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Risk of obesity during a gluten-free diet in pediatric and adult patients with celiac disease: a systematic review with meta-analysis.
- Source :
-
Nutrition reviews [Nutr Rev] 2023 Feb 10; Vol. 81 (3), pp. 252-266. - Publication Year :
- 2023
-
Abstract
- Context: Obesity is a significant risk factor for many pathological conditions. Whether a gluten-free diet (GFD) is a risk factor for overweight or obesity remains controversial.<br />Objective: The primary aim of this study was to assess the prevalence of body mass index (BMI) categories at disease presentation and the variation in BMI category from underweight/normal to overweight/obese and vice versa during a GFD.<br />Data Sources: PubMed, Scopus, and Web of Science databases were searched through February 2021 for retrospective, cross-sectional, and prospective studies reporting BMI categories at disease diagnosis and during a GFD.<br />Data Extraction: Data were extracted by 2 reviewers independently. Disagreements were resolved by consensus; a third reviewer was consulted, if necessary. Risk of bias was assessed with the Cochrane ROBINS-I tool.<br />Data Analysis: Subgroup analysis based on age (pediatric/adult patients), study design (prospective, cross-sectional, retrospective), and duration of GFD was performed.. Forty-five studies were selected (7959 patients with celiac disease and 20 524 healthy controls). The mean BMI of celiac patients at presentation was significantly lower than that of controls (P < 0.001). During a GFD, the mean BMI increased significantly (mean difference = 1.14 kg/m2 [95%CI, 0.68-1.60 kg/m2]; I2 = 82.8%; P < 0.001), but only 9% of patients (95%CI, 7%-12%; I2 = 80.0%) changed from the underweight/normal BMI category to the overweight/obese category, while 20% (95%CI, 11%-29%; I2 = 85.8%) moved into a lower BMI category.<br />Conclusion: Most celiac patients had a normal BMI at presentation, although the mean BMI was significantly lower than that of controls. A GFD does not increase the risk of becoming overweight/obese, especially in children. The quality of several studies was suboptimal, with moderate or high overall risk of bias and heterogeneity.<br /> (© The Author(s) 2022. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Subjects :
- Humans
Child
Adult
Prospective Studies
Thinness epidemiology
Thinness complications
Retrospective Studies
Diet, Gluten-Free adverse effects
Cross-Sectional Studies
Obesity epidemiology
Obesity etiology
Body Mass Index
Overweight epidemiology
Overweight complications
Celiac Disease epidemiology
Celiac Disease diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1753-4887
- Volume :
- 81
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Nutrition reviews
- Publication Type :
- Academic Journal
- Accession number :
- 35947766
- Full Text :
- https://doi.org/10.1093/nutrit/nuac052