Gluten-free Diet for Pediatric Patients with Coeliac Disease: A Position Paper from the ESPGHAN Gastroenterology Committee, Special Interest Group in Coeliac Disease.

Background and ObjectiveCoeliac disease is a chronic, immune-mediated disorder for which the only treatment consists of lifelong strict adherence to gluten-free diet (GFD). However, there is a lack of evidence-based guidelines on the GFD dietary management of coeliac disease. This position paper, led by the Special Interest Group in coeliac disease of the European Society of Pediatric, Gastroenterology Hepatology, and Nutrition, supported by the Nutrition Committee and the Allied Health Professionals Committee, aims to present evidence-based recommendations on the GFD as well as how to support dietary adherence.MethodsA wide literature search was performed using the MeSH Terms: "diet, gluten free," "gluten-free diet," "diets, gluten-free," "gluten free diet," and "coeliac disease" in Pubmed until November 8th, 2022.ResultsThe manuscript provides an overview of the definition of the GFD, regulations as basis to define the term "gluten-free," which foods are naturally gluten-free and gluten-containing. Moreover, it provides recommendations and educational tips and infographics on suitable food substitutes, the importance of reading food labels, risk of gluten cross-contact at home and in public settings, nutritional considerations as well as factors associated to dietary adherence based on available evidence, or otherwise clinical expertise.ConclusionsThis position paper provides guidance and recommendations to support children with coeliac disease to safely adhere to a GFD. How to guide pediatric patients with coeliac disease to correctly follow a gluten-free diet? image Coeliac disease is a chronic disorder for which the only treatment consists of lifelong adherence to a strict gluten-free diet. There is a lack of evidence-based recommendations and guidelines on the nutritional management of coeliac disease.What is New This position paper is the first ESPGHAN position paper to provide evidence-based and experience-based recommendations on gluten-free diet in pediatric coeliac disease. Infographic material is provided for the given recommendations.