What Determines Gluten-Free Diet Success in Kids and Teens?

Celiac.com 03/28/2018 - Compliance with a gluten-free diet is difficult at all ages, but particularly for teenagers due to social, cultural, economic, and practical pressures. 

A team of researchers recently set out to assess the rates and determining factors of non-adherence to a gluten-free diet, along with the nutritional status of children and adolescents with celiac disease in a tertiary Brazilian referral center.

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The research team included Maraci Rodrigues, Glauce Hiromi Yonaminez, and Carla Aline Satiro. They are variously affiliated with the Department of Gastroenterology, Hospital das Clínicas, School of Medicine, University of Sao Paulo (SMUSP), Av. Dr Eneas de Carvalho Aguiar, 255, 05403-000, Sao Paulo, Brazil, and the Department of Pediatric, Instituto da Criança, Division of Nutrition, Hospital das Clínicas, School of Medicine, University of Sao Paulo in Sao Paulo, Brazil.

The team’s cross-sectional and retrospective study included patients under 20 years of age, with biopsy-confirmed celiac disease, followed regularly at the Department of Pediatrics, Division of Gastroenterology, Hospital das Clínicas, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil, were surveyed using a questionnaire and serologic test applied between November 2011 and February 2012. 

The team reviewed patient charts to collect the anthropometric data along with the results of the serologic test performed both at the time of diagnosis, and after at least 1 year of a gluten-free diet. They assessed 35 patients aged between 2.4 and 19.9 years. Average patient age at diagnosis was 5.4 years. Nearly 70% of the patients were women, nearly 90% had classical celiac disease, while just over 50% had other celiac-associated conditions. Despite dietary guidance, one in five patients reported deviating from the gluten-free diet. 

After five years of gluten-free diet, most children achieved normal height and weight, while some of the children gained an excessive amount of weight, especially in the first two years of gluten-free eating.  Most deviation from gluten-free eating was intentional, and occurred at parties and other social gatherings.

In addition to teaching self-management skills, factors that promote knowledge and tools to manage celiac disease among independent children and adolescents include more choices and easier access of low cost gluten-free foods, and increased family discussions about the benefits of eating gluten-free diet. 

Helping kids and adolescents with celiac disease to effectively manage their condition by closely following a gluten-free diet is crucial, and parents have an important role to play in reinforcing information from doctors and health care professionals.

Source:

• BMC Gastroenterol. 2018; 18: 15. doi: 10.1186/s12876-018-0740-z