Nutrient intake of adolescents with celiac disease and their non-celiac counterparts : A comparative study of Swedish 14-year-old boys and girls on gluten-free diet with a non-celiac, gender- and age-matched control group

Abstract Introduction: Following a strict gluten-free diet means exclusion of many staple foods such as traditionally made bread, flour, pasta, and whole grain products that are largely included in the Swedish daily diet. Such exclusions of vital resources could have harmful consequences on nutritional status and cause nutritional hazard, if they are not substituted with appropriate alternatives. Aim: To compare the nutrient and energy intakes of 14-year-old boys and girls on gluten free diet with their non-celiac counterparts as well as the estimated average requirement. Method: All 14-year-old adolescents with suspected and previously diagnosed Celiac disease from the ETICS study (Exploring the Iceberg of Celiac in Sweden) as well as a randomized gender- and age-matched non-celiac controls were invited to a dietary sub-study; ETICS-diet. A four-week food frequency questionnaire was used to assess the dietary intakes of 129 celiac cases (63 boys and 66 girls) with 428 non-celiac controls (boys 188 and girls 240). Basal Metabolic Rate was used to evaluate the validity of the reported food intakes in the present study through comparison with individually calculated energy requirements. Results: There were no significant differences between Celiac disease cases and controls regarding their food and energy intakes nor physical activity level. In general, the nutrient intakes were significantly lower among cases compared to controls, particularly in fiber, but similar patterns were observed among both cases and controls when we assessed whether they were within the recommended range of nutrient intake or not. Conclusion: The current study, in sum, informs public health intervention programs to promote healthy eating habits for all children by endorsing foods highest in Folate, Vitamin C, Iron, and fiber