFD) is the only possible treatment for CD. It is less evident in adults considering the nutrient status in patients on GFD. Therefore, the aim of the study is to systematically evaluate the effect of GFD on the nutritional status of celiac patients. Methodology: A comprehensive electronic search with time and language restrictions was done. Several known databases were included: “Google Scholar, PubMed, The Cochrane Library, Web of Science” from 2000 to 2022. Keywords used included “celiac disease”, “nutrient status”, “gluten-free diet”, “nutritional deficiencies”, “dietary deficiencies”, “nutrient intake”, “micronutrient”, “macronutrient”, “vitamin”, “mineral”, “fiber intake”, “Protein intake”, and “Fat intake” Results: The electronic search strategy conducted in this review ended in 875 hits which after removing duplications reduced to 360 studies. These 360 studies were considered eligible for further evaluation, from which 346 studies were excluded for different reasons as 216 studies were based on title and abstract, 86 studies were not relevant to the subject of this study or of this review, 17 were considered replies of authors, 2 were books, and 27 were reviews. Finally , 12 articles were included in the qualitative synthesis of the present review. Conclusion: The current review showed that gluten free diet is associated with unbalanced intake of macro and micronutrients in both, celiac women and men mainly because of the unhealthy dietary habits and difficulty eliminating gluten from the diet which leads to low cereal intake and high consumption of processed gluten free products. Keywords: Gluten free diet, nutritional status, celiac disease, Saudi Arabia