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Body composition in children with celiac disease and the effects of a gluten-free diet: a prospective case-control study^1,2

¹ From the Department of Pediatrics and the Laboratory of Pediatric Endocrinology, Scientific Institute H San Raffaele, University of Milan, Italy.

Background: Celiac disease is the most common cause of malnutrition in children of Western countries.

Objective: The objective was to measure body composition in children at the time celiac disease was diagnosed and after consumption of a gluten-free diet (GFD).

Design: We assessed body composition by dual-energy X-ray absorptiometry in 29 children and adolescents with a mean (±SD) age of 9.5 ± 3.4 y at the time celiac disease was diagnosed and in a subset of 20 patients after 1.2 ± 0.2 y of a GFD. We also studied 23 patients aged 21.2 ± 4.6 y who consumed a GFD for 10.6 ± 4.5 y. Each patient was matched with a healthy control subject of the same age and sex.

Results: Untreated patients weighed less than control subjects (P = 0.04). Fat mass and bone mineral content were lower in the patients than in the control subjects (P < 0.01), as was lean mass of the limbs (P = 0.0013). After 1 y of the GFD, there were no significant differences in body-composition values between patients and control subjects. Similarly, body-composition values of celiac disease patients who consumed the GFD long term were comparable with those of healthy subjects.

Conclusions: Remarkable abnormalities in body composition were found in children at the time of diagnosis of celiac disease. Appropriate dietary treatment reverses body-composition abnormalities quickly and the beneficial effects of gluten withdrawal are persistent. Because these results are harder to achieve if celiac disease is first diagnosed in adulthood, efforts to encourage early diagnosis of celiac disease should be made.

Key Words: Body composition • celiac disease • children • dual-energy X-ray absorptiometry • gluten-free diet

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