Importance of an Ongoing Nutritional Counselling Intervention on Eating Habits of Newly Diagnosed Children with Celiac Disease

Abstract

A strict lifelong gluten-free diet (GFD) is the current treatment for the management of celiac disease (CD). Several studies have demonstrated that without proper dietary assessment, this diet leads to nutritional deficiencies and/or imbalances. The present study aimed to improve the dietary habits of newly diagnosed children with CD through ongoing and face-to-face dietary counseling. Forty-three participants were followed during the first year after CD diagnosis. Dietary data were collected at diagnosis (Vt0), after 3 months on a GFD (Vt3), and after 1 year following a GFD (Vt12). Participants completed a 3-day 24-h food recall, a food frequency questionnaire, and the KIDMED index. After each data collection, participants received dietary assessment and nutritional education. Participants consumed more plant-origin foods after the intervention, with most of them reaching the daily recommendations. Fresh food intake increased and that of ultra-processed foods decreased. Compliance with the Mediterranean diet also improved. Personalized dietary assessment and ongoing follow-up improved the dietary patterns of children recently diagnosed with CD, highlighting the importance of dietitian involvement in the management of CD.

Keywords: celiac disease; dietary adherence; follow-up; gluten-free diet; intervention; nutrition education; nutritional balance.

Figure 1

Percentage of children and adolescents with CD who accomplished more than 2/3 of the dietary reference intake of specified vitamins (a) and minerals (b). Vt0 = visit at diagnosis; Vt3 = visit after 3 months on a GFD; Vt12 = visit after 12 months on a GFD; p < 0.05 = Statistically significant. * above Vt3 column indicates a significant difference between Vt0 and Vt3; * above Vt12 column indicates a significant difference between Vt0 and Vt12. Percentage of children with CD and adolescents who reached or did not accomplish 2/3 of the dietary reference intakes of vitamins and minerals (suggested by the Federation of Spanish Societies of Nutrition and Dietetics (FESNAD) [37].