ASSESSMENT OF THE NUTRITIONAL STATUS OF A SELECTED SAMPLE OF JORDANIAN CHILDREN WITH CELIAC DISEASE ON GLUTEN-FREE DIET
ABSTRACT
Background and Aims: Celiac disease (CD) is a lifelong, systematic, immune-mediated, enteropathic disorder. It is triggered by ingestion of gluten in genetically predisposed individuals. It primarily affects the proximal part of the small intestine, which is the main site of absorption of many micronutrients. Furthermore, it commonly causes growth failure in children. Interestingly, the only lifelong therapy for CD is a gluten-free diet (GFD). However, GFD has many nutritional restrictions, which may lead to an imbalance in nutrient intakes in celiac patients. Therefore, this study aims to assess the nutritional status, dietary intake, and growth status of Jordanian children with celiac disease on a gluten-free diet.
Methods: A cross-sectional observational study was conducted in the period between April 2021 to February 2022. A total number of 45 CD patients were approached (at least 6 months on a GFD). The children in the study ranged in age from 6 to 13 years old and were of both sexes. Anthropometric, biochemical, and dietary intake assessments were performed to all participants.
Results: Twenty-six participants (57.8%) had a normal body mass index. whereas overweight and obesity were detected in 9 (20%) and 4 (8.9%) children, respectively. Seven (15.6%) children were suffering from underweight. There were 35 children (77.8%) and 36 children (80%) of the participants had normal height-for-age and weight-for-age, respectively. Eight out of forty-five (17.8%) children were stunted. Regarding the biochemical results, only 4 subjects had a low hemoglobin level, 3 subjects had low iron in serum, and 10 subjects had a low ferritin level. The children in this study had a significantly lower intake of carbohydrates, fiber, calcium, magnesium, zinc, and vitamin D in comparison with the dietary reference intake (p-values = 0.001, 0.001, 0.001, 0.001, 0.001, and 0.001, respectively). On the other hand, participants had a significantly higher intake of fat, iron, vitamin A, and vitamin B12 in comparison with the dietary reference intake (p-values= 0.005, 0.014, 0.008 and 0.020, respectively). There was no statistically significant difference between energy consumption and estimated energy requirement (p-value = 0.820), or between protein intake and the reference value (p-value= 0.971). The macronutrient distribution from total energy was as follows: 49.3% carbohydrates, 15.9% protein, and 34.1% fat. There were no strong correlations between anthropometric, biochemical, and dietary data. Also, there were no statistically significant differences in dietary intake based on gender (p-values > 0.05).
Conclusion: According to this study findings, celiac children on GFD had an inadequate intake of carbohydrates, fiber, calcium, magnesium, zinc, and vitamin D. Also, their diet was rich in fat, iron, vitamin A, and vitamin B12 with an adequate quantity of energy, protein, and selenium.