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Special Issue "Advances in Prevention and Management of Celiac Disease"

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (25 May 2023) | Viewed by 3082

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Dr. Maria Teresa Nestares Pleguezuelo

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Guest Editor

Biomedical Research Centre (CIBM), Institute of Nutrition and Food Technology “José MataixVerdú” (INYTA), Dept Physiology, University of Granada, Granada, Spain
Interests: nutrition; celiac disease; anemia; gluten free diet
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Dr. Rafael Martín-Masot

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Guest Editor

Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Malaga, 29010 Málaga, Spain
Interests: gastroenterology; pediatrics; nutrition; celiac disease; inflammatory bowel disease

Special Issue Information

Dear Colleagues,

Celiac disease (CD) is an autoimmune condition characterized by a heterogeneous clinical presentation, affecting any organ or tissue with gastrointestinal and extraintestinal manifestations. CD remains a challenging condition because of a steady increase in its prevalence and comorbidities and the recognition that diagnosis is suboptimal.

We have witnessed an epidemic of CD, questioning the previous paradigm that gluten is the only key element dictating the onset of the CD. A genetic background is a mandatory determinant of the development of the CD, but it is modulated by a diverse range of environmental factors. These include quantity and type of gluten consumption, gut microbiota, diet and lifestyle, exposure to pathogens, loss of intestinal barrier function, inappropriate adaptive immune response, among others. It is of pivotal importance to improve the understanding of factors involving pathophysiology, diagnosis, management, and possible therapeutic options.

In this Special Issue, we would like to introduce readers to the state of the art in the field by presenting papers covering different aspects of environmental factors to identify possible targets for the prevention and management of CD. Both original research articles and reviews spanning clinical and preclinical work are welcome.

Dr. Maria Teresa Nestares Pleguezuelo
Dr. Rafael Martín-Masot
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

celiac disease
genetics
gluten-free diet
gluten
dietary habits
food
microbiome
physical activity
autoimmune disease
epigenome
environmental factors
lifestyle

Published Papers (4 papers)

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Research

Open AccessArticle

Nutritional Composition of Breakfast in Children and Adolescents with and without Celiac Disease in Spain—Role of Gluten-Free Commercial Products

Natalia Úbeda

María Purificación González

María Achón

Ángela García-González

Catalina Ballestero-Fernández

Violeta Fajardo

and

Elena Alonso-Aperte

Nutrients 2023, 15(10), 2368; https://doi.org/10.3390/nu15102368 - 18 May 2023

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Abstract

Eating a nutritionally balanced breakfast can be a challenge when following a gluten-free diet (GFD). We assessed the ingredients and nutrient composition of 364 gluten-free breakfast products (GFPs) and 348 gluten-containing counterparts (GCCs), and we analysed the nutritional quality of breakfast in a group of Spanish children and adolescents with celiac disease (CD) (n = 70), as compared to controls (n = 67). Food intakes were estimated using three 24 h dietary records. The composition of GFPs and GCCs was retrieved from the package labels of commercially available products. Most participants (98.5%) ate breakfast daily, and only one person in each group skipped breakfast once. The breakfast contribution of the total daily energy was 19% in participants with CD and 20% in controls. CD patients managed a balanced breakfast in terms of energy (54% from carbohydrates; 12% from proteins; 34% from lipids) and key food groups (cereals, dairy, fruits), but their intake of fruits needs improvement. Compared to controls, breakfast in the CD group provided less protein and saturated fat, a similar amount of carbohydrates and fibre, and more salt. Fibre is frequently added to GFPs, but these contain less protein because of the flours used in formulation. Gluten-free bread contains more fat and is more saturated than is GCC. Sugars, sweets, and confectionery contribute more to energy and nutrient intakes in participants with CD, while grain products do so in controls. Overall, breakfast on a GFD can be adequate, but can be improved by GFPs reformulation and a lower consumption of processed foods. Full article

(This article belongs to the Special Issue Advances in Prevention and Management of Celiac Disease)

Open AccessArticle

The Importance of an Early Evaluation after Establishing a Gluten-Free Diet in Children with Celiac Disease

Víctor Manuel Navas-López

and

Teresa Nestares

Nutrients 2023, 15(7), 1761; https://doi.org/10.3390/nu15071761 - 04 Apr 2023

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Abstract

A gluten-free diet (GFD) is the only treatment available for celiac disease (CD); hence, it is important to ensure correct adherence to the diet and adequate monitoring of the diet. The present study aims to assess the importance of an early follow-up of celiac patients after diagnosis of the disease, identify the role of stool gluten immunogenic peptides (GIPs) in the assessment of GFD adherence, and analyze possible nutritional imbalances or deficiencies in the GFD. This is a cross-sectional study carried out in pediatric patients with newly diagnosed CD in a tertiary hospital in Spain. Of the 61 patients included, 14% had positive stool GIPS at 4 months after CD diagnosis, Among them, 88% had negative stool GIPS at 9 months after diagnosis, following dietary advice. We found nutritional deficiencies in the GFD, such as vitamin D (with only 27% of patients with adequate intakes), folate, calcium, magnesium, and fiber. Similarly, we found imbalances: excess protein and fat intakes and a high percentage of total daily energy intake came from ultra-processed foods (UPF). These findings emphasize the importance of early follow-up of children after diagnosis of CD. It is also crucial to identify patients with poor GFD compliance based on stool GIPS and analyze GFD nutritional imbalances and deficits. Our findings may contribute to the development of specific strategies for the early follow-up of patients with CD, including appropriate nutritional counselling. Full article

(This article belongs to the Special Issue Advances in Prevention and Management of Celiac Disease)

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Open AccessArticle

Evaluation of the Usefulness of an Automatable Immunoassay for Monitoring Celiac Disease by Quantification of Immunogenic Gluten Peptides in Urine

Verónica Segura

Ángela Ruiz-Carnicer

Irati Mendía

Marta Garzón-Benavides

Ángeles E. Pizarro

Isabel Comino

and

Carolina Sousa

Nutrients 2023, 15(7), 1730; https://doi.org/10.3390/nu15071730 - 31 Mar 2023

Viewed by 560

Abstract

A gluten-free diet (GFD) is currently the only treatment available for patients with celiac disease (CD). However, adherence to a GFD can be challenging because gluten is present in many foods. A lifelong follow-up of patients with CD must be performed to promote adherence to a GFD and to identify the appearance of symptoms and the associated diseases. Therefore, the development of tools to analyze gluten exposure in these patients is important. This study proposes the development of the first automatable ELISA to monitor adherence to a GFD through the quantification of urine gluten immunogenic peptides (u-GIP). Seven healthy volunteers without suspicion of CD and 23 patients with CD were monitored as part of this study to optimize, validate, and apply this assay. Non-interference was found in the urine matrix, and the recovery percentage for spiked samples was 81–101%. The u-GIP was stable for up to 16 days when the samples were stored at different temperatures. Overall, 100% of the patients had detectable u-GIP at diagnosis (range of 0.39–2.14 ng GIP/mL), which reduced to 27% after 12 months on a GFD. Therefore, this highly sensitive immunoassay would allow the analysis of u-GIP from a large battery of samples in clinical laboratories of specialized healthcare centers. Full article

(This article belongs to the Special Issue Advances in Prevention and Management of Celiac Disease)

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Open AccessArticle

Coeliac Disease Case–Control Study: Has the Time Come to Explore beyond Patients at Risk?

Gemma Castillejo

Carlos Ochoa-Sangrador

David Pérez-Solís

Maria Luz Cilleruelo

Ester Donat

Jose Ignacio García-Burriel

Félix Sánchez-Valverde

Salvador Garcia-Calatayud

Francisco Javier Eizaguirre

and

Nutrients 2023, 15(5), 1267; https://doi.org/10.3390/nu15051267 - 03 Mar 2023

Viewed by 769

Abstract

The worldwide prevalence of asymptomatic coeliac disease (CD) is increasing, which is in part due to the routine screening of children with risk factors. Both symptomatic and asymptomatic patients with CD are at risk of long-term complications. The objective of this study was to compare the clinical characteristics of asymptomatic and symptomatic children at the time of CD diagnosis. A case–control study was conducted using data from a cohort of 4838 CD patients recruited from 73 centers across Spain between 2011 and 2017. A total of 468 asymptomatic patients (cases) were selected and matched by age and sex with 468 symptomatic patients (controls). Clinical data, including any reported symptoms, as well as serologic, genetic, and histopathologic data were collected. No significant differences were found between the two groups in most clinical variables, nor in the degree of intestinal lesion. However, the asymptomatic patients were taller (height z-score −0.12 (1.06) vs. −0.45 (1.19), p < 0.001) and were less likely to have anti transglutaminase IgA antibodies ≥ 10 times the upper normal limit (66.2% vs. 758.4%, p = 0.002). Among the 37.1% of asymptomatic patients who were not screened for CD due to the absence of risk factors, only 34% were truly asymptomatic, while the remaining 66% reported non-specific CD-related symptoms. Therefore, expanding CD screening to any child who undergoes a blood test could reduce the burden of care for some children, as many of those considered asymptomatic reported non-specific CD-related symptoms. Full article

(This article belongs to the Special Issue Advances in Prevention and Management of Celiac Disease)

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