Risk of Eating Disorders in Patients With Celiac Disease.

OBJECTIVES: Several cases of eating disorders (EDs) have been reported in patients with celiac disease (CD), suggesting that ED could be a comorbidity associated with CD. Few epidemiological studies have, however, assessed this potential association. We aimed to evaluate the risk of EDs in individuals diagnosed with CD in comparison to healthy controls. METHODS: A total of 98 cases and 98 controls matched for sex, age, and body mass index between 10 and 23 years old were studied. A questionnaire was completed on medical history and sociodemographic as well as anthropometric characteristics. Various ED screening self-reported tests were administered. RESULTS: A total of 61.2% of the study population were girls with a mean age of 15.3 ±â€Š3.7 years old. Patients with CD scored nonsignificantly higher on all the ED screening tests than control participants. No differences were observed between study groups in terms of the frequency of individuals who exceeded the clinical cutoff identifying those at risk of ED. Patients with CD above 13 years old were associated with a 2.15-point increase in the Eating Attitude Test score compared with controls [ß-coefficient = 2.15 SE 1.04; P = 0.04] after adjusting for various confounders. CONCLUSIONS: Although being a patient with CD was associated with a significantly higher Eating Attitude Test score in individuals older than 13 years old, no clear differences were observed between individuals with CD and controls in terms of risk of ED when other screening tests were used. More studies with larger samples and prospective designs are warranted to confirm these findings.

Evolución en los conocimientos sobre alimentación: una intervención educativa en estudiantes universitarios / Developments in food knowledge: an educational intervention in university studentes

To analyze the relationship between the level of knowledge about food, the degree of adherence to the Mediterranean Diet (MeDi) and nutritional status; an intervention study was performed with pre- and post-intervention evaluation after three educational sessions, designed according to the learning preferences of health science university students. Sixty-five physiotherapy and podology students participated. The mean age was 22.0 years and participants were mostly male 58.5%. The majority were normal weight (63.1%), but many (69.2%) needed to improve their eating habits in order to comply with DiMe recommendations. The statistical relationship found between the level of previous knowledge in nutrition and nutritional status (Pearson's Correlation Coefficient= 0.7; p= 0.049) suggests that nutritional education actions in this group could contribute to improving the quality of the diet, nutritional status and future health of university students. Educational sessions were able to improve the level of knowledge regarding nutrition and food in the majority of students, thus it is possible to consider the intervention as an efficient tool for the transmission of nutritional knowledge in this group.

Con el objetivo de analizar la relación entre el nivel de conocimientos en alimentación, el grado de adherencia a la Dieta Mediterránea (DiMe) y el estado nutricional; se realizó un estudio de intervención con evaluación pre y post intervención; a través de tres sesiones educativas, diseñadas según las preferencias de aprendizaje de estudiantes universitarios de ciencias de la salud. Participaron 65 estudiantes de Fisioterapia y Podología, preferentemente masculinos 58,5% y con una edad media de 22,0 años. La mayoría resultó normo peso (63,1%), pero muchos deben mejorar sus hábitos alimentarios para ajustarse a las recomendaciones de la DiMe (69,2%). La relación estadística encontrada entre el nivel de conocimientos previos en nutrición y el estado nutricional (Coeficiente de Correlación de Pearson= 0,7; p= 0,049), sugiere que las acciones de educación nutricional en este colectivo, podrían contribuir a mejorar la calidad de la dieta y con ella el estado nutricional y la salud futura de los universitarios. Las sesiones educativas consiguieron mejorar el nivel de conocimientos en nutrición y alimentación en la mayoría de estudiantes, por lo que es posible considerarlas como una herramienta eficiente en la trasmisión de conocimientos nutricionales en este colectivo.

Patients With Celiac Disease Reported Higher Consumption of Added Sugar and Total Fat Than Healthy Individuals.

OBJECTIVES: The aim of the study was to compare the dietary pattern between subjects with celiac disease (CD) (cases) and subjects without (healthy controls) CD. METHODS: A case-control design study was conducted. A total of 98 subjects with CD (age 10-23 years) were matched by age, sex, and body mass index with 98 nonceliac participants. A nonconsecutive 3-day food record was completed to assess energy, nutrient, and food intake and evaluate the participant's adherence to recommendations. Differences in energy, nutrients, food consumption, and compliance with general recommendations between cases and control groups were assessed by Student t test. Pearson chi-squared test was used to compare categorical variables. Sociodemographic, personal, and family history data were collected. RESULTS: Compared with the control group, the cases with CD reported a significantly higher consumption of added sugar (P < 0.001) and total fat (P < 0.017). Mean fiber consumption was below the nutritional recommendations in both groups. Participants with CD consumed significantly lower amounts of foods rich in starch (P < 0.001) and higher amounts of foods rich in protein such as meat, fish, and eggs (P = 0.007). Subjects with CD showed a significantly lower percentage of adherence to recommendations for folic acid (53.2 vs 70.5; P < 0.001), calcium (49.0 vs 56.3; P = 0.025), iron (57.4 vs 78.0; P < 0.001), and magnesium (50.0 vs 63.9; P < 0.001). CONCLUSIONS: The subjects with CD showed a more unbalanced diet than controls in terms of added sugars, total fat, and micronutrient consumption.

Consumption of gluten-free products: should the threshold value for trace amounts of gluten be at 20, 100 or 200 p.p.m.?

OBJECTIVE: The threshold of gluten contamination in gluten-free products of both dietary and normal consumption is under debate. The objective of this study was to gather information on consumption of gluten-free products intended for dietary use of people under a gluten-free diet. This information is essential to ascertain the exposure of coeliac patients to gluten through their diet and deduce the maximum gluten content that these products should contain to guarantee a safe diet. METHODS: A diet diary of consumption of gluten-free products intended for dietary use was distributed to the coeliac societies of two typical Mediterranean countries (Italy and Spain) and two Northern countries (Norway and Germany). The diet diary included a self-weigh table of the selected food items and a 10-day consumption table. Results were reported in percentiles as distributions were clearly right skewed. RESULTS: The respondents included in the study accounted for 1359 in Italy, 273 in Spain, 226 in Norway and 56 in Germany. Gluten-free products intended for dietary use contributed significantly to the diet of coeliac patients in Italy, Germany and Norway and to a lesser degree in Spain. The most consumed gluten-free product in all countries was bread, and it was double consumed in the Northern countries (P<0.001). Mediterranean countries showed consumption of a wider variety of gluten-free foods and pasta was eaten to a large degree in Italy. CONCLUSIONS: The differences between Northern and Mediterranean countries were not in the total amount of gluten-free products but in the type of products consumed. The observed daily consumption of gluten-free products results in the exposure to rather large amounts of gluten, thus the limit of 200 p.p.m. should be revised. A limit of 20 p.p.m. for products naturally gluten-free and of 100 p.p.m. for products rendered gluten-free is proposed to guarantee a safe diet and to enable coeliac patients to make an informed choice. These limits should be revised as new data become available.