RESUMO
OBJECTIVE: To identify the prevalence of anxiety and depression and its association with psychoaffective, family-related, and daily-life variables of celiac individuals. METHODS: Crosssectional study, developed with 83 celiac patients in Fortaleza. An instrument was applied with variables grouped in the categories: psychoaffective, family-related, and daily-life. RESULTS: It was found that 52 celiac patients (62.7%) had anxiety and 29 (34.9%) had depression. The clinical conditions found and the number of symptoms increased the chance of anxiety/depression. The predominant factors in those with anxiety were Lack of control of the celiac disease (98.1%), Perceived clinical condition (75.0%), Daily obstacles for maintaining a gluten-free diet (63.4%), and Daily activities (55.8%). In those with depression, there was a higher prevalence of Lack of control of the celiac disease (100.0%), Perceived clinical condition (82.2%), and Daily obstacles for maintaining a gluten-free diet (69.0%). CONCLUSION: Celiac individuals with anxiety and depression frameworks presented a higher frequency of Perceived clinical condition, Insufficient social support (psychoaffective factors) and Daily obstacles for maintaining a gluten-free diet (daily-life factor).
Assuntos
Ansiedade/etiologia , Doença Celíaca/psicologia , Depressão/etiologia , Dieta Livre de Glúten/efeitos adversos , Dieta Livre de Glúten/psicologia , Psicotrópicos/uso terapêutico , Adulto , Ansiedade/epidemiologia , Doença Celíaca/dietoterapia , Doença Crônica , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Qualidade de VidaRESUMO
INTRODUCTION AND OBJECTIVES: It is essential for patients with celiac disease (CD) to be on a gluten-free diet (GFD) but said diet has also been reported to increase the risk for metabolic syndrome. There is no evidence on the metabolic effects of a GFD in patients with nonceliac gluten sensitivity (NCGS) or in asymptomatic subjects. Therefore, the aim of the present study was to evaluate the metabolic effects of a GFD over a 6-month period in patients with CD, patients with NCGS, and in asymptomatic controls (ACs). MATERIALS AND METHODS: A prospective study was conducted that evaluated metabolic syndrome and its components of obesity, high blood pressure, hepatic steatosis, and hyperglycemia at the baseline and at 6 months. RESULTS: A total of 66 subjects (22 CD, 22 NCGS, and 22 AC) were included in the study. At the baseline, 10% of the patients with CD presented with obesity, high blood pressure, hepatic steatosis, and metabolic syndrome. After 6 months, obesity and metabolic syndrome increased by 20% (p=0.125). In the patients with NCGS, obesity increased by 5% after the GFD and 20% of those patients presented with de novo hepatic steatosis. The prevalence of obesity decreased by 10% in the controls after the GFD (30 vs 20%, p=0.5) and none of the other components of metabolic syndrome were affected. CONCLUSIONS: The metabolic benefits and risks of a GFD should be considered when prescribing said diet in the different populations that opt for that type of intervention.
Assuntos
Doença Celíaca/dietoterapia , Dieta Livre de Glúten/efeitos adversos , Hipersensibilidade Alimentar/dietoterapia , Glutens/efeitos adversos , Síndrome Metabólica/etiologia , Adulto , Estudos de Casos e Controles , Doença Celíaca/complicações , Doença Celíaca/metabolismo , Feminino , Hipersensibilidade Alimentar/complicações , Hipersensibilidade Alimentar/metabolismo , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
A strong association between celiac disease (CD) and dental enamel defects (DEDs) have been extensively reported, however, the nature of this relationship is still unclear. The aim of this study was to evaluate DEDs phenotype in CD individuals according to the time they were introduced to a gluten-free diet (GFD). Forty-five CD individuals were examined by a pediatric dentist. DEDs were classified according to the type of affected teeth. CD individuals were classified into two groups (with or without DEDs) and the differences between these groups were tested using chi-square or Fisher´s exact tests and t-test to compare differences between means. The Pearson coefficient test was used to evaluate the degree of the correlation between the age of GFD introduction and number of affected teeth. Individuals with MIH were introduced earlier to the GFD (p = 0.038). An association was also observed for molar DED (p = 0.013). In conclusion, our study suggested an association between a specific type of DED and the time that CD individuals were introduced to a GFD.
Assuntos
Doença Celíaca/dietoterapia , Hipoplasia do Esmalte Dentário/etiologia , Esmalte Dentário/patologia , Dieta Livre de Glúten/efeitos adversos , Adolescente , Brasil , Criança , Feminino , Humanos , Masculino , FenótipoRESUMO
Different dietary approaches have been attempted for the treatment of attention-deficit/hyperactivity disorder and autism, but only three of them have been subjected to clinical trials: education in healthy nutritional habits, supplementation and elimination diets. On the other hand, for multiple reasons, the number of people who adopt vegetarian and gluten-free diets (GFD) increases daily. More recently, a new entity, non-celiac gluten sensitivity (NCGS), with a still evolving definition and clinical spectrum, has been described. Although, the benefits of GFD are clearly supported in this condition as well as in celiac disease, in the last two decades, GFD has expanded to a wider population. In this review, we will attempt to clarify, according to the existing evidence, which are the myths and facts of these diets.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/dietoterapia , Transtorno Autístico/dietoterapia , Fenômenos Fisiológicos da Nutrição Infantil , Dieta Livre de Glúten , Dieta com Restrição de Proteínas , Dieta Vegetariana , Intolerância Alimentar/dietoterapia , Caseínas/efeitos adversos , Criança , Desenvolvimento Infantil , Dieta Livre de Glúten/efeitos adversos , Dieta com Restrição de Proteínas/efeitos adversos , Dieta Vegetariana/efeitos adversos , Hipersensibilidade Alimentar/dietoterapia , Humanos , NeurogêneseRESUMO
The present study investigated the perceptions of individuals with celiac disease about gluten-free (GF) products, their consumer behavior and which product is the most desired. A survey was used to collect information. Descriptive analysis, χ² tests and Multiple Logistic Regressions were conducted. Ninety-one questionnaires were analyzed. Limited variety and availability, the high price of products and the social restrictions imposed by the diet were the factors that caused the most dissatisfaction and difficulty. A total of 71% of the participants confirmed having moderate to high difficulty finding GF products. The logistic regression identified a significant relationship between dissatisfaction, texture and variety (p < 0.05) and between variety and difficulty of finding GF products (p < 0.05). The sensory characteristics were the most important variables considered for actual purchases. Bread was the most desired product. The participants were dissatisfaction with GF products. The desire for bread with better sensory characteristics reinforces the challenge to develop higher quality baking products.
Assuntos
Doença Celíaca/dietoterapia , Comportamento do Consumidor , Dieta Livre de Glúten/efeitos adversos , Qualidade dos Alimentos , Alimentos Especializados/efeitos adversos , Cooperação do Paciente , Adolescente , Adulto , Brasil , Pão/efeitos adversos , Pão/análise , Pão/economia , Doença Celíaca/economia , Fenômenos Químicos , Comportamento do Consumidor/economia , Dieta Livre de Glúten/economia , Feminino , Contaminação de Alimentos , Rotulagem de Alimentos , Preferências Alimentares , Abastecimento de Alimentos/economia , Alimentos Especializados/análise , Alimentos Especializados/economia , Fidelidade a Diretrizes , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Sensação , Adulto JovemRESUMO
AIM: To evaluate the effectiveness of a rapid and easy fingertip whole blood point-of-care test for celiac disease (CD) case finding and diet monitoring. METHODS: Three hundred individuals, 206 females (68.7%) and 94 males (31.3%), were submitted to a rapid and easy immunoglobulin-A-class fingertip whole blood point-of-care test in the doctor's office in order to make immediate clinical decisions: 13 healthy controls, 6 with CD suspicion, 46 treated celiacs, 84 relatives of the celiac patients, 69 patients with dyspepsia, 64 with irritable bowel syndrome (IBS), 8 with Crohn's disease and 9 with other causes of diarrhea. RESULTS: Upper gastrointestinal endoscopy with duodenal biopsies was performed in patients with CD suspicion and in individuals with positive test outcome: in 83.3% (5/6) of the patients with CD suspicion, in 100% of the patients that admitted gluten-free diet transgressions (6/6), in 3.8% of first-degree relatives (3/79) and in 2.9% of patients with dyspepsia (2/69). In all these individuals duodenal biopsies confirmed CD (Marsh's histological classification). The studied test showed good correlation with serologic antibodies, endoscopic and histological findings. CONCLUSION: The point-of-care test was as reliable as conventional serological tests in detecting CD cases and in CD diet monitoring.
Assuntos
Anticorpos/sangue , Doença Celíaca/diagnóstico , Dieta Livre de Glúten/efeitos adversos , Transglutaminases/sangue , Brasil , Estudos de Casos e Controles , Doença Celíaca/dietoterapia , Doença Celíaca/imunologia , Ensaio de Imunoadsorção Enzimática , Família , Feminino , Humanos , Imunoglobulina A/sangue , Masculino , Pessoa de Meia-Idade , Sistemas Automatizados de Assistência Junto ao Leito/normas , Kit de Reagentes para Diagnóstico , Transglutaminases/imunologia , Adulto JovemRESUMO
Context and objective: Low bone mineral density may be a finding among children and adolescents with celiac disease, including those undergoing treatment with a gluten-free diet, but the data are contradictory. The aim of this study was to determine the frequency of bone mineral density abnormalities in patients on a gluten-free diet, considering age at diagnosis and duration of dietary treatment. Design and setting: Cross-sectional prevalence study at the Pediatric Gastroenterology Outpatient Clinic of Instituto Materno Infantil Professor Fernando Figueira. Methods: Thirty-one patients over five years of age with celiac disease and on a gluten-free diet were enrolled. Bone mineral density (in g/cm²) was measured in the lumbar spine and whole body using bone densitometry and categorized using the criteria of the International Society for Clinical Densitometry, i.e. low bone mineral density for chronological age < -2.0 Z-scores. Age at diagnosis and duration of dietary treatment were confirmed according to the date of starting the gluten-free diet. Results: Low bone density for chronological age was present in 3/31 patients in the lumbar spine and 1/31 in the whole body (also with lumbar spine abnormality). At diagnosis, three patients with low bone mineral density for the chronological age were more than 7.6 years old. These patients had been on a gluten-free diet for six and seven months and 3.4 years. Conclusion: Pediatric patients with celiac disease on long-term treatment are at risk of low bone mineral density. Early diagnosis and long periods of gluten-free diet are directly implicated in bone density normalization.
Contexto e objetivo: Baixa densidade mineral óssea pode ser encontrada em crianças e adolescentes com doença celíaca, incluindo aqueles em tratamento com dieta sem glúten, mas dados são contraditórios. O objetivo deste estudo foi determinar a frequência de alteração da densidade mineral óssea nos pacientes em dieta sem glúten, conforme a idade ao diagnóstico e o tempo de tratamento dietético. Tipo de estudo e local: Foi realizado estudo transversal de prevalência no Ambulatório de Gastroenterologia Pediátrica do Instituto Materno Infantil Professor Fernando Figueira (IMIP). Métodos: Trinta e um pacientes maiores de cinco anos com doença celíaca que estavam em dieta sem gluten foram avaliados. A densidade mineral óssea (em g/cm²) foi medida na coluna lombar e no corpo inteiro utilizando densitometria óssea, categorizando-a pelo critério da Sociedade Internacional para Densitometria Clínica (baixa densidade mineral óssea para a idade cronológica < -2.0 escores Z). A idade ao diagnóstico e o tempo de tratamento foram confirmados pela data de início da dieta sem glúten. Resultados: Baixa densidade mineral óssea para a idade cronológica foi detectada em 3/31 pacientes na coluna lombar e 1/31 no corpo inteiro (também apresentava alteração da coluna lombar). Ao diagnóstico, três pacientes com baixa densidade mineral óssea para a idade cronológica estavam com mais de 7,6 anos. Esses pacientes estavam em dieta sem glúten por seis e sete meses e 3,4 anos. Conclusão: Pacientes pediátricos com doença celíaca em tratamento a longo prazo são de risco para baixa densidade mineral óssea. Diagnóstico precoce e longo período de dieta sem glúten são diretamente implicados na normalização da densidade óssea.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Doenças Ósseas Metabólicas/epidemiologia , Doença Celíaca/dietoterapia , Dieta Livre de Glúten/efeitos adversos , Densidade Óssea/fisiologia , Doenças Ósseas Metabólicas/etiologia , Doença Celíaca/fisiopatologia , Estudos Transversais , Prevalência , Fatores de Risco , Fatores de TempoRESUMO
CONTEXT AND OBJECTIVE: Low bone mineral density may be a finding among children and adolescents with celiac disease, including those undergoing treatment with a gluten-free diet, but the data are contradictory. The aim of this study was to determine the frequency of bone mineral density abnormalities in patients on a gluten-free diet, considering age at diagnosis and duration of dietary treatment. DESIGN AND SETTING: Cross-sectional prevalence study at the Pediatric Gastroenterology Outpatient Clinic of Instituto Materno Infantil Professor Fernando Figueira. METHODS: Thirty-one patients over five years of age with celiac disease and on a gluten-free diet were enrolled. Bone mineral density (in g/cm(2)) was measured in the lumbar spine and whole body using bone densitometry and categorized using the criteria of the International Society for Clinical Densitometry, i.e. low bone mineral density for chronological age < -2.0 Z-scores. Age at diagnosis and duration of dietary treatment were confirmed according to the date of starting the gluten-free diet. RESULTS: Low bone density for chronological age was present in 3/31 patients in the lumbar spine and 1/31 in the whole body (also with lumbar spine abnormality). At diagnosis, three patients with low bone mineral density for the chronological age were more than 7.6 years old. These patients had been on a gluten-free diet for six and seven months and 3.4 years. CONCLUSION: Pediatric patients with celiac disease on long-term treatment are at risk of low bone mineral density. Early diagnosis and long periods of gluten-free diet are directly implicated in bone density normalization.