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

Abeer S. Alzaben MSc,a Justine Turner MD, FRCPC,b,c Leanne Shirton RN,b,c Tarah M. Samuel MN, NP,b,c Rabin Persad MD, FRCPC,b,c Diana Mager PhD, RDa,b

aDepartment of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AB

bDepartment of Pediatrics, University of Alberta, Edmonton, AB

cDivision of Pediatric Gastroenterology, Stollery Children's Hospital, Edmonton, AB

Published on the web 17 February 2015.


Canadian Journal of Dietetic Practice and Research, 2015, 76(2): 56-63, https://doi.org/10.3148/cjdpr-2014-040

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.


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