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

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 mu g 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.