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Objectives: To assess the effects of a gluten-free diet on bone structure in children with celiac disease using fractal analysis on panoramic radiographs. Method and materials: A total of 49 patients with celiac disease aged 6 to 13 years, separated into two groups as previously and newly diagnosed, and a control group of 32 healthy individuals were evaluated. In previously and newly diagnosed patients with celiac disease, body mass index Z-scores were calculated, calcium, alkaline phosphatase, vitamin D3, and parathormone levels were measured, and bone mineral density Z-scores were obtained from dual energy x-ray absorptiometry. In all patients, the fractal dimensions of the right and left temporomandibular condyles were evaluated with the fractal analysis method on panoramic radiographs. Results: The mean values of serum biomarker levels and the body mass index and bone mineral density Z-scores for both celiac groups were within the normal reference range. No statistically significant difference was determined between right and left condyle fractal dimensions values in the three groups examined. In terms of both right and left condyle fractal dimensions values, there was a statistically significant difference between groups. The highest fractal dimensions values were determined in the previously diagnosed group. Conclusions: Differences in fractal dimensions values were observed among patients with celiac disease following the gluten-free diet. Utilizing fractal analysis on panoramic radiographs can prove valuable for dental practitioners in evaluating bone mineral density due to its cost-effect iveness, easy accessibility, and reduced radiation exposure for patients, enabling them to provide comprehensive oral health care and potential early interventions for patients with celiac disease. [ABSTRACT FROM AUTHOR]

BackgroundA subgroup of adults with celiac disease experience persistent gastrointestinal and extraintestinal symptoms, which vary between individuals and the cause(s) for which are often unclear.MethodsThe present observational study sought to elucidate patterns of persistent symptoms and the relationship between those patterns and gluten-free diet adherence, psychiatric symptoms, and various aspects of quality of life (QOL) in an online sample of adults with celiac disease. U.S. adults with self-reported, biopsy-confirmed celiac disease (N = 523; Mage = 40.3 years; 88% women; 93.5% White) voluntarily completed questionnaires as part of the iCureCeliac® research network: (a) Celiac Symptoms Index (CSI) for physical symptoms and subjective health; (b) Celiac Dietary Adherence Test for gluten-free diet adherence; (c) PROMIS-29, SF-36, and Celiac Disease Quality of Life Survey for psychiatric symptoms and QOL. Symptom profiles were derived using latent profile analysis and profile differences were examined using auxiliary analyses.ResultsLatent profile analysis of CSI items determined a four-profile solution fit best. Profiles were characterized by: (1) little to no symptoms and excellent subjective health (37% of sample); (2) infrequent symptoms and good subjective health (33%); (3) occasional symptoms and fair to poor subjective health (24%); (4) frequent to constant symptoms and fair to poor subjective health (6%). Profiles 2 and 3 reported moderate overall symptomology though Profile 2 reported relatively greater extraintestinal symptoms and Profile 3 reported relatively greater gastrointestinal symptoms, physical pain, and worse subjective health. Profiles differed on anxiety and depression symptoms, limitations due to physical and emotional health, social functioning, and sleep, but not clinical characteristics, gluten-free diet adherence, or QOL. Despite Profile 3's moderate symptom burden and low subjective health as reported on the CSI, Profile 3 reported the lowest psychiatric symptoms and highest quality of life on standardized measures.ConclusionsAdults with celiac disease reported variable patterns of persistent symptoms, symptom severity, and subjective health. Lack of profile differences in gluten-free diet adherence suggests that adjunctive dietary or medical assessment and intervention may be warranted. Lower persistent symptom burden did not necessarily translate to better mental health and QOL, suggesting that behavioral intervention may be helpful even for those with lower celiac symptom burden.

Background and Aim Methods Results Conclusion Non‐responsive celiac disease (NRCD) is defined as ongoing symptoms despite 6–12 months of gluten‐free diet (GFD), the only known treatment for celiac disease (CeD). There is inconsistency in studies describing the proportion of patients having NRCD and its various causes among patients with CeD. We therefore conducted a systematic review and meta‐analysis to determine the prevalence and causes of NRCD.The PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases were searched for original studies reporting the proportion of patients with persistent symptoms after ≥ 6 months of GFD. Studies reporting the etiologies of NRCD were also identified. The systematic review was conducted as per the Meta‐analysis of Observational Studies in Epidemiology guidelines. Statistical analysis was performed in STATA.Of 2965 search results, nine studies met the inclusion and exclusion criteria. Five studies (n = 4414) reported data on prevalence, and seven studies (n = 790) reported the causes of NRCD. The pooled prevalence of NRCD was 22% (95% confidence interval, 11–35%). Among patients with NRCD, inadvertent exposure to gluten was the most common cause (33%), followed by functional gastrointestinal disorders including irritable bowel syndrome in 16%. Refractory CeD type II along with its premalignant and malignant sequelae was observed in 7% of patients with NRCD.One in five patients with CeD may not respond to GFD and would likely be classified as NRCD. Inadvertent gluten exposure was the cause of ongoing symptoms in one‐third of patients with NRCD. Improving adherence to GFD along with developing novel therapeutics to mitigate symptoms due to ongoing gluten exposure is critical. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of gluten-related disorders, mainly celiac disease (CD) and non-celiac gluten sensitivity (NCGS), varies between 0.6% and 13% in the general population. There is controversial evidence regarding the association of both CD and NCGS with extra-digestive manifestations, including recurrent reproductive failure (RRF), which may have clinical implications. Objective: To study the prevalence of HLA susceptibility alleles for CD/NCGS in a cohort of female patients with RRF from a single reference center and to evaluate the effect of a gluten-free diet on reproductive success. Material and methods: A retrospective study was conducted on 173 patients with RRF, consecutively attended at the Reproductive Immunology Unit of San Carlos University Clinical Hospital in Madrid. We collected and analyzed the clinical, analytical, and immunological profiles of RRF patients who presented HLA alleles associated with CD and NCGS (HLA DQ2.2, DQ2.5, DQ8, and DQ7.5). Results: We observed a significantly higher prevalence of HLA alleles associated with CD and NCGS in our RRF cohort compared to the prevalence in the general population (69% vs. 35%–40%, p<0.0001). Only 2.3% of patients met the criteria for a CD diagnosis. In our RRF cohort, HLA-genetic susceptibility for CD/NCGS (HLA-risk group) was associated with a significantly higher rate of hypothyroidism compared to patients without these alleles (HLA-negative group) (48.7% vs. 26.92%, p=0.03). Patients with HLA-genetic susceptibility for CD/NCGS and thyroid disease had a significantly higher success rate in the subsequent pregnancy after management (55% vs. 30%, p=0.002). Two factors were found to be significant in this group: a gluten-free diet (p=0.019) and the use of levothyroxine (p=0.042). Conclusions: In our cohort of RRF patients, we observed a significantly higher prevalence of HLA susceptibility genes for CD/NCGS compared to the general population, also associated with a higher incidence of thyroid alterations. A gluten-free diet and the use of levothyroxine in cases of thyroid pathology had significant beneficial effects on pregnancy outcomes. We suggest that HLA typing for CD/NCGS and a gluten-free diet, in the presence of risk alleles, can improve pregnancy outcomes in RRF patients. [ABSTRACT FROM AUTHOR]

Background: Most people maintaining a gluten-free diet (GFD) do not have celiac disease (CD). Comorbidities and associated conditions in this population are largely unknown. Aims: This study identified demographics, dietary patterns, and diagnoses for patients prescribed a GFD during hospitalization and compared patients with CD to those without CD. Methods: We performed a retrospective cross-sectional study for hospital admissions with a GFD between Jan 1, 2010 and June 30, 2022, while excluding patients missing demographic data (n = 113). We compared patients with and without a CD diagnosis, including multivariable logistic regression to identify characteristics independently associated with a CD diagnosis. Results: We analyzed 1527 hospitalized patients of all ages. A minority (n = 467, 30.6%) carried a CD diagnosis. Age, sex, body mass index, and Medicare/Medicaid enrollment and additional diagnoses associated with a GFD (e.g., IBS) were not significantly different. The CD cohort was more predominantly white (66.6% vs 58.4%, p = 0.007) and non-Hispanic (62.5% vs. 52.7%, p = 0.001). While hospitalized, patients with CD had fewer additional dietary restrictions (mean 0.33 vs 0.56, p < 0.001) and more frequent micronutrient supplementation (26.6% vs 21.4%, p = 0.03). CD was independently associated with malnutrition (OR 1.86, 95% CI 1.31–2.65) and inversely associated with a vegetarian diet (OR 0.35, 95% CI 0.15–0.81), reduced lactose diet (OR 0.25, 95% CI 0.13–0.50), and Hispanic ethnicity (OR 0.56, 95% CI 0.35–0.90) while controlling for other covariates. Discussion: Two-thirds of hospitalized patients receiving a GFD do not have a diagnosis of CD. Among GFD inpatients, CD is associated with fewer dietary restrictions and independently associated with malnutrition. [ABSTRACT FROM AUTHOR]

Background: Common gastrointestinal disease irritable bowel syndrome (IBS) is marked by symptoms like changed bowel habits, bloating, and stomach ache. A low-FODMAP combined gluten-free diet (LF-GFD) has been suggested as a possible therapy for IBS symptoms management. Objective: This study sought to investigate whether a LF-GFD would help patients with IBS. Methods: Strict inclusion and exclusion criteria from internet databases helped to identify clinical studies evaluating the intervention of LF-GFD in the treatment of IBS patients. Using measurements including the visual analog scale (VAS) for bloating and pain, the IBS symptom severity scale (IBS-SSS), and IBS quality of life (IBS-QoL), the main results evaluated were the efficacy of LF-GFD in reducing IBS symptoms. Furthermore assessed were the psychological impacts of LF-GFD utilizing the self- rating depression scale (SDS) and self- rating anxiety scale (SAS). Results: A total of 437 patients (221 on LF-GFD diet and 216 on GFD) were involved in 4 randomized controlled trials and 4 cohort studies. The combined results indicated that LF-GFD reduced the VAS bloating ratings (RR = − 0.58, 95%CI − 0.92–0.23, P = 0.0010, I2 = 83%) and the VAS pain scores (RR = − 0.42, 95%CI − 0.66–0.19, P = 0.005, I2 = 58%). In addition, LF-GFD indicated a substantial enhancement in IBS-SSS scores (MD = − 1.42, 95%CI − 2.74–0.10, P = 0.03, I2 = 24%) and IBS-QoL ratings (MD = 3.75, 95%CI 0.98–6.53, P = 0.008, I2 = 33%). Moreover, the LF-GFD group showed a substantial drop in SDS (MD = − 2.56, 95%CI − 3.38–1.74, P < 0.00001, I2 = 65%) and SAS (MD = − 4.30, 95%CI − 6.53–2.24, P < 0.0001, I2 = 0%) scores compared to the GFD group. Conclusion: LF-GFD therapy significantly enhances clinical symptoms and reduces anxiety and depression in individuals diagnosed with irritable bowel syndrome. [ABSTRACT FROM AUTHOR]

The potential modulation of thyroid inflammatory conditions via a gluten-free diet has been suggested after establishing a link between Hashimoto's thyroiditis (HT) and celiac disease. However, the majority of targeted studies in this field do not support the general recommendation of prescribing a gluten-free diet (GFD) for all HT patients. This study aims to analyze data regarding the impact of a GFD supplemented with eicosapentaenoic (EPA) and docosahexaenoic acid (DHA), along with vegetables, on the course of inflammation involving long-chain fatty acid mediators. The study cohort consisted of 39 Caucasian female patients with autoimmune HT. Metabolite separations were performed using a liquid chromatograph with a DAD detector. Absorption peaks were read at 210 nm for resolvin E1, protectin DX, and maresin 1 and at 302 nm for resolvin D1. The introduction of a gluten-free diet completed with omega-3, including EPA and DHA, may contribute to a reduction in the inflammatory state in HT patients. This effect is supported by the elevation in the levels of anti-inflammatory mediators derived from long-chain fatty acids with anti-inflammatory properties but not by eliminating gluten. Significant statistical changes in the levels of all derivatives were observed before and after the implementation of the diet. It is worth noting that this effect was not observed in anti-TPO and anti-TG levels. The induction of anti-inflammatory changes can be achieved by supplementing the diet with EPA, DHA and vegetables with increased anti-inflammatory potential. [ABSTRACT FROM AUTHOR]

The genetic architecture of multiple sclerosis (MS) is similar to that of coeliac disease, with human leukocyte antigen (HLA) being the greatest genetic determinant in both diseases. Furthermore, similar to the involvement of gluten in coeliac disease, Epstein–Barr virus (EBV) infection is now widely considered to be an important environmental factor in MS. The molecular basis for the HLA association in coeliac disease is well defined, and B cells have a clear role in antigen presentation to gluten-specific CD4+ T cells. By contrast, the mechanisms underlying the HLA association of MS are unknown but accumulating evidence indicates a similar role of B cells acting as antigen-presenting cells. The growing parallels suggest that much could be learned about the mechanisms of MS by using coeliac disease as a model. In this Perspective article, we discuss the insights that could be gained from these parallels and consider the possibility of antiviral treatment against EBV as a therapy for MS that is analogous to the gluten-free diet in coeliac disease. In this Perspective, the authors discuss how our understanding of coeliac disease could provide insights into the mechanisms of multiple sclerosis, the involvement of Epstein–Barr virus and the possibility of antiviral treatment against the virus as a therapy for multiple sclerosis. [ABSTRACT FROM AUTHOR]

Cereal gluten-free (CGF) products have been popular in recent years, supporting a growing demand as they appeal not only to persons with medical needs but also to consumers seeking a gluten-free diet. The aim of this study was to develop cereal gluten-free pasta by replacing wheat flour with semi-popped makhana (SPM) flour, water chestnut (WCN) flour, and potato flour (PF) and to evaluate the effect of these ingredients on nutritional, technological phytochemical, and sensorial properties of CGF pasta. Optimization and statistical analysis were carried out using Box–Behnken design of response surface methodology using variables: SPM flour (30–50 g), WCN flour (20–30 g), and PF (30–50 g) with constant level of carrot juice. The results showed that incorporation of SPM flour increased total protein, iron, total phenolics, flavonoids, FRAP, and DPPH activity of developed CGF pasta. With increasing addition of PF and WCN in pasta, the L* (lightness) values of pasta decreased gradually, while the a* (redness) and b* (yellowness) values increased. Moreover, SPM flour, WCN flour, and PF had significant effect on technological properties and tensile strength of CGF pasta. Thus, 47.81% SPM flour, 23.50% WCN flour, and 28.69% PF in formulation were optimized for development of CGF pasta with 10.29% total protein, 39.41 mg/100 g calcium, 10.53 mg/100 g iron, 1.59 min cooking time, 2.45 rehydration ratio, peak viscosity as 798 cP, final viscosity as 957 cP, 27.82 g tensile strength, 28.36% DPPH inhibition, 716.83 mg GAE/100 g TPC, and 339.57 mg QE/100 g TFC. In addition, FTIR revealed no structural changes between optimized CGF pasta and control semolina pasta. Sensory data revealed that optimized CGF pasta had overall sensory acceptability of 7.41 and storage stability up to 6 months. [ABSTRACT FROM AUTHOR]

Iron deficiency (ID) without anemia is common in children with newly diagnosed celiac disease (CD). We aimed to assess the effect of iron supplementation versus no treatment on ferritin levels in newly diagnosed CD patients with ID adhering to a gluten-free diet (GFD). A retrospective review of children < 18 years, with low ferritin (≤ 10 ng/mL) and normal hemoglobin levels diagnosed between 12.2018 and 12.2021. We compared hemoglobin and ferritin levels between patients who received supplemental iron to those who did not. Data, including demographics, laboratory tests, and anthropometrics, were collected at baseline, and at 6 and 12 months following the initiation of the GFD. Adherence to GFD was assessed at each visit. Among 304 children diagnosed during the study period, 43 (14.1%) had iron deficiency anemia and 60 (19.7%) ID without anemia. Among children with ID, 29 (48%) were female, mean age 7.3 ± 3.9 years. Twenty-nine (48%) children received iron supplementation, and 31 (52%) did not. At the 12-month follow-up visit, tissue transglutaminase levels decreased significantly (p < 0.001), from a mean baseline level of 226.6 ± 47.8 to 34.5 ± 46 U/mL in children that received iron supplementation and from 234.2 ± 52.4 to 74.5 ± 88.7 U/mL in non-treated children, with no significant difference between the groups p = 0.22. Ferritin levels increased significantly (p < 0.001), from 9.0 ± 4.7 to 25.2 ± 20.8 ng/mL in patients who received supplementation and from 8.9 ± 3.8 to18.6 ± 9.5 ng/mL in patients who did not, with no significant difference between the groups (p = 0.46). Conclusion: Most children with newly diagnosed celiac disease and iron deficiency, who adhere to GFD, will normalize ferritin levels within 12 months without the need of iron supplementation. What is Known: • Iron deficiency and iron deficiency anemia are common in newly diagnosed celiac disease. • Improved iron absorption may follow mucosal healing process in patients adhering to a strict gluten-free diet. What is New: • This single-center, retrospective cohort study evaluated the effect of iron supplementation versus no treatment on ferritin levels in children with newly diagnosed celiac disease with iron deficiency adhering to a gluten-free diet. • Most children with newly diagnosed celiac disease and iron deficiency, who adhere to gluten-free diet, will normalize ferritin levels within 12 months without the need of iron supplementation. [ABSTRACT FROM AUTHOR]

Nutrition is an essential part of therapy for type 1 diabetes and is constantly evolving, offering growing opportunities to prevent this disease, slow down its evolution, and mitigate it. An attempt was made to bring together the current state of knowledge. In the path from the preclinical phase of the disease to its clinical onset, there is a phase known as the "honeymoon period" or partial remission, where different possible dietary options for combatting this disease have been presented. The most commonly used dietary models were compared, and the most frequent co-existing pathologies, such as overweight, non-alcoholic fatty liver disease, dyslipidemia, celiac disease, and metabolic instability, were addressed from their nutritional and dietary perspectives to provide clinicians with an updated framework of knowledge and support researchers in further investigations into the topic. Finally, a glimpse into the possible interplay between nutrition and the gut microbiome, food security, and ultra-processed food is provided. It is hoped that clinicians treating people with type 1 diabetes will be provided with further opportunities for the daily management of their patients through personalized nutrition. [ABSTRACT FROM AUTHOR]

A decade of research on gluten-related disorders (GRDs) is reviewed in this study, with a particular emphasis on celiac disease (CD) and non-celiac gluten sensitivity (NCGS). GRDs are triggered by the ingestion of gluten and gluten-like proteins found in wheat, barley, and rye. These proteins lead to intestinal damage in celiac disease, an autoimmune condition characterized by villous atrophy and a variety of gastrointestinal and extraintestinal symptoms. More enigmatic and less understood, NCGS involves symptoms similar to CD but without the immunological reaction or intestinal damage. Recent years have seen advances in the understanding of GRDs, particularly in connection to how intestinal microbiota influences disease progression and patient outcomes. The gluten-free diet (GFD) is still the standard therapy recommended for GRDs despite significant challenges, as discussed in this article. Precise diagnostic methods, patient education and dietary counseling are critical for improving patients' quality of life. The purpose of this review is to provide a more clear and up-to-date understanding of GRDs, and to help further research on this important topic. [ABSTRACT FROM AUTHOR]

Sustainable diets, as defined by the Food and Agriculture Organisation, aim to be nutritionally adequate, safe, and healthy, while optimising natural and human resources. Teff (Eragrostis tef), a gluten-free grain primarily grown in Ethiopia, has emerged as a key contender in this context. Widely regarded as a "supergrain", teff offers an outstanding nutrition profile, making it an excellent choice for people with gluten-related disorders. Rich with protein, essential amino acids, polyunsaturated fats, and fibre, and abundant in minerals like calcium and iron, teff rivals other popular grains like quinoa and durum wheat in promoting human health. Beyond its nutritional benefits, teff is a hardy crop that thrives in diverse climates, tolerating both drought and waterlogged conditions. Due to its resilience and rich nutrient content, teff holds the potential to address nine of the 17 United Nations' Sustainable Development Goals (SDGs), including SDG 1 (no poverty), SDG 2 (zero hunger), and SDG 3 (good health and wellbeing), which are tied to improving food and nutrition security. However, teff production in Ethiopia faces significant issues. Traditional farming practices, insufficient storage infrastructure, and food safety challenges, including adulteration, hinder teff's full potential. This review explores teff's dual role as a nutritious, sustainable food source and outlines the key challenges in its production to conclude on what needs to be done for its adoption as a golden crop to address global food and nutrition security. [ABSTRACT FROM AUTHOR]

AbstractA gluten-free diet is the only treatment for patients with coeliac disease, who report dissatisfaction with the availability and variety of products, especially bread and pasta. The aim was to compare availability, cost, nutritional composition and ingredients of gluten-free and conventional bread and pasta products. Census of breads and pastas available in online commerce belonging to the third largest supermarket chain in southern Brazil. Information was collected at supermarket′s and brand’s websites. One hundred and fourteen products were analysed (n = 37 breads and n = 77 pastas): 32.4% (n = 12) gluten-free breads and 18.2% (n = 14) gluten-free pastas. Both gluten-free breads and pastas were significantly more expensive when compared to gluten-containing breads and pastas. Gluten-free breads have higher fat content, gluten-free pastas have higher content of sodium and ingredients. Gluten-free breads and pastas are less available, more expensive and have lower nutritional value compared to conventional versions. [ABSTRACT FROM AUTHOR]

The high cost of gluten‐free products (GFPs) is being discussed as a potential barrier to adherence to a gluten‐free diet, rendering monitoring of their pricing an ongoing demand in a market subject to continuous fluctuations. The current study aimed to assess the current pricing status of GFPs in the Greek retail market, with a focus on differences between staple and non‐staple foods. The retail price and packaging weight of all available GFPs and their gluten‐containing (GCPs) counterparts of a GFP‐shopping basket (formulated based on the results of a preceding online survey) were recorded by visiting one store of the five most popular reported supermarket chains. The food categories were grouped into staple (e.g. breads, pasta and flours) and non‐staple (e.g. chips, sweets and sauces) foods. Adjusting for supermarket chain and product type, a quantile mixed regression model was applied to assess the extent to which median product price (per 100 g) differed between GFPs and GCPs. The unique products recorded were 1058 (of which 408 GFPs), with a total of 2165 retail price recordings. While the overall median price/100 g of GFPs was not found to be significantly different from that of GCPs, the median price of staple GFPs was estimated to be higher than staple GCPs (+€1.03 [95% CI: €0.93; €1.13] per 100 g), whilst that of non‐staple GFPs was slightly lower (−€0.20 [95% CI: −€0.37; −€0.02] per 100 g). In conclusion, the persisting higher cost of staple GFPs suggests the need for ongoing financial support for people with coeliac disease. [ABSTRACT FROM AUTHOR]

Background/Objectives: Among the most important challenges associated with the gluten-free diet are the high costs and limited availability of gluten-free products, accompanied by the lower nutritional value of gluten-free products. The aim of the presented study was to assess gluten-free products' availability and satisfaction in a Polish population of coeliac-disease patients and their caregivers. Methods: The study was conducted in a population of Polish female coeliac-disease patients and female family members/relatives of patients diagnosed with coeliac disease, being members of the Polish Coeliac Society and purchasing gluten-free products. A population of n = 819 was included in the studied group based on the inclusion and exclusion criteria (n = 547 of patients and n = 272 of family members/relatives of patients). The study was conducted as a part of an international project to assess the opinions of coeliac-disease patients about gluten-free products, as well as the availability and prices of gluten-free products in various countries, while an identical questionnaire was applied in all participating countries, with transcultural adaptation applied. Opinions concerning the availability of and satisfaction with gluten-free products were assessed based on a questionnaire of agreement with fixed statements about the accessibility, range and quality of gluten-free products in Poland, with a five-point Likert scale to declare the agreement. This was stratified by the following variables: age, place of residence, being diagnosed with coeliac disease, place of purchasing major grocery shopping, gluten-free products at least occasionally bought online, declared problem(s) with the availability and quality of gluten-free products. Results: While comparing the studied sub-groups, it may be stated that some of them were more satisfied than the other sub-groups with the gluten-free products, including their availability and quality; namely, older respondents were more satisfied than younger ones (p < 0.05), respondents living in small towns/villages were more satisfied than those living in big cities (p < 0.05), respondents undertaking major grocery shopping in hypermarkets were more satisfied than those not doing this (p < 0.05), and respondents not buying gluten-free products online were more satisfied than those undertaking this at least occasionally (p < 0.05). At the same time, respondents diagnosed with coeliac disease were more satisfied with the availability and less satisfied with the quality of gluten-free products, while respondents with diagnosed family members/relatives were less satisfied with the availability and more satisfied with the quality (p < 0.05). Conclusions: The group of female coeliac-disease patients and female family members/relatives of patients diagnosed with coeliac disease was highly diverse in terms of their satisfaction with gluten-free products' availability and quality, whilst older respondents, respondents living in small towns/villages, respondents doing major grocery shopping in hypermarkets, and respondents not buying gluten-free products online were more satisfied. Respondents with family members/relatives diagnosed with coeliac disease declared serious efforts and sacrifice to purchase gluten-free products, which was associated with their higher satisfaction with quality and lower satisfaction with availability, while respondents diagnosed with coeliac disease chose easier options, resulting in their higher satisfaction with availability and lower satisfaction with quality. [ABSTRACT FROM AUTHOR]

Background: This study aimed to estimate the prevalence of obesity, overweight, and underweight in celiac disease (CD) at diagnosis before starting the Gluten-free diet (GFD). Methods: A comprehensive search was conducted in PubMed, Embase, Scopus, and Web of Science until July 2024 to find the cross-sectional and longitudinal studies that measured the body mass index (BMI) in CD patients at diagnosis. The risk of bias assessment was conducted using the Newcastle–Ottawa Quality Assessment scale. Meta-regression analyses were applied to understand whether weight status is associated with CD. Results: A total of 23 studies involving 15,299 CD patients and 815,167 healthy individuals were included in this study. In newly diagnosed CD patients, pooled estimates of the prevalence of obesity, overweight, and underweight before GFD were 11.78%, 18.42%, and 11.04%, respectively. The prevalence of overweight and obesity in newly diagnosed CD patients increased from 22.15% in 2003–2009 to 32.51% in 2016–2021. Meta-regression analyses indicated that the CD patients with higher BMI had a higher mean age (p = 0.001), and female gender had a marginally significant (p = 0.055) association with higher BMI. Only a few CD patients were underweight at the time of diagnosis, and more patients were overweight/obese. Conclusions: our meta-analysis demonstrated that only a few CD patients were underweight at the time of diagnosis, and almost 37% were overweight or obese. Meta-regression showed a significant association between higher BMI and higher mean age and female gender. A delay or failure for diagnosis of CD is more common in overweight/obese patients, resulting in more progression of the disease and counteracting any advantages of diagnosis. [ABSTRACT FROM AUTHOR]

Background: Celiac disease is an autoimmune disorder triggered by dietary gluten in genetically predisposed individuals that primarily affects the small intestine. Studies have reported differentially abundant bacterial taxa in the gut microbiota of celiac patients compared with non-celiac controls. However, findings across studies have inconsistencies and no microbial signature of celiac disease has been defined so far. Results: Here, we showed, by comparing celiac patients with their non-celiac 1st-degree relatives, that bacterial communities of related individuals have similar species occurrence and abundance compared with non-relatives, regardless the disease status. We also found in celiac patients a loss of bacterial species associated with fiber degradation, and host metabolic and immune modulation, as ruminiclostridia, ruminococci, Prevotella, and Akkermansia muciniphila species. We demonstrated that the differential abundance of bacterial species correlates to different dietary patterns observed between the two groups. For instance, Ruminiclostridium siraeum, Ruminococcus bicirculans, and Bacteroides plebeious, recognized as fiber-degraders, appear more abundant in non-celiac 1st-degree relatives, which have a vegetable consumption pattern higher than celiac patients. Pattern of servings per day also suggests a possible link between these species' abundance and daily calorie intake. Conclusions: Overall, we evidenced that a kinship approach could be valuable in unveiling potential celiac disease microbial traits, as well as the significance of dietary factors in shaping microbial profiles and their influence on disease development and progression. Our results pave the way for designing and adopting novel dietary strategies based on gluten-free fiber-enriched ingredients to improve disease management and patients' quality of life. [ABSTRACT FROM AUTHOR]

The American College of Gastroenterology revised its recommendations for diagnosing and managing celiac disease in its updated 2023 clinical guideline. Celiac disease is an autoimmune disorder causing malabsorption following exposure to gluten. A wide range of both gastrointestinal and nongastrointestinal signs and symptoms can occur. This article provides an overview of the diagnosis and management of celiac disease, aiding the NP in developing a greater awareness of the condition both to diagnose it and to refer patients as needed to gastroenterology for evaluation. [ABSTRACT FROM AUTHOR]

Background: Children in India who have been diagnosed with celiac disease deal with a variety of challenges and difficulties as a result of their condition. Understanding their experiences is important to help the patients adapt better to the demands of celiac disease and gluten-free diet. Methods: The present study has used a constructivism paradigm as a study design. Participants were recruited through purposive sampling. In-depth telephonic interviews were conducted with 10 children with celiac disease. Thematic analysis was used to analyze the interview data. Results: The main themes and sub-themes that emerged from the data were emotional responses (the feeling of deprivation, the feeling of being different from others, the novelty of gluten-free diet leading to excitement), physical health impact (getting tired easily, delayed growth), social constraints (social limitations brought on by celiac disease, peer pressure to eat gluten, and non-acceptance of celiac disease by others), future concerns (uncertainty about the future, improved physical health, celiac disease cure, dependency on others), navigating dietary changes (fear of cross-contamination, food restrictions caused by celiac disease, non-availability of gluten-free food, and limited food options outside the home), coping strategies, and management of celiac disease (eat home-cooked meals, receiving support from family, and friends, adhering to gluten-free diet). Conclusion: Governmental organizations and experts in mental health must acknowledge the needs of Indian children with celiac disease. The need of the hour is to improve gluten-free product labelling and raise awareness of celiac disease. [ABSTRACT FROM AUTHOR]

Background: Facebook (FB) is the most popular online networking platform. Many celiac disease Facebook (CD-FB) pages spread awareness about celiac disease (CD). To get the latest information, patients with CD frequently follow such pages. However, little is known about whether such pages provide authentic and reliable information. Aims: This study aims to investigate whether CD-FB pages spread misleading information to patients with CD. Methods: On the Facebook social networking platform, CD-FB pages created in three celiac-prevalent countries (Italy, the USA, and India) were explored using different combinations of keywords. The type/category of the CD-FB page, country of origin, purpose, page web link, and number of followers/members were documented in a Microsoft spreadsheet. All posts distributed on selected CD-FB pages in the last 3 years were thoroughly screened. Results: From August 2022 to March 2023, a total of 200 CD-FB pages from Italy, the USA, and India were explored. Out of these 200 pages, 155 CD-FB (Italy 70; the USA 46; India 39) were found eligible. Of them, 20 (13%) CD-FB pages (Italy 4; the USA 5; India 11) shared misleading information about CD. Surprisingly, 11 (8%) of these 20 pages (Italy 0; the USA 2; India 9) supported alternative treatment options for CD. Conclusions: CD-FB pages are useful for disseminating celiac-disease-related information. While most such pages provide useful information, 13% of CD-FB pages allow misleading information. Patients with CD should consult their treating unit before following any uncertain information posted on CD-FB pages. [ABSTRACT FROM AUTHOR]

INTRODUCTION: In different countries, the exact prevalence of people that refer symptoms after gluten ingestion is increasing and the unavailability of reliable laboratory tests to diagnose the condition known as nonceliac gluten sensitivity (NCGS) has opened the door to the spread of survey-based studies to hypothesize a prevalence of this condition with highly discordant results. We aim to describe the attitude toward gluten consumption in a large population of young adults in Italy. METHODS: A questionnaire-based cross-sectional study was conducted in 13 Italian cities to investigate the dietary attitudes of more than 9,400 people distributed throughout the country about gluten consumption. Only those referring to gluten-related symptoms with a frequency equal to "always" or "most of the time" were considered self-reported NCGS (SR-NCGS) patients. RESULTS: Five thousand two hundred thirty-four of 9,432 eligible participants (55.5%) fully completed the questionnaire. Excluding those with previous gastrointestinal diagnoses of celiac disease and wheat allergy, we have finally analyzed 4,987 questionnaires. Four hundred eighty-seven participants indicated gluten-related symptoms always or most of the time (SR-NCGS subjects), while 121 already had a medical diagnosis of NCGS. The minimum prevalence figure of SR-NCGS is 6.4% (95% confidence interval 6.0-6.9), with a higher prevalence in women (79.9%). The most frequent glutenrelated symptoms were bloating, abdominal pain, and tiredness. DISCUSSION: The high prevalence of people reporting symptoms after gluten ingestion requires that the diagnosis of NCGS should be ascertained with a double-blind controlled study to limit the number of people who improperly approach a gluten-free diet. [ABSTRACT FROM AUTHOR]

Introduction: Although separate immunogenic mechanisms are involved, IgE-type sensitization to wheat and celiac disease (CD) may coexist. We observationally assessed the importance of this relationship in daily practice using CD and wheat sensitization screenings. Methods: Celiac antibody (CA) screening and food prick tests (FPTs) were requested simultaneously from patients who presented to the Allergy Clinic between January 2022 and December 2023 and had any complaint accompanied by CD symptoms/findings (non-celiac group). Patients with positive CA (CA+) underwent endoscopy. As another group, FPT results were recorded for patients previously diagnosed with CD following a gluten-free diet (celiac group). Results: In total, 169 patients (124 non-celiac and 45 celiac) were included in the study. Wheat prick positivity (WP+) was observed in 1 patient with CD. Among 65 WP+ patients without a CD diagnosis, 14 (20.3%) tested positive for CA+, and histopathology detected CD in 4 of these cases. Among the 59 WP– patients, 4 (8.8%) had CA+. The CA+ status of those with WP+ was significantly higher than those with WP– (p = 0.023). Conclusion: The 4 patients unaware of their CD exhibited WP+, with a higher rate of CA+ observed in the WP+ group. The association between WP+ and CA+ suggests that an impaired intestinal barrier may lead to simultaneous T helper 1 and 2 type inflammatory responses. Although different types of sensitization to the same food would not typically be expected, growing evidence indicates that this phenomenon does occur. Further studies are necessary to confirm these findings and to explore the underlying causes. [ABSTRACT FROM AUTHOR]

Background: Collagenous gastritis (CG) and Lymphocytic gastritis (LG) are rare types of gastritis. Thick sub-epithelial collagen bands characterize CG. Numerous lymphocytes in the surface and foveolar epithelium characterize LG. We aimed to characterize these disorders in our pediatric unit. Methods: A retrospective review of children diagnosed with CG and LG between 2000 and 2023. Baseline data; demographics, anthropometric, symptoms, laboratory data, macroscopic and histopathologic findings. Follow-up data; treatment, improvement of symptoms and laboratory parameters. Results: We identified 31 children, 11 (35.5%) had CG and 20 (64.5%) LG, mean age 9.07 ± 5.04 years. Seven (22.6%) children were diagnosed between 2000 and 2016 and 24 (77.4%) between 2017 and 2023. Baseline characteristics included gastrointestinal symptoms in 16 (51.6%), iron deficiency anemia in 22 (71%), with a mean hemoglobin level of 8.8 ± 2.5 gr/dl. Gastric endoscopic findings were normal in 12 (38.7%), demonstrated nodularity in 14 (45.2%) and an inflamed mucosa without nodularity in 5 (16.1%). Helicobacter pylori was positive in 3 (9.7%) children, celiac disease was diagnosed in 7 (22.6%). Treatment included iron supplementation in 24 (77.4%), proton pump inhibitors in 16 (51.6%) and a gluten free diet in seven. Mean follow-up was 2.9 ± 2.2 years. Hemoglobin levels normalized in 21/22; however, 9 (29%) patients required repeat iron supplementation. Eight patients had a repeat endoscopy (6 CG and 2 LG) without changes in their gastric histopathology. Conclusions: CG and LG are not rare in pediatric patients. Physicians and pathologist should be aware of these types of gastritis. [ABSTRACT FROM AUTHOR]

Background: The only treatment for Celiac Disease (CeD), which affects about 1% of the population, is a gluten-free diet (GFD). Studies have indicated an association between the GFD, a diminished quality of life (QOL), and maladaptive eating patterns. This study aims to explore food avoidance behaviors in adults with CeD. Methods: This cross-sectional study assessed 50 adults with biopsy-confirmed CeD who completed validated surveys evaluating demographics, psychological factors, QOL, eating pathology, and food avoidance. Results: Overall CDQOL scores were good (mean: 62.7 out of 100). However, 58.0% of the participants self-elected to avoid one or more additional foods without diagnosed allergies or intolerances. Those avoiding one or more other foods had lower QOL scores (57.4 (23.2) vs. 70.2 (15.9)) compared to those only avoiding gluten (p = 0.034). The mean depression score (CESD) for the group avoiding foods beyond gluten was in the depressive range, unlike those avoiding only gluten (16.0 (4.9) vs. 13.6 (4.0), p = 0.078), with 77% of those avoiding more than gluten scoring above the CESD cut-off point of 15, indicating clinical depression. Conclusions: Over half of participants (58%) reported avoiding additional foods beyond the GFD, a behavior associated with decreased QOL and increased depression. [ABSTRACT FROM AUTHOR]

Background and aims: The clinical presentation of celiac disease (CD) has changed over time with more patients presenting with non-classical symptoms, extra-intestinal manifestations (EIM) or no symptoms. We aimed to investigate the main symptoms/signs leading to the diagnosis of CD in adult patients. As secondary end-point, we evaluated the outcome of gastrointestinal (GI) symptoms following gluten-free diet (GFD). Methods: All consecutive CD adult patients referring to our University Hospital from September 2022 to February 2024 were included. Clinical data were retrospectively evaluated. Results: 134 patients, 104 females/30 males, median age at diagnosis 35 years, were included. 79 patients reported GI symptoms (i.e., diarrhea, abdominal bloating, dyspepsia) as the main symptom leading to CD diagnosis. In 40 patients, the leading symptom/sign was an EIM (i.e., iron deficiency anemia, infertility/miscarriages, dermatitis, osteoporosis, elevated transaminase levels). Fifteen patients were asymptomatic, being diagnosed because of a positive family history or concomitant autoimmune hypothyroidism. Of the 79 patients reporting GI symptoms, 20 did not experience complete resolution with the GFD. Among the 17 patients who reported a strict adherence to GFD (vs 1 patient with low-adherence, 2 non-compliant), lactose intolerance and irritable bowel syndrome overlap were diagnosed in 2 and 15 patients, respectively. Conclusion: GI manifestations remain the main symptoms at presentation of CD, however clinicians should be aware of the EIM of CD and the association with other autoimmune disorders. In non-responsive CD patients, an overlap with functional disorders might be considered. [ABSTRACT FROM AUTHOR]

Across the world and within Europe, a growing number of consumers are choosing to buy gluten-free products. Motivations for a gluten-free diet and the consequences of consuming gluten are varied, from a medical necessity for those diagnosed with celiac disease to a range of health complications and discomfort for those who are gluten-intolerant. In this research, 7296 gluten-free consumers across 13 European countries responded to an online survey on the 33 types of gluten-free products purchased, how frequently they purchased them, their satisfaction with gluten-free quality and availability, the problems they have experienced, and the strategies they have employed to cope with these problems. The investigation examines whether and how these consumer attitudes and behaviors differ between those diagnosed with celiac disease, those who are gluten-intolerant, and those who are caregivers for others with a gluten-free diet. The results show that significant differences existed for all these habits and issues across the three gluten-free consumer groups. Specifically, caregivers purchased most of the gluten-free product types more frequently than the other two groups, experienced more availability problems, and were more likely to shop at multiple stores or make their own gluten-free products. Celiac-diagnosed consumers tended to buy gluten-free products more frequently than those who are gluten-intolerant, and they tended to be the most satisfied with the quality and range of gluten-free offerings. Despite purchasing frequency differences between the groups, the results suggest a similar hierarchy of gluten-free products that could provide the foundation for a European gluten-free food basket. [ABSTRACT FROM AUTHOR]

Coeliac disease (CD) affects almost of 1% of the population, yet remains undiagnosed in the majority. Though the demonstration of enteropathy in duodenal biopsy was traditionally the essential criterion for the diagnosis of coeliac disease, the guidelines published by the European Society of Paediatric Gastroenterology and Nutrition (ESPGHAN) in 2012, and revised in 2020, paved the way to a no-biopsy approach to diagnosis. In a select group of children meeting certain criteria, a definitive diagnosis of CD can now be made without the need for duodenal biopsies. This is being increasingly applied in clinical practice. It is well established that untreated coeliac disease is associated with several chronic adverse health conditions. At present, a strict gluten-free diet remains the only effective treatment for CD. The advances in our understanding of the pathogenesis of CD have led to a search for alternative treatment agents. Several investigational agents are in various phases of clinical trials at present. In this review, we outline the clinical aspects of coeliac disease and summarise various investigational treatment agents. [ABSTRACT FROM AUTHOR]

Celiac disease is a chronic inflammatory condition that is not well understood in relation to the microbiome. Our objective was to demonstrate changes in the microbiota and the relationships between nutrients in children with celiac disease (CD) who followed a gluten‐free diet (GFD). A group of 11 children who were recently diagnosed with CD, ranging in age from 3 to 12, were monitored for a period of 6 months. GFD is designed based on the individual's specific energy and nutrient needs, with strict control over dietary adherence. Food consumption, blood, and fecal samples were taken. Fecal samples were put through 16s rRNA sequencing. Microbial modifications were demonstrated using alpha diversity, beta diversity, nonmetric multidimensional scaling analysis (NDMS), t‐test, and metastats. Mean age was 6.4 ± 2.66 years and 54.5% were male participants. Serological parameters were negative after 6 months. Both unweighted (p = .019) and weighted (p = .021) Unifrac distances were higher before GFD, and differences were reliable according to NDMS analysis (stress = 0.189). The abundance of Bacteroides ovatus was increased (p = .014), whereas unidentified Lachnospiraceae, Paeniclostridium, Paraclostridium Peptostreptococcus, and Dielma were decreased after GFD (p < .001). Associations between nutrients and several genera and species were identified. The presence of genus Bifidobacterium and Bifidobacterium adolescentis was inversely associated with fat intake after GFD (p < .01). Microbiota changes became evident over a period of 6 months. The presence or absence of small bacteria may play a role in the development of CD. Modifying the children's dietary intake can potentially influence the microbial composition. [ABSTRACT FROM AUTHOR]

Background: The inclusion of minor and pseudo-cereals enhances the nutritional quality of a gluten-free diet. Yet, affordability determines practical implementation. Environmental concerns should also be considered as moving towards a more sustainable diet. How do these aspects of sustainability manifest themselves in a special diet, such as gluten-free? Methods: An international pilot survey among practicing dietitians was conducted during the Congress of The European Federation of the Associations of Dietitians (EFAD, Budapest, 2023). Respondents marked their recommendation for eight gluten-free cereals based on five criteria, including nutritional quality, accessibility/price, and climate change. Differences were analysed using Cohran's Q and pairwise post-hoc tests (N = 38). Results: There were significant differences in the recommendation for cereals (p < 0.05 for each grain), with quinoa (89.5%), gluten-free oats (89.5%), rice (86.8%), and corn (65.8%) being the most recommended. Buckwheat (55.3%), millet (50.0%), amaranth (44.7%) and sorghum (26.3%) were less recommended. Although gluten-free oats were recommended overall, quinoa was recommended for its nutritional content, and rice and corn were recommended for accessibility/price. No cereal received a high recommendation for climate change. Conclusions: According to this pilot survey, nutritional content and accessibility/price were the most important criteria for evaluating gluten-free grains. Dietitians were willing to integrate climate change considerations into practice, but more information is needed. The recommendation for minor and pseudo-cereals contradicted the importance emphasised by the literature. Further research is needed to integrate these aspects, helping dietitians formulate recommendations. [ABSTRACT FROM AUTHOR]

Celiac disease (CD) is an autoimmune disease that affects many aspects of patients including their quality of life (QoL). The aim of this meta-analysis was to highlight the impact of gluten-free diet (GFD) adherence on QoL using specific instruments. The included studies should meet to PRISMA guidelines. Thirty-nine studies using developed or adapted specific instruments were included in review, and 25 of them were included in meta-analysis. In overall, the results showed a neutral QoL both in children and adolescents (47.81, 95% CI [40.50; 55.12]), and in adults (45.12, 95% CI [38.24; 52.00]). The QoL was low in subscales related to GFD such as "Diet" in CD-Dux, "Inadequate treatment" in CD-QoL and in "Dietary burden" in CD-AQ instruments. In children, the QoL was higher in patients adhering to GFD, with mean difference (MD) estimated at 8.24 (95% CI [5.11; 11.37]; P < 0.00001). All studies used CD-Dux as specific instrument and the results showed that the QoL was significantly lower in proxies than their children and adolescents (MD −5.60, 95% CI [−8.06; −3.15]; P < 0.00001). In adults, no significant difference was observed regarding the impact of GFD adherence on QoL (MD 3.68, 95% CI [−0.53; 7.88]; P = 0.09). Using specific instruments, this meta-analysis highlighted a reduced QoL in subscales related to GFD, and has been improved after GFD adherence. [ABSTRACT FROM AUTHOR]

Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of proline- and glutamine-rich proteins, widely termed "gluten", in genetically susceptible individuals. CD induces an altered immune response that leads to chronic inflammation and duodenal mucosal damage. Currently, there are no specific tests for the accurate diagnosis of CD, and no drugs are available to treat this condition. The only available treatment strategy is lifelong adherence to a gluten-free diet. However, some studies have investigated the involvement of microRNAs (miRNAs) in CD pathogenesis. miRNAs are small noncoding ribonucleic acid molecules that regulate gene expression. Despite the growing number of studies on the role of miRNAs in autoimmune disorders, data on miRNAs and CD are scarce. Therefore, this study aimed to perform a literature review to summarize CD, miRNAs, and the potential interactions between miRNAs and CD in adults. This review shows that miRNA expression can suppress or stimulate pathways related to CD pathogenesis by regulating cell proliferation and differentiation, regulatory T-cell development, innate immune response, activation of the inflammatory cascade, focal adhesion, T-cell commitment, tissue transglutaminase synthesis, and cell cycle. Thus, identifying miRNAs and their related effects on CD could open new possibilities for diagnosis, prognosis, and follow-up of biomarkers. [ABSTRACT FROM AUTHOR]

Introduction: The association between food protein-induced enterocolitis syndrome (FPIES) and wheat ingestion in children with celiac disease is unknown at this time. Methods: We present seven cases of children with celiac disease who presented with symptoms of wheat-triggered acute FPIES (a-FPIES). An oral food challenge (OFC) with wheat allergen followed by 4 h of observation was performed. Activation of innate system cells was measured at baseline (T0), during symptoms (Ts), and 4 h after symptom onset (Ts + 4). A panel of human inflammatory cytokines was also performed. Results: All patients reacted to the first allergen dose. Three patients experienced a decrease of 30 mm Hg in systolic blood pressure and tachycardia and required hemodynamic resuscitation. Neutrophilia and a decrease in eosinophil count were evident at 4 h after symptom onset. At 4 h after symptom onset, cytokines (IL-6 and IL-8, and to a lesser degree, IL-10) were elevated. Conclusion: In a small sample of celiac patients with wheat exposure in an OFC, symptoms and acute immunological changes in serum inflammatory cytokine profile were consistent with a-FPIES. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this research was to investigate the impact of dietary factors on developmental trajectories in young autistic children. Methods: A gluten-free and casein-free diets, as well as six types of food (meat and eggs, vegetables, uncooked vegetables, sweets, bread, and "white soft bread that never molds") were investigated observationally for up to three years in 5,553 children 2 to 5 years of age via parent-report measures completed within a mobile application. Children had a parent-reported diagnosis of Autism Spectrum Disorder (ASD); 78% were males; the majority of participants resided in the USA. Outcome was monitored on five orthogonal subscales: Language Comprehension, Expressive Language, Sociability, Sensory Awareness, and Health, assessed by the Autism Treatment Evaluation Checklist (ATEC) (Rimland & Edelson, 1999) and Mental Synthesis Evaluation Checklist (MSEC) (Arnold & Vyshedskiy, 2022; Braverman et al., 2018). Results: Consumption of fast-acting carbohydrates – sweets, bread, and "white soft bread that never molds" – was associated with a significant and a consistent Health subscale score decline. On the contrary, a gluten-free diet, as well as consumption of meat, eggs, and vegetables were associated with a significant and consistent improvement in the Language Comprehension score. Consumption of meat and eggs was also associated with a significant and consistent improvement in the Sensory Awareness score. Conclusion: The results of this study demonstrate a strong correlation between a diet and developmental trajectories and suggest possible dietary interventions for young autistic children. [ABSTRACT FROM AUTHOR]

Aim: To compare the adherence to gluten‐free diet between children with serology‐based and biopsy‐proven coeliac disease. Methods: Medical records were retrospectively reviewed in 257 Swedish children diagnosed with coeliac disease between 2012 and 2019 at a tertiary hospital. Adherence to a gluten‐free diet was systematically assessed by trained dietitians at follow‐up. Mixed models were used to analyse the dietary adherence by mode of diagnosis (serology‐based vs. biopsy‐proven). Results: After mean 6.3 (SD 2.4) years, there was neither a difference in the dietary adherence over time depending on the mode of diagnosis (OR 0.64 [95% confidence interval (CI) 0.26, 1.60], p = 0.342), nor if coeliac disease was detected in screening studies (OR 0.74 [95% CI 0.25, 2.17], p = 0.584) or in risk‐groups (OR 1.01 [95% CI 0.26, 3.91], p = 0.991) compared to clinically detected diagnosis. Non‐adherence to a gluten‐free diet increased with age (OR 1.19 [95% CI 1.06, 1.33], p = 0.003). There was no difference in the proportion of patients improving their dietary adherence from non‐adherent to adherent over time (p = 0.322). Conclusion: Mode of diagnosis did not influence the dietary adherence in Swedish children with coeliac disease, although adherence to a gluten‐free diet was inversely associated with increasing age. [ABSTRACT FROM AUTHOR]

The article explores the connection between gluten sensitivity and laryngopharyngeal reflux (LPR), highlighting that gluten sensitivity can exacerbate or mimic LPR symptoms. Topics include the mechanisms linking gluten sensitivity to reflux, diagnostic and management strategies, and the potential benefits of a gluten-free diet for treating refractory LPR cases.

Inadequate adherence to a gluten-free diet in coeliac disease triggers autoimmune reactions and can reduce the quality of life. The strict diet requires constant vigilance, which can cause psychological distress. Our research aimed to assess the quality of life in adult patients with coeliac disease and to find a correlation between quality of life, dietary intervention, and adherence. The study included 51 adult patients with coeliac disease who completed a quality-of-life questionnaire. Adherence was assessed using serological tests and a dietary adherence test. The patients were divided into two groups: those on a gluten-free diet for at least three months (Group I) and newly diagnosed patients (Group II). Group I showed a significant decrease in the dysphoria subscale of the quality-of-life test between the first and last surveys. Poor quality of life was associated with worse adherence in Group II. A higher "Health concerns" quality of life subscale score was also associated with worse adherence in Group II. Our results suggest that dietetic care may be beneficial for patients with coeliac disease by reducing dysphoria. We recommend regular and long-term dietary monitoring from diagnosis to ensure adherence to a gluten-free diet and to maintain quality of life. [ABSTRACT FROM AUTHOR]

Celiac disease (CD) is a chronic gastrointestinal disorder that is most frequently found in Western countries, and the only treatment available today is a lifelong gluten-free diet (GFD). The main aim of the present study is to compare the self-care practices and body mass index (BMI) of adolescents with CD and without CD in different dimensions (physical, psychological, social, and management). The non-probabilistic sample included 236 participants (118 with CD) aged between 12 and 16 years old, who were part of the project "Role of the family in the perception of youth self-care". The data were obtained through the self-administration of the Practice and Management of Youth Self-care questionnaire, while the celiac population also completed the Adherence to a Gluten-Free Diet (GFD) questionnaire. The celiac population analyzed showed significant correlations between the Physical Practices and Management with adherence to a GFD, and between a GFD and Psychological Practices. Differences were observed between the celiac and the non-celiac populations in the dimensions of Physical Practices, Social Practices, and Management. With respect to BMI, age and CD showed a significant influence of a GFD on BMI (p < 0.001). In conclusion, the application of multi-dimensional questionnaires and their relationship with the adherence to a GFD provide valuable information to propose interventions directed to this population. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study aimed to assess the nutritional status of children and adolescents with celiac disease (CD) in Kuwait and investigate the nutritional deficiencies and sociodemographic factors associated with growth stunting in this population. Methods: This case–control study included 77 CD patients aged 3–18 years diagnosed with CD using IgA anti-tissue transglutaminase and duodenal biopsy and 33 healthy controls. Nutritional status was evaluated based on demographic and clinical characteristics, anthropometric measurements, and biochemical parameters. Univariate and multivariate logistic regression models were used to determine the association between CD and growth stunting. Results: Approximately one-third (31%) of children with CD had stunted growth, 20.8% had a low body mass index for their age, and 5.2% had both growth stunting and wasting. Children with CD had higher odds of iron-deficiency anemia, vitamin D deficiency, anemia, and lower socioeconomic status. They were also younger and had decreased serum levels of vitamin D compared to the controls. These factors were all significantly associated with an increased risk of CD, collectively explaining over 50% of the risk. For growth stunting, lower education status among mothers, family income, and serum ferritin were identified as risk factors. Conclusions: A significant proportion of children and adolescents with CD had malnutrition, overt deficiencies, and impaired growth despite coherence with a gluten-free diet. Recommendation: Routine monitoring and targeted nutritional interventions are recommended for children and adolescents with CD to address malnutrition and growth stunting. Addressing socioeconomic disparities and enhancing maternal education may also help mitigate the risk factors. [ABSTRACT FROM AUTHOR]

A healthy and balanced diet is a critical requirement for pregnant women as it directly influences both the mother's and infant's health. Poor maternal nutrition can lead to pregnancy-related complications with undesirable effects on the fetus. This requirement is equally important for pregnant women with celiac disease (CD) who are already on a gluten-free diet (GFD). Although the GFD is the sole treatment option for CD, it still presents some challenges and confusion for celiac women who wish to conceive. Poorly managed CD has been linked to miscarriages, preterm labor, low birth weight, and stillbirths. Current CD guidelines primarily focus on screening, diagnosis, treatment, and management but lack an evidence-based approach to determine appropriate energy requirements, recommended weight gain during pregnancy, target macronutrient distribution from the diet, the recommended intake of vitamins and minerals from diet and/or supplementation, timing for starting supplementation, and advised portions of gluten-free foods during pregnancy. We recommend and call for the development of such guidelines and/or authoritative papers in the future. [ABSTRACT FROM AUTHOR]

Introduction: Celiac disease has been associated with gastrointestinal malignancies, most commonly gastrointestinal lymphoma. Nevertheless, rarer malignancies have also been reported, such as small bowel adenocarcinoma, mainly located in the duodenum or jejunum. Case Presentation: We report a case of a female patient with celiac disease with poor adherence to a gluten-free diet who presented with small bowel obstruction due to a primary ileal adenocarcinoma. The patient remains asymptomatic, adherent to the gluten-free diet, and without clinical, biochemical, or imaging evidence of cancer recurrence. Discussion/Conclusion: This case should raise awareness about the importance of the gluten-free diet and the early diagnosis and appropriate management of rare small bowel malignant complications of celiac disease, namely, adenocarcinoma.

Abstract Background Celiac disease is an autoimmune disorder triggered by dietary gluten in genetically predisposed individuals that primarily affects the small intestine. Studies have reported differentially abundant bacterial taxa in the gut microbiota of celiac patients compared with non-celiac controls. However, findings across studies have inconsistencies and no microbial signature of celiac disease has been defined so far. Results Here, we showed, by comparing celiac patients with their non-celiac 1st-degree relatives, that bacterial communities of related individuals have similar species occurrence and abundance compared with non-relatives, regardless the disease status. We also found in celiac patients a loss of bacterial species associated with fiber degradation, and host metabolic and immune modulation, as ruminiclostridia, ruminococci, Prevotella, and Akkermansia muciniphila species. We demonstrated that the differential abundance of bacterial species correlates to different dietary patterns observed between the two groups. For instance, Ruminiclostridium siraeum, Ruminococcus bicirculans, and Bacteroides plebeious, recognized as fiber-degraders, appear more abundant in non-celiac 1st-degree relatives, which have a vegetable consumption pattern higher than celiac patients. Pattern of servings per day also suggests a possible link between these species’ abundance and daily calorie intake. Conclusions Overall, we evidenced that a kinship approach could be valuable in unveiling potential celiac disease microbial traits, as well as the significance of dietary factors in shaping microbial profiles and their influence on disease development and progression. Our results pave the way for designing and adopting novel dietary strategies based on gluten-free fiber-enriched ingredients to improve disease management and patients' quality of life.

The review describes the state of the vitamin D system and bone metabolism in celiac disease, the mechanisms of the influence of vitamin D on the state of the intestinal mucosa, and risk factors that contribute to pathological changes in bones in celiac disease. Studies are presented that evaluate bone mineral density, bone metabolism, and vitamin D status in patients with celiac disease. The results of a discussion on the effect of calcium and vitamin D supplements on the course of celiac disease and the condition of bone tissue in this disease are presented.

Background/Objective: We present an adolescent male with Noonan syndrome (NS) and celiac disease (CD) who attained normal adult height with growth hormone (GH) treatment and gluten-free diet (GFD). Case Report: A 15 ½ year old healthy male presented with short stature and delayed puberty. His mother and maternal grandmother were short with heights 142.2 cm and 147.3 cm, respectively. Examination showed bilateral epicanthal folds and down slanting eyes like his mother, fifth finger clinodactyly, height 147.5 cm (

Abstract Background The inclusion of minor and pseudo-cereals enhances the nutritional quality of a gluten-free diet. Yet, affordability determines practical implementation. Environmental concerns should also be considered as moving towards a more sustainable diet. How do these aspects of sustainability manifest themselves in a special diet, such as gluten-free? Methods An international pilot survey among practicing dietitians was conducted during the Congress of The European Federation of the Associations of Dietitians (EFAD, Budapest, 2023). Respondents marked their recommendation for eight gluten-free cereals based on five criteria, including nutritional quality, accessibility/price, and climate change. Differences were analysed using Cohran’s Q and pairwise post-hoc tests (N = 38). Results There were significant differences in the recommendation for cereals (p

Abstract Background Cardiac manifestations are infrequently reported in association with celiac disease, but clear link has not been established. The aim of this study was to explore the connection of dilated cardiomyopathy in celiac disease. This systematic review also provides a comprehensive overview of the association between celiac disease and various cardiac manifestations with pathophysiology and management. Main body We searched PubMed, Cochrane Library, Google Scholar, Embase, Scopus, and Springer nature databases through June 4th 2023 for preferred studies related to our topic using MeSH and Regular keywords. After comprehensive search analysis, data extraction and quality appraisal 19 studies were included in the study. Although results varied across studies, majority of the studies revealed a positive link. Notably, some studies suggested an association between celiac disease and dilated cardiomyopathy, while others did not. These discrepancies could be attributed to differences in methodologies, study populations, and regional variations. Several studies have shown the association of various cardiac manifestations in celiac disease. Conclusion Although dilated cardiomyopathy is associated with celiac disease in majority of the studies, there are also studies that conflict with the association. The complex relationship between celiac disease and cardiovascular manifestations potentiates the need for further research with standardized methodologies, larger sample sizes, and consideration of regional variations. Such insights are vital for improving clinical practice by establishing preventive strategies, active screening, early diagnosis, mitigating risks which helps in optimizing cardiovascular health in individuals with celiac disease.

A healthy and balanced diet is a critical requirement for pregnant women as it directly influences both the mother’s and infant’s health. Poor maternal nutrition can lead to pregnancy-related complications with undesirable effects on the fetus. This requirement is equally important for pregnant women with celiac disease (CD) who are already on a gluten-free diet (GFD). Although the GFD is the sole treatment option for CD, it still presents some challenges and confusion for celiac women who wish to conceive. Poorly managed CD has been linked to miscarriages, preterm labor, low birth weight, and stillbirths. Current CD guidelines primarily focus on screening, diagnosis, treatment, and management but lack an evidence-based approach to determine appropriate energy requirements, recommended weight gain during pregnancy, target macronutrient distribution from the diet, the recommended intake of vitamins and minerals from diet and/or supplementation, timing for starting supplementation, and advised portions of gluten-free foods during pregnancy. We recommend and call for the development of such guidelines and/or authoritative papers in the future.