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Micronutrients Dietary Supplementation Advices for Celiac Patients on Long-Term Gluten-Free Diet with Good Compliance: A Review

1
IRCCS Mondino Foundation, 27100 Pavia, Italy
2
Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
3
Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy
4
Research and Development Unit, Indena, 20139 Milan, Italy
5
University of Bari, Department of Biomedical Science and Human Oncology, 70121 Bari, Italy
6
Department of Biology, College of Science, University of Bahrain, Sakhir Campus P. O. Box 32038, Bahrain
*
Author to whom correspondence should be addressed.
Medicina 2019, 55(7), 337; https://doi.org/10.3390/medicina55070337
Received: 24 April 2019 / Revised: 26 June 2019 / Accepted: 27 June 2019 / Published: 3 July 2019
(This article belongs to the Special Issue Advances in Celiac Disease)
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Abstract

Background and objective: Often micronutrient deficiencies cannot be detected when patient is already following a long-term gluten-free diet with good compliance (LTGFDWGC). The aim of this narrative review is to evaluate the most recent literature that considers blood micronutrient deficiencies in LTGFDWGC subjects, in order to prepare dietary supplementation advice (DSA). Materials and methods: A research strategy was planned on PubMed by defining the following keywords: celiac disease, vitamin B12, iron, folic acid, and vitamin D. Results: This review included 73 studies. The few studies on micronutrient circulating levels in long-term gluten-free diet (LTGFD) patients over 2 years with good compliance demonstrated that deficiency was detected in up to: 30% of subjects for vitamin B12 (DSA: 1000 mcg/day until level is normal, then 500 mcg), 40% for iron (325 mg/day), 20% for folic acid (1 mg/day for 3 months, followed by 400–800 mcg/day), 25% for vitamin D (1000 UI/day or more-based serum level or 50,000 UI/week if level is <20 ng/mL), 40% for zinc (25–40 mg/day), 3.6% of children for calcium (1000–1500 mg/day), 20% for magnesium (200–300 mg/day); no data is available in adults for magnesium. Conclusions: If integration with diet is not enough, starting with supplements may be the correct way, after evaluating the initial blood level to determine the right dosage of supplementation. View Full-Text
Keywords: celiac disease; vitamin B12; iron; folic acid; vitamin D; long-term GFD therapy (LTGFD); LTGFD with good compliance (LTGFDWGC) celiac disease; vitamin B12; iron; folic acid; vitamin D; long-term GFD therapy (LTGFD); LTGFD with good compliance (LTGFDWGC)
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Rondanelli, M.; Faliva, M.A.; Gasparri, C.; Peroni, G.; Naso, M.; Picciotto, G.; Riva, A.; Nichetti, M.; Infantino, V.; Alalwan, T.A.; Perna, S. Micronutrients Dietary Supplementation Advices for Celiac Patients on Long-Term Gluten-Free Diet with Good Compliance: A Review. Medicina 2019, 55, 337.

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