LONGITUDINAL-STUDY ON THE EFFECT OF TREATMENT ON BODY-COMPOSITION ANDANTHROPOMETRY OF CELIAC-DISEASE PATIENTS

Objectives: This prospective study was designed to assess the nutritio nal changes associated with the longterm treatment of celiac disease. In addition, we analyzed whether these changes were related to the deg ree of compliance with a gluten-free diet. Methods: We studied nutriti onal parameters and body composition in 25 newly diagnosed celiac pati ents after a mean period of 37 months (range 25-49 months) on a gluten -free diet. Body composition parameters (fat, lean tissue, and bone ma sses) were measured by dual energy x-ray absorptiometry. Anthropometry was measured according to conventional formulas. Results: At diagnosi s, fat (-49%), lean tissue (-12%), and bone (-24%) compartments were r educed, compared with that of sex- and age-matched controls. After tre atment, we noted a significant increase in body weight (p < 0.0001), f at mass (p < 0.0005), bone mass (p < 0.002), and body mass index (p < 0.005). In contrast, we did not observe a significant increase in lean -tissue mass or muscle mass. Patients who adhered strictly to a gluten -free diet experienced a greater, though nonsignificant improvement in fat mass, body weight, and body mass index than patients whose compli ance had been partial. Mean caloric intake at the end of the study was significantly lower among those patients who had adhered strictly to a gluten-free diet, compared with those who had complied only partiall y with the diet (p < 0.05). Conclusions: This study shows that the ins titution of a gluten-free diet in celiac disease patients results in a significant improvement in nutritional parameters, as measured by ant hropometry and/or body composition. This effect was more pronounced in patients who followed strict gluten restriction and was related mainl y to changes in fat and bone compartments.