RESUMEN
People suffering from a food intolerance (FI) tend to initiate restrictive diets such as a gluten-free diet (GFD), to alleviate their symptoms. To learn about how people live with these problems in daily life (independent of their medical diagnoses), 1203 participants answered a previously validated questionnaire and were divided into: G1 (those self-reporting symptoms after gluten consumption) and G2 (those informing no discomfort after gluten consumption). Self-reported clinical characteristics, diagnoses and diets followed were registered. Twenty nine percent referred some FI (8.5% in G1). In G1, self-reported diagnoses were more frequent (p < 0.0001), including a high proportion of eating and mood disorders. Diagnoses were reported to be given by a physician, but GFD was indicated by professional and nonprofessional persons. In G2, despite declaring no symptoms after gluten consumption, 11.1% followed a GFD. The most frequent answer in both groups was that GFD was followed "to care for my health", suggesting that some celiac patients do not acknowledge it as treatment. Conclusion: close to one third of the population report suffering from some FI. Those perceiving themselves as gluten intolerant report more diseases (p < 0.0001). A GFD is followed by ~11% of those declaring no symptoms after gluten ingestion. This diet is perceived as a healthy eating option.
Asunto(s)
Intolerancia Alimentaria/dietoterapia , Intolerancia Alimentaria/diagnóstico , Glútenes/efectos adversos , Autoinforme , Adulto , Enfermedad Celíaca/diagnóstico , Enfermedad Celíaca/dietoterapia , Chile , Dieta Sin Gluten , Femenino , Enfermedades Gastrointestinales/diagnóstico , Enfermedades Gastrointestinales/dietoterapia , Glútenes/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To evaluate the nutritional status and gastrointestinal changes in children with autism spectrum disorder (ASD). METHODS: Cross-sectional, descriptive analysis of 39 children with ASD aged between three and ten years old, registered in the participating association. Nutritional status was evaluated by body mass index/age and weight/age, according to the guidelines from the World Health Organization. In order to investigate whether gastrointestinal alterations occurred, the interviewees answered a questionnaire about the presence of these symptoms within the last 30 days. In order to evaluate food consumption, a 24-hour recall questionnaire was applied and the food reported were grouped as: gluten sources, casein and ultra-processed sources. For the statistical analysis, Epi-Info software version 7.2 was used. Multivariate logistic regression analysis was performed to evaluate the variables associated with gastrointestinal alterations. RESULTS: There was a high prevalence of overweight children with autism spectrum disorder (64.1%). No child was underweight. Thirty-four children (84.2%) had gastrointestinal symptoms. Consumption of gluten was associated with gastrointestinal symptoms (ß=0.38; 95%CI 0.07-0.75; p=0.02). CONCLUSIONS: The high prevalence of being overweight should be considered during the follow-up visits of children with ASD. The influence of gluten consumption on the presence of gastrointestinal symptoms was observed in this study, and the causes involved in these alterations need to be further investigated.
Asunto(s)
Trastorno del Espectro Autista/complicaciones , Enfermedades Gastrointestinales/complicaciones , Estado Nutricional , Sobrepeso/complicaciones , Índice de Masa Corporal , Niño , Preescolar , Estudios Transversales , Registros de Dieta , Femenino , Glútenes/administración & dosificación , Glútenes/efectos adversos , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
ABSTRACT Objective: To evaluate the nutritional status and gastrointestinal changes in children with autism spectrum disorder (ASD). Methods: Cross-sectional, descriptive analysis of 39 children with ASD aged between three and ten years old, registered in the participating association. Nutritional status was evaluated by body mass index/age and weight/age, according to the guidelines from the World Health Organization. In order to investigate whether gastrointestinal alterations occurred, the interviewees answered a questionnaire about the presence of these symptoms within the last 30 days. In order to evaluate food consumption, a 24-hour recall questionnaire was applied and the food reported were grouped as: gluten sources, casein and ultra-processed sources. For the statistical analysis, Epi-Info software version 7.2 was used. Multivariate logistic regression analysis was performed to evaluate the variables associated with gastrointestinal alterations. Results: There was a high prevalence of overweight children with autism spectrum disorder (64.1%). No child was underweight. Thirty-four children (84.2%) had gastrointestinal symptoms. Consumption of gluten was associated with gastrointestinal symptoms (β=0.38; 95%CI 0.07-0.75; p=0.02). Conclusions: The high prevalence of being overweight should be considered during the follow-up visits of children with ASD. The influence of gluten consumption on the presence of gastrointestinal symptoms was observed in this study, and the causes involved in these alterations need to be further investigated.
RESUMO Objetivo: Avaliar o estado nutricional e a presença de alterações gastrintestinais em crianças com transtorno do espectro autista. Métodos: Estudo transversal, descritivo, composto por 39 crianças autistas com idades entre três e dez anos, cadastradas na associação participante. O estado nutricional foi analisado a partir do índice de massa corporal/idade e do peso/idade, tendo como referências as curvas da Organização Mundial da Saúde. Para investigação das alterações gastrintestinais, o entrevistado respondeu sobre a presença de alterações nos últimos 30 dias. Na avaliação do consumo alimentar foi aplicado um recordatório de 24 horas e os alimentos listados foram categorizados em: fontes de glúten, fontes de caseína e ultraprocessados. A análise estatística utilizou o software Epi-Info, versão 7.2. Foi realizada a análise de regressão logística multivariada para avaliar os fatores associados às alterações gastrintestinais. Resultados: Observou-se alta prevalência de excesso de peso nas crianças com transtorno do espectro autista (64,1%), não sendo registrada nenhuma criança com déficit de peso. Um total de 34 crianças (84,2%) apresentava alterações gastrintestinais. O consumo de glúten esteve associado às manifestações gastrintestinais (β=0,38; IC95% 0,07-0,75; p=0,02). Conclusões: A elevada prevalência do excesso de peso deve ser tratada com maior atenção em crianças com transtorno do espectro autista. Foi observada a influência do consumo de glúten no aparecimento das alterações gastrintestinais, sendo necessário que as causas envolvidas nessas alterações sejam mais bem investigadas.
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Estado Nutricional , Sobrepeso/complicaciones , Trastorno del Espectro Autista/complicaciones , Enfermedades Gastrointestinales/complicaciones , Índice de Masa Corporal , Registros de Dieta , Estudios Transversales , Encuestas y Cuestionarios , Glútenes/administración & dosificación , Glútenes/efectos adversosRESUMEN
Gluten-related disorders (GRDs) are gradually emerging as epidemiologically relevant diseases, with a global prevalence estimated to be approximately 5% in the population. Conditions related to gluten ingestion include celiac disease (CD), wheat allergy (WA), and nonceliac gluten sensitivity (NCGS). Although mediated by different pathogenic pathways, these 3 conditions share similar clinical manifestations and can present a difficult differential diagnosis. The gluten challenge (GC) is an important diagnostic tool for GRDs, but there is great variability in regards to deciding which patients should be challenged, what amount of gluten should be used, what the GC duration should be, when and where the GC should occur, and, sometimes, why to conduct a GC. This review summarizes the current knowledge about the desirable characteristics of GCs in the 3 main GRDs following a 5 Ws approach-that is, the 5 main journalistic questions: who, what, when, where, why. The answers will help to determine the correct use of the GC in diagnosing GRDs.
Asunto(s)
Enfermedad Celíaca/diagnóstico , Glútenes/administración & dosificación , Hipersensibilidad al Trigo/diagnóstico , Dieta Sin Gluten , Glútenes/efectos adversos , Humanos , Factores de TiempoRESUMEN
Cereal-based diets formulated as semi-purified diets can provide flexibility for researchers, enabling open controlled formulas, besides being cheaper than purified diets. Seeking to widen the researchers' options in their experimental design developments, we aimed at assaying the chemical score, growth performance and protein utilization of nine semi-purified experimental chows. These diets were formulated at 17.8%, 12% and 8% protein contents, using three variations of ingredients for each one, as follows: casein (C), casein+soybean meal (C+S, 1:1 w/w protein) and casein+soybean meal+corn gluten meal (C+S+G, 1:1:1 w/w protein), without cysteine supplementation and setting casein 17.8% (AIN-93G) as reference diet. The diets C and C+S (17.8%) had the Cys as the limiting amino acid once the addition of gluten turns the Lys as second limiting. All diets had the potential for promoting growth with body mass gain, feed conversion ratio (FCR; chow consumed per body weight gain, average 3.12) and feed efficiency ratio (FER; body weight gain per chow consumed, average 0.3), except for C+S+G 8% (FCR = 6 g; FER = 0.13). These variations were mainly due to the protein amounts independently from the protein ingredient used and could characterize the C+S+G 8% as unable to support growth. For the other parameters (digestibility, net protein ratio, net protein utilization and protein efficiency ratio), there were no relevant differences between the diets. We can conclude that 17.8%, 12% and 8% chows (C and C+S) allowed a proper combination of ingredients from the point of view of palatability, nutrient availability/utilization, metabolic processes, growth performance and feed utilization parameters.
Asunto(s)
Alimentación Animal , Fenómenos Fisiológicos Nutricionales de los Animales , Proteínas en la Dieta/administración & dosificación , Grano Comestible , Animales , Caseínas/administración & dosificación , Caseínas/metabolismo , Proteínas en la Dieta/metabolismo , Ingestión de Alimentos , Metabolismo Energético , Estudios de Factibilidad , Glútenes/administración & dosificación , Glútenes/metabolismo , Masculino , Estado Nutricional , Valor Nutritivo , Ratas Wistar , Proteínas de Soja/administración & dosificación , Proteínas de Soja/metabolismo , Aumento de Peso , Zea maysRESUMEN
PURPOSE: The only effective and safe treatment of celiac disease (CD) continues being strict exclusion of gluten for life, the so-called gluten-free diet (GFD). Although this treatment is highly successful, following strict GFD poses difficulties to patients in family, social and working contexts, deteriorating his/her quality of life. We aimed to review main characteristics of GFD with special emphasis on factors that may interfere with adherence to it. METHODS: We conducted a search of various databases, such as PubMed, Google Scholar, Embase, and Scielo, with focus on key words such as "gluten-free diet", "celiac disease", "gluten" and "gluten-free diet adherence". Available literature has not reached definitive conclusions on the exact amount of gluten that is harmless to celiac patients, although international agreements establish cutoff points for gluten-free products and advise the use of clinical assessment to tailor the diet according to individual needs. Following GFD must include eliminating gluten as ingredient as well as hidden component and potential cross contamination in foods. There are numerous grains to substitute wheat but composition of most gluten-free products tends to include only a small number of them, especially rice. The diet must be not only free of gluten but also healthy to avoid nutrient, vitamins and minerals deficiencies or excess. Overweight/obesity frequency has increased among celiac patients so weight gain deserves attention during follow up. Nutritional education by a trained nutritionist is of great relevance to achieve long-term satisfactory health status and good compliance. CONCLUSIONS: A balanced GFD should be based on a combination of naturally gluten-free foods and certified processed gluten-free products. How to measure and improve adherence to GFD is still controversial and deserves further study.
Asunto(s)
Enfermedad Celíaca/dietoterapia , Dieta Sin Gluten , Dieta Saludable , Contaminación de Alimentos , Glútenes/administración & dosificación , Glútenes/efectos adversos , Humanos , Mucosa Intestinal , Intestino Delgado , Estilo de Vida , Ciencias de la Nutrición/educación , Estado Nutricional , Cooperación del Paciente , Educación del Paciente como Asunto , Calidad de Vida , Aumento de PesoRESUMEN
BACKGROUND: The rate of compliance with a gluten-free diet in patients with gluten-related disorders is unknown in most Latin American countries. OBJECTIVE: To study the adherence to a gluten-free diet of Mexican individuals with celiac disease and nonceliac gluten sensitivity at the time of their first medical and nutritional consultation at a tertiary referral center. METHODS: A cross-sectional study was performed. A specific questionnaire was used to gather information on demographics, clinical condition, and self-reported adherence to a gluten-free diet, and to determine strict compliance and intentional or inadvertent gluten consumption. All questionnaires were applied by a nutritionist with expertise in gluten-related disorders. RESULTS: Fifty-six patients with celiac disease and 24 with non-celiac gluten sensitivity were included. Overall, 46 (57.5%) subjects perceived themselves as strictly adherent; however, inadvertent gluten intake was frequent in both celiac disease and non-celiac gluten sensitivity patients (39.2 vs. 33.3%; p = 0.2). Intentional consumption was more prevalent in subjects with celiac disease (48.8 vs. 29.1%; p = 0.048) and individuals with non-celiac gluten sensitivity showed better adherence (37.5 vs. 12.5%; p = 0.035). CONCLUSIONS: The importance of a gluten-free diet is underestimated by Mexican patients with celiac disease. The role of a team with expertise in gluten-related disorders is essential to identify inadvertent gluten intake.
Asunto(s)
Enfermedad Celíaca/tratamiento farmacológico , Dieta Sin Gluten , Glútenes/administración & dosificación , Cooperación del Paciente , Adulto , Anciano , Estudios Transversales , Femenino , Glútenes/efectos adversos , Humanos , Masculino , México , Persona de Mediana Edad , Prevalencia , Encuestas y CuestionariosRESUMEN
La enfermedad celíaca (EC) es un trastorno sistémico inmune mediado por la ingesta de gluten en individuos genéticamente susceptibles. Se caracteriza por manifestaciones clínicas variables, auto anticuerpos anti-endomisio, anti-transglutaminasa (tTG) y/o anti-péptidos de gliadina deamidados (PGD) en sangre, más daño variable de la mucosa intestinal. En Chile el 0,76% de los mayores de 15 años tiene IgA-tTG positiva y la prevalencia de EC se estima en ~0,6%. En familiares de primer grado de celíacos se ha identificado ~17% de casos tTG positivos. Hasta hoy el único tratamiento es la dieta libre de gluten (DLG), que para ser efectiva debe ser estricta, permanente y durante toda la vida. La DLG no contiene cero gluten, sino que lo disminuye hasta un «punto de corte¼, que en Chile es 3 ppm (o mg/kg de producto). La mortalidad de la EC es mayor que la de la población general, y la falta de adherencia al tratamiento se asocia a complicaciones (procesos autoinmunes y cáncer principalmente). La DLG es difícil de mantener estrictamente, y las transgresiones son por lejos la principal causa de falta de respuesta al tratamiento. El seguimiento también es difícil, porque no existen marcadores objetivables que midan la adherencia. En la práctica clínica se utiliza la medición de auto anticuerpos anti-endomisio, tTG y/o PGD; más recientemente se están evaluando las entrevistas por una nutricionista especializada, cuestionarios validados y la medición de péptidos 33-mer en heces como alternativas o complementos de la evaluación de adherencia. En este artículo se revisan las herramientas de seguimiento actualmente utilizadas, poniendo énfasis en aquellas disponibles en Chile.
Coeliac disease (CD) is a systemic autoimmune disorder triggered by gluten consumption in genetically susceptible individuals. It exhibits several clinical features, such as blood auto-antibodies (anti-endomysial antibodies EMA, anti-transglutaminase antibodies tTG, anti-deamidated gliadin peptides PGD), plus variable degrees of damage in the small intestinal mucosa. In Chile, tTG is positive in 0.76% in individuals >15 years, with the prevalence of CD being estimated at 0.6%. Approximately17% of first-degree relatives of coeliac patients have been reported tTG positive. To date, the gluten free diet (GFD) is the only known treatment for CD. To be effective, this must be lifelong, permanent, and strict. Gluten content in the GFD is not zero, but is limited to a cut-off of 3 ppm (or mg/kg of product) in Chile. Mortality higher than that of the general population has been reported among coeliac patients, and poor adherence to GFD is associated with complications (mainly autoimmune processes and cancer). GFD is difficult to maintain strictly and poor adherence is by far the main cause of lack of response to treatment. Follow-up of adherence is also difficult because there are no objective measurements to assess it. In clinical practice determination of serum EMA, tTG and PGD is routinely used for these purposes, although more recently, the interview by an expert dietitian, validated questionnaires and measurement of faecal 33-mer peptide are being assessed as alternatives or complements to measure adherence to GFD. A review is presented with the current concepts on the available tools to follow up patients on GFD, emphasising those available in Chilel.
Asunto(s)
Humanos , Enfermedad Celíaca/dietoterapia , Cooperación del Paciente , Dieta Sin Gluten , Autoanticuerpos/análisis , Enfermedad Celíaca/inmunología , Chile , Encuestas y Cuestionarios , Glútenes/administración & dosificación , Glútenes/efectos adversosRESUMEN
Coeliac disease (CD) is a systemic autoimmune disorder triggered by gluten consumption in genetically susceptible individuals. It exhibits several clinical features, such as blood auto-antibodies (anti-endomysial antibodies EMA, anti-transglutaminase antibodies tTG, anti-deamidated gliadin peptides PGD), plus variable degrees of damage in the small intestinal mucosa. In Chile, tTG is positive in 0.76% in individuals >15 years, with the prevalence of CD being estimated at 0.6%. Approximately17% of first-degree relatives of coeliac patients have been reported tTG positive. To date, the gluten free diet (GFD) is the only known treatment for CD. To be effective, this must be lifelong, permanent, and strict. Gluten content in the GFD is not zero, but is limited to a cut-off of 3ppm (ormg/kg of product) in Chile. Mortality higher than that of the general population has been reported among coeliac patients, and poor adherence to GFD is associated with complications (mainly autoimmune processes and cancer). GFD is difficult to maintain strictly and poor adherence is by far the main cause of lack of response to treatment. Follow-up of adherence is also difficult because there are no objective measurements to assess it. In clinical practice determination of serum EMA, tTG and PGD is routinely used for these purposes, although more recently, the interview by an expert dietitian, validated questionnaires and measurement of faecal 33-mer peptide are being assessed as alternatives or complements to measure adherence to GFD. A review is presented with the current concepts on the available tools to follow up patients on GFD, emphasising those available in Chilel.
Asunto(s)
Enfermedad Celíaca/dietoterapia , Dieta Sin Gluten , Cooperación del Paciente , Autoanticuerpos/análisis , Enfermedad Celíaca/inmunología , Chile , Glútenes/administración & dosificación , Glútenes/efectos adversos , Humanos , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To assess the evidence regarding the effect of time of gluten introduction and breastfeeding on the risk of developing celiac disease (CD). STUDY DESIGN: We included randomized controlled trials and observational studies evaluating the proper timing for introducing gluten to the infant diet, the appropriate quantity of gluten consumption at weaning, and the effect of breastfeeding on CD risk. Studies were located through the electronic databases Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), EMBASE (Ovid), and System for Information on Grey Literature in Europe (SIGLE). Two independent authors collected the data. RESULTS: A total of 1982 studies were identified, 15 of which were eligible for data extraction. A meta-analysis was performed on 2 randomized controlled trials, 10 cohort studies, and 1 case-control study. There was a 25% increase in CD risk with late (>6 months) vs recommended (4-6 months) gluten introduction (risk ratio [RR], 1.25; 95% CI, 1.08-1.45). There was no significant effect of breastfeeding vs no breastfeeding on CD risk (OR, 0.55; 95% CI, 0.28-1.10), with substantial heterogeneity (I(2) = 92%) among studies. CONCLUSION: There is currently no evidence to support that early introduction of gluten to the infant diet increases the risk of CD; however, late introduction of gluten may be associated with increased risk of CD. More studies are needed that control for potential confounders and that evaluate environmental factors in low-risk families.
Asunto(s)
Lactancia Materna , Enfermedad Celíaca/epidemiología , Conducta Alimentaria , Glútenes/administración & dosificación , Enfermedad Celíaca/etiología , Humanos , Lactante , Estudios Observacionales como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Medición de RiesgoRESUMEN
OBJECTIVES: To investigate the risk of future diabetes mellitus type 1 (T1D) in children who suffered from infection at time of gluten introduction. STUDY DESIGN: Population-based prospective study. Parents filled out a diary at home. We hereby obtained data on date of gluten introduction, breastfeeding duration, and infections in 9414 children born in the southeast of Sweden from October 1, 1997, through October 1, 1999 (the All Babies in Southeast Sweden cohort). The Cox proportional hazards model was used to investigate the risk of future T1D until February 1, 2012, among children with infection at time of gluten introduction. RESULTS: Forty-six children (0.5%) developed T1D and were compared with 9368 reference children from the general population. Some 10 of 46 children with later T1D had an infection at time of gluten introduction (22%) compared with 2520 reference children (27%, P=.43). Later T1D was not associated with age at end of breastfeeding, age at any infection, or age at gluten introduction. Breastfeeding at time of gluten introduction was not protective against future T1D (hazard ratio 1.2; 95% CI, 0.5-2.7). In our final model, when we adjusted for age at gluten introduction, age at infection, and breastfeeding duration, infection at time of gluten introduction did not influence the risk of future T1D (hazard ratio 0.8; 95% CI, 0.3-1.6). CONCLUSION: Infection at time of gluten introduction is not a major risk factor for future T1D in nonselected children.
Asunto(s)
Enfermedades Transmisibles/epidemiología , Diabetes Mellitus Tipo 1/epidemiología , Glútenes/administración & dosificación , Adolescente , Niño , Preescolar , Enfermedades Transmisibles/complicaciones , Diabetes Mellitus Tipo 1/complicaciones , Diabetes Mellitus Tipo 1/etiología , Femenino , Humanos , Lactante , Masculino , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Factores de Riesgo , Encuestas y Cuestionarios , Suecia/epidemiologíaRESUMEN
The objective of this study was to develop and analyze a gluten-free pasta made with green banana flour. The study was divided into five steps: preparation/selection, chemical, sensory, technological, and statistical analysis. The modified sample presented greater acceptance (84.5% for celiac individuals and 61.2% for nonceliac) than standard samples (53.6% for nonceliac individuals). There was no significant difference between the modified and the standard samples in terms of appearance, aroma, flavor, and overall quality. The modified pastas presented approximately 98% less lipids. Green bananas are considered a subproduct of low commercial value with little industrial use. The possibility of developing gluten-free products with green banana flour can expand the product supply for people with celiac disease and contribute to a more diverse diet.
Asunto(s)
Enfermedad Celíaca/dietoterapia , Dieta Sin Gluten , Tecnología de Alimentos , Musa/química , Adulto , Femenino , Harina , Glútenes/administración & dosificación , Glútenes/efectos adversos , Glútenes/análisis , Humanos , Masculino , Valor Nutritivo , Satisfacción del Paciente , Gusto , Adulto JovenRESUMEN
OBJECTIVES: This study compares the effects of feeding growing rats with increasing concentrations of casein (C) and wheat gluten (G), proteins that show different biological qualities, on the morphometrical and biomechanical properties of the femoral diaphysis. MATERIALS AND METHODS: Female rats were fed with one of ten diets containing different concentrations (5-30%) of C and G between the 30th and 90th days of life (Control=C-20%). Biomechanical structural properties of the right femur middiaphysis were estimated using a 3-point bending mechanical test with calculation of some indicators of bone material properties. RESULTS: Body weight and length were affected by treatments, values being highest in rats fed the C-20% diet. G diets affected negatively both parameters. Changes in cross-sectional geometry (mid-diaphyseal cross-sectional and cortical areas, femoral volume, and rectangular moment of inertia) were positively related to the C content of the diet, while they were severely and negatively affected by G diets. Similar behaviors were observed in the bone structural properties (fracture load, yielding load, diaphyseal stiffness and elastic energy absorption). When values of strength and stiffness were normalized for body weight, the differences disappeared. The bone material quality indicators (elastic modulus, yielding stress, elastic energy absorption/volume) did not differ significantly among all studied groups. Femoral calcium concentration in ashes was not significantly different among groups. CONCLUSION: The clear differences in strength and stiffness of bone beams induced by dietary protein concentration and quality seemed to be the result of an induced subnormal gain in bone structural properties as a consequence of a correlative subnormal gain in bone growth and mass, yet not in bone material properties.
Asunto(s)
Caseínas/farmacología , Proteínas en la Dieta/farmacología , Fémur/fisiopatología , Glútenes/farmacología , Trastornos del Crecimiento/etiología , Deficiencia de Proteína/complicaciones , Animales , Fenómenos Biomecánicos , Biometría , Densidad Ósea/efectos de los fármacos , Desarrollo Óseo/efectos de los fármacos , Caseínas/administración & dosificación , Proteínas en la Dieta/administración & dosificación , Relación Dosis-Respuesta a Droga , Módulo de Elasticidad , Femenino , Fémur/química , Fémur/crecimiento & desarrollo , Glútenes/administración & dosificación , Trastornos del Crecimiento/fisiopatología , Ratas , Triticum , Soporte de PesoRESUMEN
Es posible que la Enfermedad Celíaca (EC) en algunos países esté aún subdiagnosticada, y Colombia no es la excepción. Hay diversas formas de presentación. en cualquiera de los casos, es necesario las pruebas de anticuerpos y la toma de biopsia intestinal para su diagnóstico. El diagnóstico de EC, según lo recomendado desde el año 1989 por ESPGHAN, con la toma de unabiopsia intestinal ante la presencia de síntomas, para luego del retiro del gluten esperar reversiónde la sintomatología junto con seronegatividad de los anticuerpos.
Celiac Disease (CD) in some countries is still underdiagnosed, and Colombia is no exception. There are different forms. In either case, it is necessary antibody testing and intestinal biopsy for diagnosis. The diagnosis of CD, is checked as recommended since 1989 by ESPGHAN, with the capture of an intestinal biopsy in the presence of symptoms, then removal of gluten expected reversal of symptoms with seronegative for antibodies.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Biopsia/instrumentación , Biopsia/métodos , Enfermedad Celíaca/clasificación , Enfermedad Celíaca/diagnóstico , Enfermedad Celíaca/epidemiología , Enfermedad Celíaca/patología , Enfermedad Celíaca/prevención & control , Anticuerpos , Glútenes/administración & dosificación , Glútenes/clasificación , Glútenes , GlútenesRESUMEN
Celiac disease is an antibody-mediated enteropathy that presents permanent intolerance to ingested gluten. Currently, only one kind of treatment is available: the complete dietary elimination of all sources of gluten. The aim of the present study was to evaluate the effect of replacing gluten with psyllium on sensory characteristics of bread dough and to compare the chemical, nutritional, technological, and sensory characteristics of the modified preparations. This study is experimental and was subdivided into five steps: selection and development of preparation, chemical analysis, sensory analysis, and statistical analysis. Modified samples of the bread dough achieved a 93.0% acceptance rate for individuals with celiac disease and up to 97.0% for individuals without celiac disease. The most affected characteristics were odor and texture. In terms of chemical composition of the bread dough, energy was reduced by 32.1% and the fat fraction was 42.3% before being cooked. Data obtained from sensory analysis of psyllium doughs indicate that the products had good acceptance by individuals with celiac disease as well as by individuals without celiac disease. This suggests that psyllium can replace gluten in preparations. Furthermore, in terms of chemical composition, products made with modified dough had less fat and fewer calories.
Asunto(s)
Pan , Enfermedad Celíaca/dietoterapia , Dieta Sin Gluten , Tecnología de Alimentos , Psyllium/administración & dosificación , Adolescente , Adulto , Pan/análisis , Niño , Emulsionantes/administración & dosificación , Sustitutos de Grasa/administración & dosificación , Femenino , Preferencias Alimentarias , Glútenes/administración & dosificación , Glútenes/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Valor Nutritivo , Odorantes , Satisfacción del Paciente , Gusto , Adulto JovenRESUMEN
OBJECTIVE: To investigate the prevalence of both calcium metabolism alterations and bone defects in children with celiac disease (CD). STUDY DESIGN: We studied 54 untreated patients with CD (mean age, 7 years). We compared the serum concentration of calcium, magnesium, 25(OH)vitamin D3, alkaline phosphatase, and parathyroid hormone (PTH) of patients with CD with those of 60 healthy children. Children with CD with 2 laboratory alterations underwent DEXA examination, which was evaluated after 6 months of a gluten-free diet (GFD). RESULTS: The calcium and the 25(OH)vitamin D3 levels were lower in children with CD than in control subjects, and the PTH level was higher in children with CD than in control subjects (P < .001). Hyperparathyroidism was found in 29 children with CD. Twenty patients tested positive for 2 laboratory alterations, and 10 of them were osteopenic. After 6 months of GFD calcium, 25(OH)vit.D3 and PTH levels normalized, with the improvement of bone mineral density. CONCLUSIONS: Calcium metabolism defects are common in untreated children with CD, and they returned to normal after GFD. A detailed, time-consuming, and expensive study of bone metabolism is not necessary in children with CD shortly exposed to gluten who follow the GFD.
Asunto(s)
Enfermedades Óseas Metabólicas/epidemiología , Enfermedad Celíaca/epidemiología , Absorciometría de Fotón/economía , Fosfatasa Alcalina/sangre , Biomarcadores/sangre , Enfermedades Óseas Metabólicas/diagnóstico , Enfermedades Óseas Metabólicas/metabolismo , Calcio/sangre , Enfermedad Celíaca/dietoterapia , Enfermedad Celíaca/metabolismo , Niño , Colecalciferol/sangre , Comorbilidad , Costos y Análisis de Costo , Femenino , Glútenes/administración & dosificación , Humanos , Magnesio/sangre , Masculino , Hormona Paratiroidea/sangre , PrevalenciaRESUMEN
OBJECTIVE: To assess the degree of osteopenia in children with celiac disease (CD) at the time of diagnosis and the effect of a gluten-free diet (GFD). DESIGN: Longitudinal and prospective study. SUBJECTS: In total, 24 children (18 girls, six boys) diagnosed with CD by means of an intestinal biopsy were included in the study. Mean+/-s.d. age was 4.9+/-4.3 years. In all, 16 patients were under (2.20+/-0.82 year) and eight were over the age of 4 years (10.30+/-2.90 year). The time between the first symptoms and diagnosis was 17.30+/-24.70 months (range: 2-109 months). Spine bone mineral content (BMC), area and bone mineral density (BMD) were measured by DXA at baseline and 1.17+/-0.93 years after GFD. RESULTS: Before treatment, mean+/-s.d. BMD was 0.46+/-0.13 g/cm(2), the BMD Z-score was -1.36+/-1.20, and was below -1 s.d. in 14 patients (58%). BMC, area and BMD increased significantly on GFD. BMD increased from 0.46+/-0.13 to 0.55+/-0.13 g/cm(2) (P<0.001). BMD Z-score improved from -1.36+/-1.20 to -0.23+/-1.20 after GFD. However, BMD increased more than 1 s.d. in 15 of the 16 children under the age of 4 years, a similar increase was only observed in four of the eight children aged more than 4 years, some of whom did not follow GFD strictly. Height and weight increased significantly with GFD (P<0.001) and the increase correlated positively with the increase in BMD. CONCLUSIONS: Axial BMD below -1 s.d. was found in 58% of children with celiac disease. Axial bone mass reverted to normal values in most children under the age of 4, who had low bone mass, all of whom followed GFD strictly.
Asunto(s)
Densidad Ósea/efectos de los fármacos , Enfermedad Celíaca/dietoterapia , Enfermedad Celíaca/metabolismo , Glútenes/administración & dosificación , Absorciometría de Fotón/métodos , Adolescente , Estatura/fisiología , Peso Corporal/fisiología , Densidad Ósea/fisiología , Enfermedad Celíaca/fisiopatología , Niño , Preescolar , Femenino , Glútenes/efectos adversos , Humanos , Lactante , Estudios Longitudinales , Masculino , Estudios ProspectivosRESUMEN
BACKGROUND: Celiac patients are at high risk of developing insulin-dependent diabetes mellitus, a condition that has a long pre-diabetic period. During this lapse, anti-islet cell antibodies serve as markers for future disease. This may be related with the duration of the exposure to gluten. AIM: To test the hypothesis that long term adherence to a gluten free diet decreases the frequency of risk markers for insulin dependent diabetes mellitus during adolescence and early adulthood. PATIENTS AND METHODS: 158 celiac patients were classified as: G1, (n=30 patients) studied at the time of diagnosis; G2 (n=97 patients) exposed to gluten as a result of non compliance with the gluten free diet and, G3 (n=31 patients) who had maintained a long term, strict gluten free diet. Isotype IgG anti-islet cell antibodies were detected by indirect immunofluorescence using monkey pancreas, results were reported in Juvenile Diabetes Foundation (JDF) units. RESULTS: Celiac patients exposed to a gluten containing diet had a significantly higher prevalence of anti-islet cell antibodies than those who had been exposed only briefly (p < 0.017). In addition, a significantly higher prevalence of anti-islet cell antibodies was observed in those patients whose exposure to gluten was longer than 5 years than in those whose exposure was shorter (p < 0.02). CONCLUSIONS: Celiac patients long exposed to gluten have a significantly higher prevalence of anti-islet cell antibodies than those exposed for a short period. This fact supports the hypothesis that the development of these antibodies is associated with the length of the exposure to gluten.