Body mass index in celiac disease and effect of a gluten-free diet on body mass index
Keywords:BMI, Bikaner, Celiac disease, Gluten free diet, Serum cholesterol
Background: Various researchers have shown association of celiac disease with body mass index. We studied body mass index levels in patient with celiac disease and effect of gluten free diet on it. To compare body mass index levels in celiac disease patients with general population and to study effect of gluten free diet on BMI levels in them.
Methods: 50 children with biopsy confirmed celiac disease (either newly diagnosed or having poor dietary compliance for gluten free diet) and 50 healthy children were enrolled at our centre. Their initial and after 6 months of strict gluten free diet, BMIs were measured and compared with the previous levels.
Results: BMIs in patients with celiac disease was significantly lower (17.18) than the healthy children 21.20 (p <0.001). Boys with celiac disease had (17.28) and girls with celiac disease had (17.10) lower body mass index when compared to their healthy peers. The difference between both sexes was insignificant. After 6 months of strict gluten free diet, celiac patients showed 19.30 (12.36%) increase in their BMI levels. Boys had 19.41 (12.32%) and girls had 19.23 (12.45%) increase in their BMIs. These levels were significantly higher than those measured at the start of therapy and comparable to their healthy peers.
Conclusions: Thestudy concluded that, low BMI is significantly associated with celiac disease. Gluten free diet significantly increases BMI levels. According to the study, largest improvement in BMI was more pronounced in patients who were underweight initially. Whereas overweight patients losses their weight after strict GFD. Low cholesterol levels were significantly associated with low BMI.
Kelly CP. Celiac sprue - current concepts. N Engl J Med. 2002;346:180-8.
Mariani P, Viti MG, Montuori M, Vecchia A, Cipolletta E, Calvani L, et al. The gluten-free diet: a nutritional risk factor for adolescents with celiac disease? J Pediatr Gastroenterol Nutr. 1998;27:519-23.
Aurangzeb B, Leach ST, Lemberg DA, Day AS. Nutritional status of children with coeliac disease. Acta Paediatr. 2010;99:1020-25.
Venkatasubramani N, Telega G, Werlin SL. Obesity in pediatric celiac disease. J Pediatr Gastroenterol Nutr. 2010;51:295-7.
Valletta E, Fornaro M, Cipolli M, Conte S, Bissolo F, Danchielli C. Celiac disease and obesity: need for nutritional follow-up after diagnosis. Eur J Clin Nutr. 2010;64:1371-2.
Reilly NR, Aguilar K, Hassid BG, Cheng J, DeFelice AR, Kazlow P, et al. Celiac disease in children with normal weight and overweight: clinical features and growth outcomes following a gluten-free diet. J Pediatr Gastroenterol Nutr. 2011;53(5):528-31.
Cheng J, Brar PS, Lee AR, Green PH. Body mass index in celiac disease: beneficial effect of a gluten-free diet. J Clin Gastroenterol. 2010;44:267-71.
Barr DG, Shmerling DH, Prader A. Catch-up growth in malnutrition, studied in celiac disease after institution of a glutenfree diet. Pediatr Res. 1972;6:521-7.
De LF, Astori M, Pandullo E, Sferlazzas C, Arrigo T, Sindoni A, et al. Effects of a gluten-free diet on catch-up growth and height prognosis in coeliac children with growth retardation recognized after the age of 5 years. Eur J Pediatr. 1988;147:188-91.
Bosio L, Barera G, Mistura L, Sassi G, Bianchi C. Growth acceleration and final height after treatment for delayed diagnosis of celiac disease. J Pediatr Gastroenterol Nutr. 1990;11:324-9.
Murray JA, Watson T, Clearman B, Mitros F. Effect of a gluten free diet on gastrointestinal symptoms in celiac disease. Am J Clin Nutr. 2004;79:669-73.
Smecuol E, Gonzalez D, Mautalen C, Siccardi A, Cataldi M, Niveloni S, et al. Longitudinal study on the effect of treatment on body composition and anthropometry of celiac disease patients. Am J Gastroenterol. 1997;92:639-43.
Patwari AK, Kapur G, Satyanarayana L, Anand VK, Jain A, Gangil A, et al. Catch-up growth in children with latediagnosed coeliac disease. Br J Nutr. 2005;94:437-42.
Delvecchio M, De BA, Francavilla R, Rutigliano V, Predieri B, Indrio F, et al. Anti-pituitary antibodies in children with newly diagnosed celiac disease: a novel finding contributing to linear-growth impairment. Am J Gastroenterol. 2010;105:691-6.