Influence of nutrition education in paediatric coeliac disease: impact of the role of the registered dietitian: a prospective, single-arm intervention study

J Hum Nutr Diet. 2020 Dec;33(6):775-785. doi: 10.1111/jhn.12800. Epub 2020 Aug 12.

Abstract

Background: The diagnosis of coeliac disease (CD) involves a change in the diet of the individual, which may influence their quality of life and nutritional status. The present study aimed to determine whether nutrition education by a registered dietitian is able to improve eating habits and body composition in children with CD.

Methods: Dietary, physical activity and body composition changes were analysed, comparing baseline assessments with those 1 year after receiving education on healthy eating. At both time points, a 3-day dietary survey, a food frequency consumption questionnaire, an adherence to the Mediterranean diet test (Kidmed), duration of activity and an electrical bioimpedance study were conducted. Student's paired t-test and the McNemar test were also employed.

Results: Seventy-two subjects (42 girls) with an mean (range) age of 10 (2-16) years were included. Before the intervention, an unbalanced diet was observed, rich in protein and fat, and deficient in complex carbohydrates. Only 14% consumed an adequate Mediterranean diet. After nutrition intervention, a significant increase in the consumption of plant-based foods and a concomitant decrease in meat, dairy and processed food intake (P < 0.001) were observed. Moreover, 92% of the patients (P < 0.001) managed to consume an adequate Mediterranean diet. Similarly, an increase was observed in the duration of physical activity undertaken [mean (SD) 1.02 (1.79) h, P < 0.001] and improvements in body composition were recorded, with a 17% decrease in fat mass percentage (P < 0.001).

Conclusions: Nutrition intervention focused on healthy eating is effective with respect to improving the nutritional status and diet quality in CD patients.

Keywords: coeliac disease; gluten-free diet; healthy eating; nutrition education; nutritional status.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Celiac Disease / diet therapy*
  • Celiac Disease / psychology
  • Child
  • Child, Preschool
  • Counseling / methods*
  • Diet, Gluten-Free / methods
  • Diet, Gluten-Free / psychology
  • Diet, Healthy / methods*
  • Diet, Healthy / psychology
  • Diet, Mediterranean / psychology*
  • Exercise / psychology
  • Feeding Behavior / psychology
  • Female
  • Humans
  • Infant
  • Male
  • Nutrition Assessment
  • Nutritional Status
  • Nutritionists / psychology
  • Nutritive Value
  • Patient Compliance
  • Patient Education as Topic / methods*
  • Professional Role
  • Prospective Studies
  • Quality of Life
  • Treatment Outcome