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Meta-Analysis
. 2021 Aug 25;13(9):2947.
doi: 10.3390/nu13092947.

It Is High Time for Personalized Dietary Counseling in Celiac Disease: A Systematic Review and Meta-Analysis on Body Composition

Zsófia Vereczkei  1   2 , Nelli Farkas  1   3 , Péter Hegyi  4   5   6 , Marcell Imrei  1 , Mária Földi  1   7 , Zsolt Szakács  1   8 , Szabolcs Kiss  1   7 , Margit Solymár  1 , Rita Nagy  1   9 , Judit Bajor  8
Affiliations
Meta-Analysis

It Is High Time for Personalized Dietary Counseling in Celiac Disease: A Systematic Review and Meta-Analysis on Body Composition

Zsófia Vereczkei et al. Nutrients. .

Abstract

The body composition of patients with celiac disease (CD), on which the effects of a gluten-free diet (GFD) are controversial, differs from that of the average population. In this study, we aimed to compare the body composition across CD patients before a GFD, CD patients after a one-year GFD and non-celiac control subjects. A systematic search was conducted using five electronic databases up to 15 July 2021 for studies that reported at least one of the pre-specified outcomes. In meta-analyses, weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated. A total of 25 studies were eligible for systematic review, seven of which were included in meta-analysis. During a ≥1-year GFD, fat mass of CD patients, compared to that at baseline, significantly increased (WMD = 4.1 kg, 95% CI = 1.5 to 6.6, three studies). In CD patients after a ≥1-year GFD, compared to non-celiac controls, fat mass (WMD = -5.8 kg, 95% CI = -8.7 to -2.9, three studies) and fat-free mass (WMD = -1.9 kg, 95% CI = -3.0 to -0.7, three studies) were significantly lower. In conclusion, body composition-related parameters of CD patients differ from that of the non-celiac control subjects even after a longstanding GFD.

Keywords: body composition; celiac disease; gluten-free diet.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
PRISMA flow chart describing the process of the study search and selection.
Figure 2
Figure 2
Forest plot of studies comparing fat mass of celiac disease patients after at least a one-year gluten-free diet to that of the same patients at diagnosis (a positive number indicates a gain in fat mass following a gluten-free diet). N: Number of patients.
Figure 3
Figure 3
Forest plot of studies comparing fat mass of celiac disease patients on a gluten-free diet for at least one year to that of non-celiac control subjects (a negative number indicates a lower fat mass of the celiac population compared to controls). N: Number of patients.
Figure 4
Figure 4
Forest plot of studies comparing fat-free mass of celiac disease patients on a gluten-free diet for at least one year to that of non-celiac control subjects (a negative number indicates a lower fat-free mass of the celiac population compared to controls). N: Number of patients.
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