8.4 – Reflection

Gluten-Free Diets and the Coeliac PatientGluten-Free Diets. Concerns have been raised on whether a gluten-free diet affects the cardiovascular risk profile of coeliac patients. Retrospective analysis of the effects of 1–5 years of gluten-free diet on indicators of cardiovascular risk and on distribution in cardiovascular risk categories in 715 coeliac patients. Compared to the baseline, significant increases were found in body mass index, total cholesterol, and ?-glutamyl transpeptidase.Significant reductions were found in serum triglycerides and homocysteine during a gluten-free diet. The proportion of patients included in an arbitrarily defined category of “lowest cardiovascular risk profile” decreased from 58% at baseline to 47% during gluten-free diet.A gluten-free diet significantly affects cardiovascular risk factors in coeliac patients, but changes do not consistently point towards worse or better risk profiles, thus suggesting that the diet is unlikely to be atherogenic.Effects of a Gluten-Free Diet on Bone Mineral Metabolism of Celiac ChildrenStudies on the effects of gluten-free diet (GFD) on bone mineral metabolism have given no univocal results in children and adults with celiac disease. Bone mineral metabolism was assessed in 23 celiac children, aged 1 to 12 years (mean 4.6) at moment of diagnosis (T0) and after 12 months of GFD (T1) without any vitamin D supplementation.At T0, calcium, phosphates and alkaline phosphatase values were within the normal range in all but few subjects, but their respective average values significantly rose at T1. The percentages of low values of bone mineral density and of osteocalcin at T0 were significantly higher than those at T1 and their respective average values significantly increased between T0 and T1.Circulating parathyroid hormone values were within the normal range in all patients at T0 and T1, with no significant difference in average values between 0 and T1. One year of GFD is sufficient to obtain a complete…………………

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