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Nutritional Assessment and the Effect of Gluten-Free Diets in Celiac...
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Nutritional Assessment and the Effect of Gluten-Free Diets in Celiac Disease

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (25 March 2025) | Viewed by 8484

Special Issue Editors

Dr. Fabiana Zingone

E-Mail Website
Guest Editor
Department of Surgery, Oncology and Gastroenterology, University of Padua, 35100 Padua, Italy
Interests: nutrition in coeliac disease and gluten-related disorders; nutrition in inflammatory bowel disease; autoimmune atrophic gastritis
Special Issues, Collections and Topics in MDPI journals
Dr. Giacomo Caio

E-Mail Website
Guest Editor
1. Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
2. Mucosal Immunology and Biology Research Center, Massachusetts General Hospital—Harvard Medical School, Boston, MA 02114, USA
Interests: celiac disease; non-celiac gluten/wheat sensitivity; gluten-related disorders; amylase trypsin inhibitors; food allergy; food sensitivity; food intolerance; irritable bowel syndrome; functional gastrointestinal disorders; leaky gut; microbiome; small bowel enteropathies

Special Issue Information

Dear Colleagues,

This Special Issue explores the possible intersection of nutritional status and therapeutic interventions in celiac disease. We invite contributions that delve into the latest research, innovative strategies, and emerging trends in nutritional challenges and novel therapeutic approaches. Topics may include, but are not limited to, novel therapeutic interventions for celiac diseases, nutritional assessment methods in celiac patients, impact of gluten-free diet on nutritional status, micronutrient deficiencies and supplementation in celiac patients, nutritional implications of celiac diseases in specific populations (e.g., children, elderly), and the risk of MAFLD. This Special Issue aims to bridge the gap between scientific understanding and clinical application, offering a platform for researchers and practitioners to share insights, advancements, and challenges in the realms of nutrition and therapy for individuals affected by celiac diseases. This Special Issue aims to uncover the potential relationship between nutritional status and therapeutic strategies in the context of celiac disease. We welcome contributions that delve into the most recent research, innovative strategies, and emerging trends in addressing nutritional challenges and introducing novel therapeutic approaches. Topics may span a range of subjects, including, but not limited to, novel therapeutic interventions for celiac diseases, nutritional assessment methods in celiac patients, the impact of gluten-free diets on nutritional status, micronutrient deficiencies and supplementation in celiac patients, and the nutritional implications of celiac diseases in specific populations (e.g., children, elderly).

With this Special Issue, we aim to foster a collaborative environment that improves clinical outcomes and the overall well-being of those managing celiac diseases through advancements in nutritional strategies and therapeutic interventions.

Dr. Fabiana Zingone
Dr. Giacomo Caio
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • celiac diseases
  • gluten-free diet
  • nutritional status
  • therapeutic interventions
  • micronutrient deficiencies
  • dietary management
  • clinical nutrition
  • pediatric celiac disease

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Published Papers (5 papers)

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Research

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36 pages, 1152 KiB  
Article
Celiac Disease and Liver Damage: The Gut–Liver Axis Strikes Back (Again)? A Retrospective Analysis in the Light of a Literature Review
by Aurelio Seidita, Federica Latteri, Mirco Pistone, Alessandra Giuliano, Luca Bertoncello, Giorgia Cavallo, Marta Chiavetta, Francesco Faraci, Alessia Nigro, Alessandro Termini, Laura Verona, Agnese Ammannato, Salvatore Accomando, Francesca Cavataio, Maria Letizia Lospalluti, Michele Citrano, Diana Di Liberto, Maurizio Soresi, Pasquale Mansueto and Antonio Carroccio
Nutrients 2025, 17(1), 85; https://doi.org/10.3390/nu17010085 - 28 Dec 2024
Viewed by 1390
Abstract
Background/Objectives: An increasing number of studies have reported liver involvement in both children and adults with celiac disease (CD). This often manifests as isolated hypertransaminasemia or hepatic steatosis (HS). The aim of this study was to define the prevalence of hypertransaminasemia and [...] Read more.
Background/Objectives: An increasing number of studies have reported liver involvement in both children and adults with celiac disease (CD). This often manifests as isolated hypertransaminasemia or hepatic steatosis (HS). The aim of this study was to define the prevalence of hypertransaminasemia and HS in a pediatric population with CD before starting a gluten-free diet (GFD) and to analyze how the introduction of a GFD could modify this condition. We also conducted a state-of-the-art literature review of the association between hypertransaminasemia, metabolic dysfunction-associated steatotic liver disease (MASLD) and CD. Methods: We retrospectively reviewed the clinical charts of pediatric CD patients diagnosed in three different pediatric units of Sicily, analyzing clinical, laboratory, ultrasound, and histology data before and 12 months after the introduction of a GFD. Results: A total of 160 patients (65.0% females, median age 6.4 (0.8–13.2) years) were included; hypertransaminasemia and HS prevalences at diagnosis were 8.1% and 6.1%, respectively. Subjects with hypertransaminasemia were younger (p = 0.01) than those without and had higher frequencies of HS (p = 0.034) and anti-tissue transglutaminase (tTg) immunoglobulin (Ig)G positivity (p = 0.046). Subjects with HS were younger (p = 0.0001) and had a higher frequency of hypertransaminasemia (p = 0.029) compared to non-steatotic ones. After 12 months of a GFD, hypertransaminasemia and HS persisted in 53.8% and 50.0% of patients, respectively. Conclusions: The prevalences of hypertransaminasemia and HS in Sicilian pediatric CD patients seem to be lower than those reported in other geographical areas. A GFD can reverse the trend of liver involvement, although periods of longer than 12 months may be necessary. However, a GFD has been associated with an increased prevalence of HS, and so regular follow-up involving a nutritionist should be recommended to guide physicians in patient management. Full article
(This article belongs to the Special Issue Nutritional Assessment and the Effect of Gluten-Free Diets in Celiac Disease)
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11 pages, 832 KiB  
Article
Food Avoidance beyond the Gluten-Free Diet and the Association with Quality of Life and Eating Attitudes and Behaviors in Adults with Celiac Disease
by Anne R. Lee, Patricia Zybert, Zhijun Chen, Jessica Lebovits, Randi L. Wolf, Benjamin Lebwohl and Peter H. R. Green
Nutrients 2024, 16(19), 3411; https://doi.org/10.3390/nu16193411 - 8 Oct 2024
Viewed by 1697
Abstract
Background: The only treatment for Celiac Disease (CeD), which affects about 1% of the population, is a gluten-free diet (GFD). Studies have indicated an association between the GFD, a diminished quality of life (QOL), and maladaptive eating patterns. This study aims to explore [...] Read more.
Background: The only treatment for Celiac Disease (CeD), which affects about 1% of the population, is a gluten-free diet (GFD). Studies have indicated an association between the GFD, a diminished quality of life (QOL), and maladaptive eating patterns. This study aims to explore food avoidance behaviors in adults with CeD. Methods: This cross-sectional study assessed 50 adults with biopsy-confirmed CeD who completed validated surveys evaluating demographics, psychological factors, QOL, eating pathology, and food avoidance. Results: Overall CDQOL scores were good (mean: 62.7 out of 100). However, 58.0% of the participants self-elected to avoid one or more additional foods without diagnosed allergies or intolerances. Those avoiding one or more other foods had lower QOL scores (57.4 (23.2) vs. 70.2 (15.9)) compared to those only avoiding gluten (p = 0.034). The mean depression score (CESD) for the group avoiding foods beyond gluten was in the depressive range, unlike those avoiding only gluten (16.0 (4.9) vs. 13.6 (4.0), p = 0.078), with 77% of those avoiding more than gluten scoring above the CESD cut-off point of 15, indicating clinical depression. Conclusions: Over half of participants (58%) reported avoiding additional foods beyond the GFD, a behavior associated with decreased QOL and increased depression. Full article
(This article belongs to the Special Issue Nutritional Assessment and the Effect of Gluten-Free Diets in Celiac Disease)
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12 pages, 547 KiB  
Article
Resilience in Adult Coeliac Patients on a Gluten-Free Diet: A Cross-Sectional Multicentre Italian Study
by Annalisa Schiepatti, Stiliano Maimaris, Simona Randazzo, Daria Maniero, Roland Biti, Giacomo Caio, Lisa Lungaro, Antonio Carroccio, Aurelio Seidita, Davide Scalvini, Carolina Ciacci, Federico Biagi and Fabiana Zingone
Nutrients 2024, 16(16), 2595; https://doi.org/10.3390/nu16162595 - 7 Aug 2024
Cited by 2 | Viewed by 1394
Abstract
Background. Data on resilience, the ability to recover from adversity, in coeliac disease (CeD) are lacking. Aim. To assess the degree of resilience in patients with CeD on a gluten-free diet (GFD), and its association with clinical features, sociodemographic factors, psychological morbidity, and [...] Read more.
Background. Data on resilience, the ability to recover from adversity, in coeliac disease (CeD) are lacking. Aim. To assess the degree of resilience in patients with CeD on a gluten-free diet (GFD), and its association with clinical features, sociodemographic factors, psychological morbidity, and quality of life (QOL). Methods. A cross-sectional multicentre Italian study was conducted on adult CeD patients between May 2022 and April 2023. Connor–Davidson Resilience Scale (CD-RISC), the Coeliac Disease-specific Quality of Life Scale (CD-QOL), the State–Trait Anxiety Inventory scale (STAI-Y), and the Beck Depression Inventory scale (BDI) were used to evaluate resilience, QOL, anxiety, and depression, respectively. A multivariate analysis was conducted to identify factors independently associated with the degree of resilience. Results. A total of 305 patients (221 F, mean age at CeD diagnosis 36 ± 16 years) on a long-term GFD (median 8 years, IQR 3–17) were enrolled. A total of 298/305 patients (98%) had a high level of resilience (CD-RISC ≥ 35). At univariate analysis, resilience was statistically associated with male gender (p = 0.03), age at enrolment (p = 0.02), marital status (p = 0.03), QOL (p < 0.001), anxiety (p < 0.001), and depression (p < 0.001). On multivariate regression analysis, trait anxiety (STAI-Y2, p < 0.001) and depression (BDI, p = 0.02) were independent predictors of lower levels of resilience. Conclusions. Higher trait anxiety predicts lower levels of resilience. Targeted interventions in this subgroup of patients may be helpful for their management and follow-up. Full article
(This article belongs to the Special Issue Nutritional Assessment and the Effect of Gluten-Free Diets in Celiac Disease)
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Review

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14 pages, 302 KiB  
Review
Nutritional Status in Children with Celiac Disease and Type 1 Diabetes Mellitus—A Narrative Review
by Daniela Pop, Edita Gabriela Ichim and Dorin Farcău
Nutrients 2025, 17(4), 728; https://doi.org/10.3390/nu17040728 - 19 Feb 2025
Cited by 1 | Viewed by 748
Abstract
In children with type I diabetes mellitus (T1DM) and celiac disease (CD), malabsorption could add to a deficient nutritional status, resulting in impaired growth and weight and height deficits, as well as deficiencies in vitamins and micronutrients. This narrative review aims to assess [...] Read more.
In children with type I diabetes mellitus (T1DM) and celiac disease (CD), malabsorption could add to a deficient nutritional status, resulting in impaired growth and weight and height deficits, as well as deficiencies in vitamins and micronutrients. This narrative review aims to assess the current evidence regarding the consequences of the concomitant diagnoses of CD and T1DM on the nutritional status of children. Results regarding the influence of CD and T1DM weight, height, and BMI are controversial, especially if we consider that most of the studies have a small number of patients and that adherence to a gluten-free diet is not adequately assessed. There is a lack of studies considering specific dietary habits and ethnic and cultural differences. Children with T1DM and longer time with positive serology for CD have lower levels of ferritin, vitamin D 25OH, and folate and also lower bone mineral density. Full article
(This article belongs to the Special Issue Nutritional Assessment and the Effect of Gluten-Free Diets in Celiac Disease)
35 pages, 2915 KiB  
Review
Gluten Unraveled: Latest Insights on Terminology, Diagnosis, Pathophysiology, Dietary Strategies, and Intestinal Microbiota Modulations—A Decade in Review
by Dana Stanciu, Hristian Staykov, Stela Dragomanova, Lyubka Tancheva, Radu Samuel Pop, Irina Ielciu and Gianina Crișan
Nutrients 2024, 16(21), 3636; https://doi.org/10.3390/nu16213636 - 25 Oct 2024
Cited by 1 | Viewed by 2532
Abstract
A decade of research on gluten-related disorders (GRDs) is reviewed in this study, with a particular emphasis on celiac disease (CD) and non-celiac gluten sensitivity (NCGS). GRDs are triggered by the ingestion of gluten and gluten-like proteins found in wheat, barley, and rye. [...] Read more.
A decade of research on gluten-related disorders (GRDs) is reviewed in this study, with a particular emphasis on celiac disease (CD) and non-celiac gluten sensitivity (NCGS). GRDs are triggered by the ingestion of gluten and gluten-like proteins found in wheat, barley, and rye. These proteins lead to intestinal damage in celiac disease, an autoimmune condition characterized by villous atrophy and a variety of gastrointestinal and extraintestinal symptoms. More enigmatic and less understood, NCGS involves symptoms similar to CD but without the immunological reaction or intestinal damage. Recent years have seen advances in the understanding of GRDs, particularly in connection to how intestinal microbiota influences disease progression and patient outcomes. The gluten-free diet (GFD) is still the standard therapy recommended for GRDs despite significant challenges, as discussed in this article. Precise diagnostic methods, patient education and dietary counseling are critical for improving patients’ quality of life. The purpose of this review is to provide a more clear and up-to-date understanding of GRDs, and to help further research on this important topic. Full article
(This article belongs to the Special Issue Nutritional Assessment and the Effect of Gluten-Free Diets in Celiac Disease)
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