Celiac Disease and the Gluten-Free Diet: Consequences and Recommendations for Improvement
Celiac Disease and the Gluten-Free Diet: Consequences and Recommendations for Improvement
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DOI：
10.1159/000369504
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发表时间：
2015-01-01
影响因子：
2.3
通讯作者：
Dennis, Melinda
中科院分区：
文献类型：
--
作者：
Theethira, Thimmaiah G.;Dennis, Melinda
背景：乳糜泻（CD）是一种慢性小肠免疫介导的肠病，由遗传易感个体暴露于膳食麸质而诱发。 CD 相关肠病导致多种营养缺乏，包括大量营养素和微量营养素。目前，由无麸质饮食（GFD）组成的医学营养疗法是唯一被接受的 CD 治疗方法。关键信息：GFD 是 CD 治疗的基石。先前发表的研究得出的结论是，维持 GFD 可以改善大多数营养缺乏症。过去，CD的咨询主要集中在消除饮食中的麸质。然而，GFD 也并非没有不足之处。遵守 GFD 可能会导致某些缺乏，例如纤维、B 族维生素、铁和微量矿物质。缺乏强化无麸质食品可能是 GFD 出现某些缺陷的原因。体重增加和肥胖已被添加到 GFD 期间的营养后果列表中，并且部分归因于市售无麸质食品的高热量含量。据报道，开始 GFD 后诊断为 CD 的患者的随访不规律，因此不太理想。结论：通过血液检测监测营养状况并使用适当的无麸质补充剂是 CD 治疗中不可或缺的组成部分。理想的 GFD 应该是营养丰富的天然无麸质食品，宏量和微量营养素均衡，价格合理且易于获取。伪谷物的轮作提供了复合碳水化合物、蛋白质、纤维、脂肪酸、维生素和矿物质的良好来源。应鼓励强化/强化常用的无麸质商业谷物产品。专门从事 CD 的营养师在 CD 患者的 GFD 教育和维持中发挥着关键作用。 (C) 2015 S. Karger AG，巴塞尔
Background: Celiac disease (CD) is a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically susceptible individuals. CD-related enteropathy leads to multiple nutritional deficiencies involving macro-and micronutrients. Currently, medical nutrition therapy consisting of the gluten-free diet (GFD) is the only accepted treatment for CD. Key Messages: The GFD is the cornerstone of treatment for CD. Prior published studies have concluded that maintenance of the GFD results in improvement of the majority of nutritional deficiencies. In the past, counseling for CD focused mainly on the elimination of gluten in the diet. However, the GFD is not without its inadequacies; compliance to the GFD may result in certain deficiencies such as fiber, B vitamins, iron, and trace minerals. Paucity of fortified gluten-free foods may be responsible for certain deficiencies which develop on the GFD. Weight gain and obesity have been added to the list of nutritional consequences while on the GFD and have been partially attributed to hypercaloric content of commercially available gluten-free foods. Follow-up of patients diagnosed with CD after starting the GFD has been reported to be irregular and, hence, less than ideal. Conclusions: Monitoring of the nutritional status using blood tests and use of appropriate gluten-free supplementation are integral components in the management of CD. The ideal GFD should be nutrient-dense with naturally gluten-free foods, balanced with macro-and micronutrients, reasonably priced, and easily accessible. Rotation of the pseudo-cereals provides a good source of complex carbohydrates, protein, fiber, fatty acids, vitamins and minerals. Fortification/enrichment of commonly consumed gluten-free commercial grain products should be encouraged. Dietitians specializing in CD play a critical role in the education and maintenance of the GFD for patients with CD. (C) 2015 S. Karger AG, Basel