Gładyś Katarzyna, Dardzińska Jolanta, Guzek Marek, Adrych Krystian, Kochan Zdzisław, Małgorzewicz Sylwia
Department of Clinical Nutrition, Medical University of Gdansk, 80-211 Gdańsk, Poland.
Department of Gastroenterology and Hepatology, Medical University of Gdansk, 80-211 Gdańsk, Poland.
Nutrients. 2021 May 29;13(6):1859. doi: 10.3390/nu13061859.
Access to a registered dietitian experienced in celiac disease (CD) is still limited, and consultation when available focuses primarily on the elimination of gluten from the diet. Thus, the aim of this study was to evaluate the nutritional value of a gluten-free diet (GFD) in adult CD patients before, and one year after, the standard dietary education. The study included 72 CD patients on a GFD and 30 healthy controls. The dietary intake of both groups was assessed through a 3-day food diary, while adherence to a GFD in celiac subjects was assessed using Standardized Dietician Evaluation (SDE). Subsequently, all CD patients received detailed education on gluten sources, and 48 of them participated in a one-year follow-up. Results: Comparison with the control group showed that consumption of plant protein in CD patients was significantly lower, whereas fat and calories were higher. At baseline, only 62% of CD patients adhered to a GFD, but the standard dietary education successfully improved it. However, the nutritional value of a GFD after one year did not change, except for a reduced sodium intake. The CD subjects still did not consume enough calcium, iron, vitamin D, folic acid or fiber. In conclusion, while the standard dietary education improved GFD adherence, it did not significantly alter its nutritional value. Therefore, it is necessary to increase the role of a dietitian in the treatment of CD.
接触过患有乳糜泻（CD）经验的注册营养师的机会仍然有限，即便有咨询服务，其重点也主要是从饮食中剔除麸质。因此，本研究的目的是评估标准饮食教育之前及之后一年，无麸质饮食（GFD）对成年CD患者的营养价值。该研究纳入了72名采用GFD饮食的CD患者和30名健康对照者。两组的饮食摄入量通过一份为期3天的食物日记进行评估，而乳糜泻患者对GFD的依从性则使用标准化营养师评估（SDE）进行评估。随后，所有CD患者都接受了关于麸质来源的详细教育，其中48人参与了为期一年的随访。结果：与对照组相比，CD患者的植物蛋白摄入量显著较低，而脂肪和热量较高。在基线时，只有62%的CD患者坚持GFD饮食，但标准饮食教育成功改善了这一情况。然而，一年后GFD的营养价值除了钠摄入量减少外并未改变。CD患者仍然没有摄入足够的钙、铁、维生素D、叶酸或纤维。总之，虽然标准饮食教育提高了对GFD的依从性，但并没有显著改变其营养价值。因此，有必要增加营养师在CD治疗中的作用。
