In some patients with celiac disease, institution of a gluten-free diet may be detrimental without good dietary counseling as a highly-processed diet can increase the risk of adverse cardiovascular events.

A recent study (J Runde et al. JPGN 2020; 71: 533-535. A Narrow Window: Booming Gluten-free Market and Fostering Healthy Dietary Habits in Children With Celiac Disease) assessed dietary patterns of children with celiac disease and indicates that early counseling is crucial.

In total dietary surveys were completed for 100 children with celiac disease. Key findings:

• 77% consumed processed gluten-free (GF) foods multiple times per day
• 20% ate exclusively processed GF foods
• The main reasons for processed GF foods were convenience and taste
• Patients and families interest in dietary counseling diminished with time. In children <1 year from diagnosis, 35% were interested in dietary feedback, compared to 18% 2-3 years after diagnosis, 15% 4-6 years after diagnosis, and 11% at 7+ years from diagnosis

The authors speculate that highly-processed foods are leading to obesity which is increasingly reported in pediatric celiac disease.

My take:

• The greatest opportunity for dietary counseling is at the time of the diagnosis.
• Children with celiac disease commonly consume an unhealthy diet and are at risk for the same types of outcomes as children without celiac disease who also frequently consume an unhealthy diet

Related blog posts:

• “Is There a Downside to Going Gluten-Free If You’re Healthy? Yes”
• Gluten-free Diet –No Evidence It is Helpful for Healthy Individuals
• Is a Gluten-Free Diet a Healthy Diet for Those Without Celiac Disease?
• An Unexpected Twist for “Gluten Sensitivity” | gutsandgrowth
• The Science Behind IBS Dietary Interventions | gutsandgrowth
• Gluten sensitivity without celiac disease | gutsandgrowth
• Food choices, FODMAPs, and gluten haters | gutsandgrowth