Diet patterns in an ethnically diverse pediatric population with celiac disease and chronic gastrointestinal complaints. (April 2019)

• Record Type: Journal Article
• Authors: Mager, Diana R.; Liu, Amanda; Marcon, Margaret; Harms, Kristin; Brill, Herbert; Mileski, Heather; Dowhaniuk, Jenna; Nasser, Roseann; Carroll, Matthew W.; Persad, Rabin; Turner, Justine M.
• Is Part Of: Clinical nutrition ESPEN. Volume 30(2019)
• Page Start: 73
• Page End: 80
• Publication Date: 2019-04
• Subjects: Diet patterns -- Ethnically diverse -- Children and youth -- Celiac disease -- Chronic gastrointestinal complaints; Nutritionally induced diseases -- Periodicals; Metabolism -- Disorders -- Periodicals; 616.39005
• DOI: 10.1016/j.clnesp.2019.02.004
• Languages: English
• ISSNs: 2405-4577

Abstract

Summary: Introduction: Celiac disease (CD) is an autoimmune disease requiring lifelong adherence to the gluten-free diet (GFD). The GFD has significant nutritional limitations which may result in poor diet quality (DQ). We hypothesized that biopsy-proven children with CD (CCD) would have dietary patterns characterized by high saturated fat/simple sugar intake with a low micronutrient density contributing to lower DQ when compared to children with mild-gastrointestinal complaints (GI-CON). In addition, we hypothesized that ethnicity may further impact DQ. Methods: Socio-demographic (age, CD duration, parent/child ethnicity, education), household characteristics, anthropometric, dietary intake (24-h recalls), gastrointestinal pain and adherence was collected in CCD (n = 243) and GI-CON (n = 148). Dietary patterns were determined using k-mean Cluster Analysis. Results: GI-CON had significantly lower DQ than CCD (p < 0.001). Most CCD and GI-CON (>80%) had dietary patterns characterized by1) Western Diet (Cluster 1: %BMR: 110–150, low DQ, high fat, moderate CHO, high sodium) and 2) High Fat-Western Diet (Cluster 2: %BMR:130–150, low DQ, high Fat, high processed meats, high fat dairy products, CHO. Fewer children (<20%) had Prudent, Lower Fat/High Carbohydrate dietary patterns (% BMR:100–150, higher DQ, lower fat/sodium, higher CHO) with a greater proportion of non-Caucasian CCD consuming a Prudent dietary pattern. Seventy-seven percent and 37.5% of CCD and GI-CON, respectively, did not meet estimated average requirements for folate (p < 0.001). Conclusions: CCD and GI-CON have predominantly Western dietary patterns with low DQ, particularly GI-CON. Non-caucasian CCD consume more prudent dietary patterns with higher DQ. Nutrition education is warranted to ensure optimal DQ in children with chronic gastrointestinal diseases.