Avaliação da Adequação Dietética e Nutricional de Adultos com Doença Celíaca
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Data
2012-07-31
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Universidade Federal de Viçosa
Resumo
A doença celíaca (DC) é uma enteropatia auto-imune desencadeada pela exposição ao glúten em indivíduos predispostos geneticamente. A atrofia das vilosidades intestinais é um dos achados fisiopatológicos da doença, comprometendo a absorção de nutrientes. Outros sinais extra-intestinais como distúrbios neurológicos, hepáticos, artrites, infertilidade, anemia, dermatites e osteoporose podem estar presentes. O único tratamento instituído para a DC é uma dieta livre de glúten (DLG) por toda a vida. A exclusão do glúten contribui para recuperar a mucosa danificada e com isso evitar deficiências nutricionais, e ainda proteger de várias complicações da doença. Entretanto, a DLG é considerada bastante restritiva por eliminar alguns cereais e seus
derivados da alimentação (trigo, centeio, cevada, aveia, malte), o que pode dificultar uma ingestão nutricional adequada. O objetivo desse estudo foi investigar a adequação do estado nutricional de adultos com DC sob consumo de uma dieta livre de glúten, residentes na cidade de Viçosa. Vinte três adultos com DC, diagnosticados por biópsia, e quarenta e cinco indivíduos controle (sem DC) participaram do estudo
para avaliar o consumo alimentar tendo como referência as recomendações nutricionais (DRI). Foram realizadas medidas antropométricas, de composição corporal, por meio do DEXA, e coleta de sangue para exames bioquímicos. O consumo de lipídeos e colesterol acima dos níveis recomendados foi observado no grupo dos celíacos. Uma maior proporção de pacientes celíacos em relação aos indivíduos saudáveis não atingiu as recomendações da maioria das vitaminas (vitamina A, E, B1, B2, B3, B6) e cálcio. Ainda, a grande maioria (>65%) dos celíacos não alcançou a recomendação média estimada para vitamina A, D, E, riboflavina, ácido fólico, cálcio, magnésio, cobre, selênio e potássio. A densidade mineral óssea foi significante menor neste grupo. Dessa forma, a adesão a DLG pode contribuir para o surgimento de deficiências nutricionais específicas e excessos desfavoráveis como elevados consumo de lipídios, os quais se associam ao maior risco de desenvolver doenças crônicas, tais como osteoporose e doença cardiovascular.
Celiac disease (CD) is an autoimmune enteropathy triggered by exposure to gluten in genetically predisposed individuals. The atrophy of intestinal villous is one of the initial manifestations of the disease, compromising the absorption of nutrients. Other extra-intestinal signs may be present such as neurological and liver disorders, arthritis, infertility, anemia, dermatitis, and osteoporosis. The only treatment established for CD is a gluten-free diet (DLG) for the whole life. The exclusion of gluten helps to recover the damaged mucosa and thus avoid nutritional deficiencies, and to protect against the occurrence of various complications of the disease. However, DLG is considered quite restrictive, eliminating some cereals and derived food (wheat, rye, barley, oats, malt), which can hamper a proper nutritional intake. The aim of this study was to investigate the adequacy of the nutritional status of adults with CD following a gluten free diet, residents in the city of Viçosa. Twentythree adults with CD diagnosed by biopsy, and forty-five healthy individuals participated in this study. We used the food record of 3 non-consecutive days to assess food consumption and to estimate the daily intake of nutrients to compare with the nutritional recommendations (DRI), with the average intake of the control group and with the average consumption of population (POF). Anthropometric measurements were taken, body composition was assessed through DEXA, and blood was collected for biochemical tests. The consumption of fat and cholesterol above recommended levels was observed in the group of celiac patients. A larger proportion of celiac patients compared to healthy individuals did not reach the recommendations of most of the vitamins (vitamin A, E, B1, B2, B3, B6) and calcium. However, the vast majority (> 65%) of celiac patients did not reach the estimated average recommendation for vitamin A, D, E, riboflavin, folic acid, calcium, magnesium, copper, selenium and potassium. Bone mineral density was significantly lower in this group. Thus, following a gluten free diet might contribute to the emergence of specific nutritional deficiencies and excessive intake of lipids, which are associated with higher risk of developing chronic diseases such as osteoporosis and cardiovascular disease.
Celiac disease (CD) is an autoimmune enteropathy triggered by exposure to gluten in genetically predisposed individuals. The atrophy of intestinal villous is one of the initial manifestations of the disease, compromising the absorption of nutrients. Other extra-intestinal signs may be present such as neurological and liver disorders, arthritis, infertility, anemia, dermatitis, and osteoporosis. The only treatment established for CD is a gluten-free diet (DLG) for the whole life. The exclusion of gluten helps to recover the damaged mucosa and thus avoid nutritional deficiencies, and to protect against the occurrence of various complications of the disease. However, DLG is considered quite restrictive, eliminating some cereals and derived food (wheat, rye, barley, oats, malt), which can hamper a proper nutritional intake. The aim of this study was to investigate the adequacy of the nutritional status of adults with CD following a gluten free diet, residents in the city of Viçosa. Twentythree adults with CD diagnosed by biopsy, and forty-five healthy individuals participated in this study. We used the food record of 3 non-consecutive days to assess food consumption and to estimate the daily intake of nutrients to compare with the nutritional recommendations (DRI), with the average intake of the control group and with the average consumption of population (POF). Anthropometric measurements were taken, body composition was assessed through DEXA, and blood was collected for biochemical tests. The consumption of fat and cholesterol above recommended levels was observed in the group of celiac patients. A larger proportion of celiac patients compared to healthy individuals did not reach the recommendations of most of the vitamins (vitamin A, E, B1, B2, B3, B6) and calcium. However, the vast majority (> 65%) of celiac patients did not reach the estimated average recommendation for vitamin A, D, E, riboflavin, folic acid, calcium, magnesium, copper, selenium and potassium. Bone mineral density was significantly lower in this group. Thus, following a gluten free diet might contribute to the emergence of specific nutritional deficiencies and excessive intake of lipids, which are associated with higher risk of developing chronic diseases such as osteoporosis and cardiovascular disease.
Descrição
Palavras-chave
Dieta livre de glúten, Ingestão dietética, Estado nutricional, Gluten-free diet, Dietary intake, Nutritional status
Citação
CAMPOS, Tatiana do Nascimento. Evaluation of Dietetic and Nutritional Adequacy of Adults with Celiac Disease. 2012. 113 f. Dissertação (Mestrado em Valor nutricional de alimentos e de dietas; Nutrição nas enfermidades agudas e crônicas não transmis) - Universidade Federal de Viçosa, Viçosa, 2012.