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Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet

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

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 61755

Special Issue Editor

Dr. Luis Rodrigo

E-Mail Website
Guest Editor
Gastroenterology Department, Hospital Universitario Central de Asturias (HUCA), University of Oviedo, Oviedo, Spain
Interests: gastroenterology; celiac disease; diet; gluten-free; bowel
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Celiac Disease (CD) and Nonceliac Gluten Sensitivity (NCGS) are the two most frequent conditions belonging to the group of Gluten-Related Disorders (GRDs). Both diseases are triggered and worsened by gluten proteins ingestion, and these affect genetically predisposed individuals. The main prevalence of CD is around 1–2%, and NCGS is much more frequent, estimated at between 5 and 15% of the general population, all over the world.

GRDs are manifested by symptoms of gastrointestinal tract disorders, as well as many others complaints coming from various hematological dermatological endocrinological, gynecological, rheumatological, and nervous-system-associated conditions. The presence of these different extraintestinal processes can appear before or after the diagnosis of CD or NCGS, and may befit the instauration of a gluten-free diet (GFD)

It is believed that NCGS represents heterogeneous groups with different subgroups characterized by different etiologies, different clinical histories, and different courses. There also appears to be an overlap between NCGS and irritable bowel syndrome (IBS).

GFD should be used in patients with a diagnosed GRDs, including CD, NCGS, and wheat-sensitive eosinophilic esophagitis (WSEE). Use of this diet in the management of other digestive conditions, including gastroesophageal reflux disease, IBS, and inflammatory bowel disease (IBD), is still controversial.

The current Special Issue, entitled “Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet” is designed to include articles that will address these issues. We welcome different types of manuscript submissions, including original research articles and up-to-date reviews (systematic reviews and meta-analyses).

Dr. Luis Rodrigo
Guest Editor

Manuscript Submission Information

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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 Disease
  • Nonceliac Gluten-Sensitivity
  • Extraintestinal Associated Conditions
  • Gluten-Free Diet
  • Gluten-Related Disorders
  • Inflammatory Bowel Disease
  • Irritable Bowel Syndrome

Published Papers (16 papers)

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Research

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12 pages, 605 KiB  
Article
Sex–Gender Differences in Adult Coeliac Disease at Diagnosis and Gluten-Free-Diet Follow-Up
by Gloria Galli, Giulia Amici, Laura Conti, Edith Lahner, Bruno Annibale and Marilia Carabotti
Nutrients 2022, 14(15), 3192; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14153192 - 04 Aug 2022
Cited by 8 | Viewed by 2248
Abstract
Coeliac disease (CD) is an immune-mediated enteropathy triggered by gluten ingestion. At CD diagnosis, gender differences have been previously reported, but data regarding follow-up are scant. We investigated gender differences in CD adult patients both at the time of diagnosis and at follow-up [...] Read more.
Coeliac disease (CD) is an immune-mediated enteropathy triggered by gluten ingestion. At CD diagnosis, gender differences have been previously reported, but data regarding follow-up are scant. We investigated gender differences in CD adult patients both at the time of diagnosis and at follow-up after the start of the gluten-free diet (GFD). This is a longitudinal cohort study on adult CD patients diagnosed between 2008 and 2019. Clinical, biochemical, and histological data were assessed and compared between males and females. At diagnosis, female gender was significantly associated with signs of malabsorption (OR 3.39; 95% CI: 1.4–7.9), longer duration of symptoms and/or signs before the diagnosis (OR 3.39; 95% CI: 1.5–7.5), heartburn (OR 2.99; 95% CI: 1.1–8.0), dyspepsia (OR 2.70; 95% CI: 1.1–6.5), nausea/vomit (OR 3.53; 95% CI: 1.1–10.9), and constipation (OR 4.84; 95% CI: 1.2–19.6) and less frequently associated to higher body mass index (OR 0.88; 95% CI: 0.8–0.9) and osteopenia/osteoporosis (OR 0.30; 95% CI: 0.1–0.7) compared to male patients. After 12–30 months, females presented lower median BMI, performed less frequently histological control, and had more frequently anaemia and hypoferritinaemia compared to males. No significant differences concerning the presence of gastrointestinal symptoms, adherence to GFD, and Marsh score were found. Gender differences found at CD diagnosis mostly disappear at the follow-up, showing that these differences can be solved over time. Full article
(This article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet)
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9 pages, 762 KiB  
Article
Hepatic Steatosis in Patients with Celiac Disease: The Role of Packaged Gluten-Free Foods
by Alberto Raiteri, Alessandro Granito, Chiara Faggiano, Alice Giamperoli, Teresa Catenaro, Giulia Negrini and Francesco Tovoli
Nutrients 2022, 14(14), 2942; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14142942 - 18 Jul 2022
Cited by 4 | Viewed by 2667
Abstract
Background: An increased risk of nonalcoholic fatty liver disease (NAFLD) in patients with celiac disease (CD) adhering to a gluten-free diet (GFD) was recently reported. The nutritional composition of packaged gluten-free foods (PGFF) has been proposed as a possible cause. This hypothesis has [...] Read more.
Background: An increased risk of nonalcoholic fatty liver disease (NAFLD) in patients with celiac disease (CD) adhering to a gluten-free diet (GFD) was recently reported. The nutritional composition of packaged gluten-free foods (PGFF) has been proposed as a possible cause. This hypothesis has not been investigated further, since a systematic structural nutritional interview for all patients would be problematic in clinical practice. Methods: We administered a simple questionnaire based on a Recency, Frequency, and Monetary value (RFM) analysis (a cornerstone of direct marketing segmentation) to consecutive CD patients on a GFD for >6 months and verified its association with NAFLD. Subgroup analyses were performed to understand whether specific patterns of PGFF consumption were significantly associated with NAFLD. Results: Amongst 147 patients (female 82%, median age 42 years), 45 (30.6%) had NAFLD. Total RFM score (adjusted odds ratio = 1.223, 95% CI: 1.059–1.413, p = 0.006), body mass index, and total cholesterol and triglycerides were independently related to NAFLD, and “Bread and bakery” (p = 0.002), “salty convenience” (p = 0.005), and “sweet convenience” (p = 0.049) products were significantly related with NAFLD. Also, questions about the number of purchased PGFF in the last month (monetary value) and different categories of PGFF consumed in the last week (recency) were particularly able to identify NAFLD patients. Conclusions: The specific GFD dietary habits of CD patients were correlated with the degree of risk of NAFLD. Information was obtained through a questionnaire which could be used in clinical practice to favor a patient-tailored approach and in future studies to verify the reproducibility of our results in different geographical areas. Full article
(This article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet)
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14 pages, 546 KiB  
Article
Eating Competence and Aspects Related to a Gluten-Free Diet in Brazilian Adults with Gluten-Related Disorders
by Pâmela Mayara de Oliveira, Renata Puppin Zandonadi, Amanda Moreira Veloso Cutrim, Eduardo Yoshio Nakano, Fabiana Lopes Nalon de Queiroz, Raquel B. A. Botelho, Ariana Saraiva and António Raposo
Nutrients 2022, 14(14), 2815; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14142815 - 08 Jul 2022
Cited by 4 | Viewed by 1820
Abstract
This cross-sectional study aims to assess eating competence (EC—an intra-individual approach to food, behaviors, and attitudes related to food) and aspects related to a gluten-free diet (GFD) in Brazilian adults with gluten-related disorders (GRDs). The research was conducted using an online survey with [...] Read more.
This cross-sectional study aims to assess eating competence (EC—an intra-individual approach to food, behaviors, and attitudes related to food) and aspects related to a gluten-free diet (GFD) in Brazilian adults with gluten-related disorders (GRDs). The research was conducted using an online survey with a self-reported instrument consisting of 40 items, organized into three parts: (I) Socioeconomic and demographic data; (II) the Brazilian version of the Eating Competence Satter Inventory (ec-SI2.0™BR); and (III) questions about adherence and difficulties in following the gluten-free diet. EC was measured by the ecSI2.0™BR instrument, with scores ≥32 were considered competent eaters. The instrument was applied nationwide through the GoogleForms® platform from 14 February 2022 to 30 March 2022. The publicity for the recruitment was supported by Brazilian celiac local and national associations (Acelbras and Fenacelbra), pages of food services or personal pages of tips and posts about gluten-related disorders, and specialized stores that offer gluten-free foods. The recruitment occurred through social networks (emails, Facebook groups, WhatsApp, and Instagram). A total of 1030 Brazilians with GRDs answered the questionnaire. Most participants were female, aged 40 years or older, with an income >R$3000, and a high education level. The main difficulty regarding adherence to GFD was the high cost of gluten-free foods. Individuals younger than 40 years old had lower EC scores, with no differences between men and women. Increasing socioeconomic status, schooling, and culinary practices increased the total score. Participants who “never/almost never” felt socially judged because their diet had higher scores for total EC. Competent eaters GRD individuals (EC ≥ 32) were mostly individuals aged ≥40 y/o; with income > R$3000; following a GFD; satisfied with purchased gluten-free products; consuming gluten-free products prepared at home, mainly by themselves; who do not feel judged because of the GRD and who feel that they can live a normal life with GRD. Our study showed that individuals who strictly adhere to the GFD have higher scores on eating competence than those who sometimes follow the treatment. Full article
(This article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet)
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16 pages, 1688 KiB  
Article
No Difference in Tolerance between Wheat and Spelt Bread in Patients with Suspected Non-Celiac Wheat Sensitivity
by Julia Zimmermann, Friedrich H. Longin, Anna Schweinlin, Maryam Basrai and Stephan C. Bischoff
Nutrients 2022, 14(14), 2800; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14142800 - 07 Jul 2022
Cited by 3 | Viewed by 3709
Abstract
Individuals with suspected non-celiac wheat sensitivity (NCWS) often report better tolerance of spelt (Triticum aestivum ssp. spelta) compared to wheat (Triticum aestivum ssp. aestivum) bakery products. This experience has neither been validated nor explained on a molecular level. Therefore, [...] Read more.
Individuals with suspected non-celiac wheat sensitivity (NCWS) often report better tolerance of spelt (Triticum aestivum ssp. spelta) compared to wheat (Triticum aestivum ssp. aestivum) bakery products. This experience has neither been validated nor explained on a molecular level. Therefore, we performed blinded wheat and spelt bread challenge in this patient group. Twenty-four adults with a history of NCWS but suspected spelt tolerance were challenged in a single-blinded crossover design over six weeks with six different study breads each at 300 g per day for 4 days followed by a washout phase of 3 days. Study breads comprised spelt and wheat breads made either after a traditional (T) or a current (C) recipe, resulting in four bread types plus a gluten-free bread with 1.5% added oligosaccharides (+FODMAP) and a gluten-free bread with 5% added wheat gluten (+Gluten). The main outcome parameter was the Irritable Bowel Syndrome—Severity Scoring System, which was higher than self-estimated by the participants after spelt bread consumption (p = 0.002 for T; p = 0.028 for C) and lower for wheat bread (p = 0.052 for T; p = 0.007 for C), resulting in no difference between wheat and spelt bread tolerance. The +FODMAP bread was better tolerated than both T breads (p = 0.003 for spelt; p = 0.068 for wheat) and equally well tolerated as both C breads and +Gluten breads after normalization to the washout scores. Neither signs of inflammation nor markers for intestinal barrier integrity were influenced. Our data do not confirm, on an objective basis, the differences in expected symptoms resulting from wheat and spelt products, suggesting a strong nocebo effect for wheat and a placebo effect for spelt. Full article
(This article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet)
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13 pages, 303 KiB  
Article
Nutritional Status of Saudi Children with Celiac Disease Following the Ministry of Health’s Gluten-Free Diet Program
by Shiekhah S. Allowaymi, Manal Abdulaziz Binobead, Ghedeir M. Alshammari, Ali Alrasheed, Mohammed A. Mohammed and Mohammed Abdo Yahya
Nutrients 2022, 14(14), 2792; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14142792 - 07 Jul 2022
Viewed by 2259
Abstract
This study aimed to evaluate the nutritional status of Saudi children with celiac disease (CD) who followed the Ministry of Health’s gluten-free diet (GFD) program. This study involved 66 children with CD (29 boys and 37 girls) from 5 hospitals belonging to the [...] Read more.
This study aimed to evaluate the nutritional status of Saudi children with celiac disease (CD) who followed the Ministry of Health’s gluten-free diet (GFD) program. This study involved 66 children with CD (29 boys and 37 girls) from 5 hospitals belonging to the Ministry of Health. Socioeconomic characteristics were obtained using a structured questionnaire. Anthropometric indices were measured using a body composition analyzer. Dietary intake was assessed using three 24 h dietary records. The biochemical parameters were determined in the hospitals’ laboratories. According to the findings, the majority of respondents had ages ranging from 10 to 13 years, a father and mother with a university education, a high family income, and 5 to 7 family members. Carbohydrates and protein intake for both genders were significantly higher than the DRI’s recommended dietary intake. However, the majority of nutrients consumed were at levels significantly lower than the DRI. Both genders had normal anthropometric indices, with girls having at significantly higher indices than boys. The biochemical parameters of both genders were comparable and within the normal range, except for vitamin D, which was below the normal range. The most important factors influencing nutritional status were age for both genders, and family income and number of family members for boys. In conclusion, data obtained for nutrient intake, anthropometric indicators, body composition, and biochemical analysis indicated that CD children following the Ministry of Health GFD program have a generally good nutritional status. Full article
(This article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet)
12 pages, 720 KiB  
Article
Adherence to Gluten-Free Diet Restores Alpha Diversity in Celiac People but the Microbiome Composition Is Different to Healthy People
by Orazio Palmieri, Stefano Castellana, Antonio Bevilacqua, Anna Latiano, Tiziana Latiano, Anna Panza, Rosanna Fontana, Antonio Massimo Ippolito, Giuseppe Biscaglia, Annamaria Gentile, Domenica Gioffreda, Ivana Decina, Michele Tricarico, Milena Sinigaglia, Maria Rosaria Corbo, Tommaso Mazza, Francesco Perri and Carmela Lamacchia
Nutrients 2022, 14(12), 2452; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14122452 - 14 Jun 2022
Cited by 7 | Viewed by 2508
Abstract
Celiac disease (CD) is an autoimmune disease with the destruction of small intestinal villi, which occurs in genetically predisposed individuals. At the present moment, a gluten-free diet (GFD) is the only way to restore the functionality of gut mucosa. However, there is an [...] Read more.
Celiac disease (CD) is an autoimmune disease with the destruction of small intestinal villi, which occurs in genetically predisposed individuals. At the present moment, a gluten-free diet (GFD) is the only way to restore the functionality of gut mucosa. However, there is an open debate on the effects of long-term supplementation through a GFD, because some authors report an unbalance in microbial taxa composition. Methods: For microbiome analysis, fecal specimens were collected from 46 CD individuals in GFD for at least 2 years and 30 specimens from the healthy controls (HC). Data were analyzed using an ensemble of software packages: QIIME2, Coda-lasso, Clr-lasso, Selbal, PICRUSt2, ALDEx2, dissimilarity-overlap analysis, and dysbiosis detection tests. Results: The adherence to GFD restored the alpha biodiversity of the gut microbiota in celiac people but microbial composition at beta diversity resulted as different to HC. The microbial composition of the CD subjects was decreased in a number of taxa, namely Bifidobacterium longum and several belonging to Lachnospiraceae family, whereas Bacteroides genus was found to be more abundant. Predicted metabolic pathways among the CD bacterial communities revealed an important role in tetrapyrrole biosynthesis. Conclusions: CD patients in GFD had a non-dysbiotic microbial composition for the crude alpha diversity metrics. We found significant differences in beta diversity, in certain taxon, and pathways between subjects with inactive CD in GFD and controls. Collectively, our data may suggest the development of new GFD products by modulating the gut microbiota through diet, supplements of vitamins, and the addition of specific prebiotics. Full article
(This article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet)
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11 pages, 661 KiB  
Article
Long-Term Effect of Gluten-Free Diets on Nutritional Status, Body Composition, and Associated Factors in Adult Saudi Females with Celiac Disease
by Aeshah Ibrahim Alhosain, Ghedeir M. Alshammari, Barakat Lafi Almoteri, Mohammed A. Mohammed, Manal Abdulaziz Binobead and Mohammed Abdo Yahya
Nutrients 2022, 14(10), 2090; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14102090 - 17 May 2022
Cited by 2 | Viewed by 3993
Abstract
This cross-sectional study examines the influence of long-term gluten-free diet (GFD) consumption on nutritional status, body composition, and associated factors in adult Saudi females with celiac diseases (CD). Fifty-one patients who have been diagnosed with CD and have been on GFD for more [...] Read more.
This cross-sectional study examines the influence of long-term gluten-free diet (GFD) consumption on nutritional status, body composition, and associated factors in adult Saudi females with celiac diseases (CD). Fifty-one patients who have been diagnosed with CD and have been on GFD for more than 1 year were included in this study where data regarding their dietary pattern, as well as a complete analysis of their anthropometric parameters, vitamins B12 and D levels, and complete blood count (CBC), were collected. Data have shown that all included patients showed a reduced intake in all micro and macro-nutrients, as well as vitamin D, folate, calcium, and iron. However, the vast majority of all measured hematological parameters and blood indices were within the expected reference range. In addition, 51%, 43.1%, and 60.8% of the patients showed low waist/hip ratio (WHR), decreased level of total body fat (BF), and decreased level of visceral fat (VF), respectively, whereas 33.3% were slim. The poor educational level and some psychosocial factors were associated with the poor nutritional status of the patients. In conclusion, the GFD-dependent intake by female patients with CD adversely affects their nutritional intake and anthropometric indices and leads to a deficiency in major nutrients, vitamins, and ions. Full article
(This article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet)
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10 pages, 817 KiB  
Article
Compliance with Gluten Free Diet Is Associated with Better Quality of Life in Celiac Disease
by Raphaël Enaud, Candice Tetard, Raphaël Dupuis, David Laharie, Thierry Lamireau, Frank Zerbib, Pauline Rivière, Sarah Shili-Mismoudi and Florian Poullenot
Nutrients 2022, 14(6), 1210; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14061210 - 12 Mar 2022
Cited by 6 | Viewed by 3420
Abstract
The quality of life (QOL) of patients with celiac disease (CD) can be altered by both symptoms of the disease and by the restrictions of the gluten-free diet (GFD). The objective was to determine the factors associated with better QOL in a large [...] Read more.
The quality of life (QOL) of patients with celiac disease (CD) can be altered by both symptoms of the disease and by the restrictions of the gluten-free diet (GFD). The objective was to determine the factors associated with better QOL in a large cohort of CD patients. A link to an online survey was sent to the members of the French Association of Gluten Intolerant People (AFDIAG). The French-Celiac Disease Questionnaire (F-CDQ), scoring from 0 to 100, was used to measure the QOL. Other data collected were sociodemographic characteristics, information on CD, purchasing and consumption habits of gluten-free products, and a self-assessment scale (ranging from 0 to 10) to determine the compliance with the GFD. Among the 907 CD patients who returned the questionnaire, 787 were analyzed (638 women (81%); median age: 49 years; 71% with self-assessed GFD compliance > 8). Their median F-CDQ was 73 (range: 59–82). In multivariate analysis, the main factors associated with a better quality of life were the long duration of the GFD, good compliance with the GFD, and the number of follow-up visits. Compliance with and duration of the GFD are associated with a better quality of life in patients with CD. Taking this into consideration would offset its restrictive aspect and improve its adherence. Full article
(This article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet)
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16 pages, 1209 KiB  
Article
A Case Study of the Response of Immunogenic Gluten Peptides to Sourdough Proteolysis
by Olivia J. Ogilvie, Juliet A. Gerrard, Sarah Roberts, Kevin H. Sutton, Nigel Larsen and Laura J. Domigan
Nutrients 2021, 13(6), 1906; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13061906 - 01 Jun 2021
Cited by 6 | Viewed by 3324
Abstract
Celiac disease is activated by digestion-resistant gluten peptides that contain immunogenic epitopes. Sourdough fermentation is a potential strategy to reduce the concentration of these peptides within food. However, we currently know little about the effect of partial sourdough fermentation on immunogenic gluten. This [...] Read more.
Celiac disease is activated by digestion-resistant gluten peptides that contain immunogenic epitopes. Sourdough fermentation is a potential strategy to reduce the concentration of these peptides within food. However, we currently know little about the effect of partial sourdough fermentation on immunogenic gluten. This study examined the effect of a single sourdough culture (representative of those that the public may consume) on the digestion of immunogenic gluten peptides. Sourdough bread was digested via the INFOGEST protocol. Throughout digestion, quantitative and discovery mass spectrometry were used to model the kinetic release profile of key immunogenic peptides and profile novel peptides, while ELISA probed the gluten’s allergenicity. Macrostructural studies were also undertaken. Sourdough fermentation altered the protein structure, in vitro digestibility, and immunogenic peptide release profile. Interestingly, sourdough fermentation did not decrease the total immunogenic peptide concentration but altered the in vitro digestion profile of select immunogenic peptides. This work demonstrates that partial sourdough fermentation can alter immunogenic gluten digestion, and is the first study to examine the in vitro kinetic profile of immunogenic gluten peptides from sourdough bread. Full article
(This article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet)
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15 pages, 10384 KiB  
Article
Self-Reported Diet and Health Outcomes of Participants of the CCSVI-Tracking Survey Study
by Patricia Grace-Farfaglia
Nutrients 2021, 13(6), 1891; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13061891 - 31 May 2021
Cited by 1 | Viewed by 3470
Abstract
Of the 1575 participants of the CCSVI-Tracking Survey, 475 patients recorded their quality of life and EDSS outcomes for at least 2 months. Self-reported use of complementary and conventional therapies included diet, use of drug therapy, symptoms, quality of life, and mobility. Analysis [...] Read more.
Of the 1575 participants of the CCSVI-Tracking Survey, 475 patients recorded their quality of life and EDSS outcomes for at least 2 months. Self-reported use of complementary and conventional therapies included diet, use of drug therapy, symptoms, quality of life, and mobility. Analysis included comparing outcomes related to different diets within and between groups. Adherence to the MS diet was not associated with a greater quality of life, less disability, a lower Symptom Score, or faster walking speed compared to other diets. Alternately, the participants from the Mediterranean diet region as a whole (µ = 32.65 (SD = 11.37, SEM = 2.37, p = 0.05) had a significantly greater QoL (µ = 60, p = 0.05) and a lower MS symptom score, µ = 32.65 (11.37), p = 0.0029. A decline of symptoms was observed in all diet groups over 3 months with the most dramatic decline observed in participants from the Eastern Mediterranean diet region. The main effect for the within-subjects factor was significant, F(3, 1056) = 55.95, p < 0.001, indicating that there were significant differences between the groups. Full article
(This article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet)
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11 pages, 16979 KiB  
Article
Mobile Application for Promoting Gluten-Free Diet Self-Management in Adolescents with Celiac Disease: Proof-of-Concept Study
by Sonya Meyer and Gali Naveh
Nutrients 2021, 13(5), 1401; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13051401 - 21 Apr 2021
Cited by 5 | Viewed by 3397
Abstract
Celiac disease (CD) is a chronic disease treated by maintaining and managing a lifelong restrictive gluten-free diet. The purpose of this study was to develop a mobile application, Plan My C-Day, to promote self-management skills among youth with CD during adolescence—a time when [...] Read more.
Celiac disease (CD) is a chronic disease treated by maintaining and managing a lifelong restrictive gluten-free diet. The purpose of this study was to develop a mobile application, Plan My C-Day, to promote self-management skills among youth with CD during adolescence—a time when decreased adherence often occurs—and examine its usability among adolescents with CD. Plan My C-Day contains three simulations of activities involving eating out and actions to take when preparing for these events. It was developed and pilot tested by 13 adolescents with CD. Application use and user perception data were collected and analyzed. Participants chose 160 actions within the simulations. For over 75% of participants, the time to complete the simulation decreased from the first to the third (last) simulation by an average of 50%. The average reported usability perception was 3.71 on a scale of 1 to 5, with system ease of use and ease of learning obtaining the highest scores. This study demonstrated that the Plan My C-Day mobile application’s self-management content, features, and functions operated well and that the simulations were easy to understand and complete. Further development will include the option to add self-created activities and adaptation to different languages and cultures. Full article
(This article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet)
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12 pages, 9019 KiB  
Article
Prevalence of Wheat/Gluten-Related Disorders and Gluten-Free Diet in Paraguay: An Online Survey-Based Study
by Noé Ontiveros, Raúl Emilio Real-Delor, José Antonio Mora-Melgem, Carlos Eduardo Beltrán-Cárdenas, Oscar Gerardo Figueroa-Salcido, Marcela de Jesús Vergara-Jiménez, Feliznando Isidro Cárdenas-Torres, Lilian Karem Flores-Mendoza, Jesús Gilberto Arámburo-Gálvez and Francisco Cabrera-Chávez
Nutrients 2021, 13(2), 396; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13020396 - 27 Jan 2021
Cited by 9 | Viewed by 2889
Abstract
Gluten-related disorders (GRDs) are increasing around the world, but their magnitude and relevance remain unknown in most Latin American countries. Thus, an online survey was conducted to estimate the prevalence of GRDs as well as adherence to a gluten-free diet (GFD) in Paraguayan [...] Read more.
Gluten-related disorders (GRDs) are increasing around the world, but their magnitude and relevance remain unknown in most Latin American countries. Thus, an online survey was conducted to estimate the prevalence of GRDs as well as adherence to a gluten-free diet (GFD) in Paraguayan adult population. There were 1058 individuals surveyed using a validated questionnaire (response rate of 93.9%). The self-reported prevalence rates were as follows (95% CI): gluten sensitivity (GS), 10.30% (8.53–12.29); non-celiac GS (NCGS), 5.19% (3.94–6.71); physician-diagnosed celiac disease (PD-CD), 3.11% (2.15–4.35); wheat allergy (WA), 2.07% (1.30–3.13); and adherence to GFD, 15.69% (13.55–18.02). Excluding CD, more women than men met the criteria for GRDs, adverse food reactions, and GFD (p < 0.05). Eight respondents reported the coexistence of NCGS with PD-CD and/or WA. Most cases on a GFD indicated medical/dietitian advice for following the diet (68.07%). Non-self-reported GS individuals indicated weight control (46.4%) and the notion that the GFD is healthier (20.2%) as the main motivations for following the diet. GRDs are not uncommon in Paraguayan adult population. It seems that there is awareness about GRDs and the GFD, but training about the diagnosis of GRDs is desirable because of the informed overlapping diagnoses of CD or WA with NCGS. Future studies involving face-to-face interviews are necessary. Full article
(This article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet)
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Review

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16 pages, 314 KiB  
Review
Celiac Disease and Gallbladder: Pathophysiological Aspects and Clinical Issues
by Dimitri Poddighe, Kuanysh Dossybayeva, Diyora Abdukhakimova, Lyudmila Akhmaltdinova and Aigul Ibrayeva
Nutrients 2022, 14(20), 4379; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14204379 - 19 Oct 2022
Cited by 2 | Viewed by 1912
Abstract
Background: Celiac Disease (CD) is an immune-mediated disorder which primarily affects the small intestine; however, extra-intestinal organs are often affected by the pathological process, too. As regards the digestive system, liver alterations in CD patients have been widely described, which can also [...] Read more.
Background: Celiac Disease (CD) is an immune-mediated disorder which primarily affects the small intestine; however, extra-intestinal organs are often affected by the pathological process, too. As regards the digestive system, liver alterations in CD patients have been widely described, which can also extend to the biliary tract. Notably, gallbladder function can be altered in CD patients. In this review, we specifically analyze and summarize the main pathophysiological aspects and clinical evidence of gallbladder dysfunction in CD patients, in order to discuss the potential medical complications and clinical research gaps. In addition to some perturbations of bile composition, CD patients can develop gallbladder dysmotility, which mainly expresses with an impaired emptying during the digestive phase. The main pathophysiological determinant is a perturbation of cholecystokinin secretion by the specific duodenal enteroendocrine cells in response to the appropriate nutrient stimulation in CD patients. This situation appears to be reversible with a gluten-free diet in most cases. Despite this gallbladder impairment, CD patients do not seem to be more predisposed to gallbladder complications, such as calculous and acalculous cholecystitis. However, very few clinical studies have actively investigated these clinical aspects, which may not be completely evidenced so far; alternatively, the substantial improvements in the last two decades regarding CD diagnosis, which have reduced the diagnostic delay (and related dietary treatment), may have lessened the potential clinical consequences of CD-related gallbladder dysfunction. Specific clinical studies focused on these aspects are needed for a better understanding of the clinical implications of gallbladder alterations in CD patients. Full article
(This article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet)
13 pages, 749 KiB  
Review
Celiac Disease and Thrombotic Events: Systematic Review of Published Cases
by Nikola Pantic, Ivana Pantic, Dorde Jevtic, Vanajakshi Mogulla, Stevan Oluic, Momcilo Durdevic, Terri Nordin, Mladen Jecmenica, Tamara Milovanovic, Tatjana Gavrancic and Igor Dumic
Nutrients 2022, 14(10), 2162; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14102162 - 23 May 2022
Cited by 17 | Viewed by 3899
Abstract
Extraintestinal manifestations of celiac disease (CD) should be considered, even in patients without typical intestinal symptoms. The aim of our study is to examine the literature regarding the occurrence of thrombotic events in CD, and to synthesize the data from case reports and [...] Read more.
Extraintestinal manifestations of celiac disease (CD) should be considered, even in patients without typical intestinal symptoms. The aim of our study is to examine the literature regarding the occurrence of thrombotic events in CD, and to synthesize the data from case reports and case series. A systematic review of the literature was conducted by searching the Pub-Med/MEDLINE database, from the date of database inception to January 2022, to identify published cases and case series on this topic, in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 55 cases were included in the study. The majority of patients were previously healthy individuals, with no comorbidities. In less than one-third of the cases (30.91%), the diagnosis of CD was established before the onset of thrombosis, while in the remaining cases (34.54%), thrombosis preceded the diagnosis or was diagnosed concomitantly with CD. The most common sites for thrombosis occurrence were hepatic veins (30.91%), while thrombosis of cerebral blood vessels, deep venous thrombosis of lower extremities, and pulmonary thromboembolism were less frequent. Thrombosis was most commonly isolated to one site only (78.18%). In 69.09% of cases (n = 38), some form of anticoagulation, along with a gluten-free diet, was initiated. Full article
(This article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet)
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14 pages, 1213 KiB  
Review
Doubtful Justification of the Gluten-Free Diet in the Course of Hashimoto’s Disease
by Małgorzata Szczuko, Anhelli Syrenicz, Katarzyna Szymkowiak, Aleksandra Przybylska, Urszula Szczuko, Jakub Pobłocki and Danuta Kulpa
Nutrients 2022, 14(9), 1727; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14091727 - 21 Apr 2022
Cited by 8 | Viewed by 10261
Abstract
The popularization of the gluten-free diet brings with it a fashion for its use, which can harm the treatment of Hashimoto’s disease. The few studies in this regard do not confirm positive changes resulting from a gluten-free diet. At the same time, the [...] Read more.
The popularization of the gluten-free diet brings with it a fashion for its use, which can harm the treatment of Hashimoto’s disease. The few studies in this regard do not confirm positive changes resulting from a gluten-free diet. At the same time, the presence of other comorbid autoimmune diseases in this group of patients is increasing. This may have important implications for the interpretation of test results and the need for a gluten-free diet in some patients. In this review, the PubMed database was searched for links between a gluten-free diet, Hashimoto’s disease, and autoimmune diseases. When analyzing the available literature, we found no basis for introducing a gluten-free diet for the standard management of Hashimoto patients. The recommended diet is instead an anti-inflammatory diet that levels the supply (to compensate for deficiencies) of vitamin D, iodine, and selenium, which are found in plant products rich in polyphenols, antioxidants, and omega-3 fatty acids, as illustrated in this article. Full article
(This article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet)
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27 pages, 2006 KiB  
Review
Gluten and FODMAPs Relationship with Mental Disorders: Systematic Review
by Egoitz Aranburu, Silvia Matias, Edurne Simón, Idoia Larretxi, Olaia Martínez, María Ángeles Bustamante, María del Pilar Fernández-Gil and Jonatan Miranda
Nutrients 2021, 13(6), 1894; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13061894 - 31 May 2021
Cited by 3 | Viewed by 8301
Abstract
Nowadays, gluten and FODMAP food components (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) are increasingly studied due to their possible relation with extraintestinal-associated conditions. In recent years, gluten-free diets (GFD) and low-FODMAP diets (LFD) are becoming more popular not only in order to avoid [...] Read more.
Nowadays, gluten and FODMAP food components (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) are increasingly studied due to their possible relation with extraintestinal-associated conditions. In recent years, gluten-free diets (GFD) and low-FODMAP diets (LFD) are becoming more popular not only in order to avoid the food components that cause intolerances or allergies in some people, but also due to the direct influence of marketing movements or diet trends on feeding habits. Likewise, neurological and psychiatric diseases are currently of increasing importance in developed countries. For this reason, a bibliographic systematic review has been carried out to analyse whether there is a pathophysiological relationship between the dietary intake of gluten or FODMAPs with mental disorders. This review collects 13 clinical and randomized controlled trials, based on the PRISMA statement, which have been published in the last ten years. Based on these results, limiting or ruling out gluten or FODMAPs in the diet might be beneficial for symptoms such as depression, anxiety (7 out of 7 articles found any positive effect), or cognition deficiency (improvements in several cognition test measurements in one trial), and to a lesser extent for schizophrenia and the autism spectrum. Nevertheless, further studies are needed to obtain completely reliable conclusions. Full article
(This article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet)
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