Dr. Schär Institute

A gluten-free diet eliminating all foodstuffs containing gluten and replacing them with products made using gluten-free cereals is con-sidered the only way to treat coeliac disease. Al-though adherence to a gluten-free diet usually results in symptom improvement and enables the coeliac patient to return to good health, within the scientific community the question has been raised as to the nutritional quality of this diet. The reason is that a number of stud-ies undertaken in the last ten years have shown – albeit with sometimes contradictory results – that coeliac patients do not consume the rec-ommended amounts of certain important nu-trients. Most studies indicate that patients with coeliac disease consume less than the recom-mended amount of complex carbohydrates, fi-bre, folate, calcium and iron, but more than the recommended amount of protein and energy from total fat and saturated fats. Therefore, it could be suggested that a gluten-free diet has the potential to be less well balanced than a gluten-containing one. With the aim of find-ing out more about the nutritional quality of gluten-free diets in Italian coeliac patients, we are currently carrying out a study in col-laboration with the Centre for Prevention and Diagnosis of Coeliac Disease at the University of Milan involving a group of 300 individuals (150 coeliac patients and 150 non-suffer-ers). These volunteers were selected according to a series of inclusion criteria, including age (between 18 and 70 years), the existence of a regular dietary pattern – and therefore, in the case of the coeliac patients, the adherence to a gluten-free diet for at least the past two years – as well as the absence of metabolic diseases, chronic diseases, certain psychological condi-tions and special diets. Two research methods were chosen to determine the participants’ eat-ing habits: a diary in which each participant lists all the food and drink consumed during one week; and a food frequency questionnaire which all participants were asked to fill in during their first visit to the study centre for the selection procedure. The diary provides detailed information about eating habits, but it is limited to the food and drink consumed during just one week. Therefore, it is not a comprehensive description of a person’s gen-eral eating habits. The food frequency ques-tionnaire, on the other hand, gives a more general insight into the person’s eating habits throughout the previous year, albeit in a less detailed manner. Using both methods makes it possible to gather complementary informa-tion. At the same time, the food frequency questionnaire developed for the non-sufferers healthy section of the general population was also analysed in order to expand­ our study to further test centres in Italy and gather in-formation about a broader group of coeliac patients. The preliminary results of the study suggest that patients suffering from coeliac disease consume too much of their energy intake from fats, in particular saturated fats, when compared to dietary guidelines and also too much sodium. This is probably down to an increased consumption of sweet foods. Only a small proportion of coeliac patients consume appropriate amounts of calcium, iron, folate and fibre. Once this study has reached its conclusion at the end of the year it will reveal a lot of information about coe-liac patients’ diets that can then be used to improve the eating habits of persons affected by the disease.