The Gluten Free Diet's Impact on Growth in Children with Celiac Disease in Two Different Countries

Nutrients. 2020 May 26;12(6):1547. doi: 10.3390/nu12061547.

Naire Sansotta 1, Stefano Guandalini 2, Simone Romano 3, Karine Amirikian 2, Marco Cipolli 4, Gloria Tridello 4, Silvia Barzaghi 5, Hilary Jericho 2


Author information

  • 1Department of Pediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy.
  • 2Department of Pediatrics, Division of Gastroenterology, Hepatology, Nutrition, Celiac Disease Center, University of Chicago Medicine, Comer Children's Hospital, Chicago, IL 60637, USA.
  • 3Department of Medicine, University of Verona, 37129 Verona, Italy.
  • 4Cystic Fibrosis Center, Azienda Ospedaliera Universitaria Integrata, 37126 Verona, Italy.
  • 5Pediatric Department, University of Milano-Bicocca, Fondazione MBBM, San Gerardo Hospital, 20900 Monza, Italy.


The effects of gluten free diet (GFD) on body mass index (BMI) and growth parameters in pediatric patients with celiac disease (CD) and their dependence on different socio-cultural environments are poorly known. We conducted an international retrospective study on celiac patients diagnosed at the University of Verona, Italy, and at the University of Chicago, Chicago, IL, USA, as underweight. A total of 140 celiac children and 140 controls (mean age 8.4 years) were enrolled in Chicago; 125 celiac children and 125 controls (mean age 7.3 years, NS) in Verona. At time of diagnosis, Italian celiac children had a weight slightly lower (p = 0.060) and a BMI z-score significantly (p < 0.001) lower than their American counterparts. On GFD, Italian celiac children showed an increased prevalence of both underweight (19%) as well as overweight (9%), while American children showed a decrease prevalence of overweight/obese. We concluded that while the GFD had a similar impact on growth of celiac children in both countries, the BMI z-score rose more in American than in Italian celiac children. Additionally, in Italy, there was an alarming increase in the proportion of celiac children becoming underweight. We speculate that lifestyle and cultural differences may explain the observed variations.

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