A common treatment for patients with celiac disease is to follow a lifelong gluten-free diet in order to remain well.
However, there is still uncertainty as to whether or not such patients are receiving a nutritionally balanced diet.
To investigate this question, the vitamin status of 30 adult celiac patients (18 women, 12 men) living on a gluten-free diet was assessed.
The patients with mean age 55 years, range 45-64 years, were all in biopsy-proven remission, following 8-12 years of dietary treatment.
Levels of total plasma homocysteine, a metabolic marker of folate, vitamin B-6 and vitamin B-12 deficiency and related plasma vitamin levels were all recorded.
In addition the daily vitamin intake of all subjects was assessed using a 4-day food record.
| Gluten-free diets - lead to lower intake of folate and vitamin B-6. |
| Alimentary Pharmacology and Therapeutics |
Normative data were obtained from the general population of the same age.
The researchers found celiac patients to have higher total plasma homocysteine levels than the general population, indicative of a poor vitamin status.
Additionally, the plasma levels of folate and pyridoxal 5-phosphate, the active form of vitamin B-6, were low in 37% and 20% of celiac patients respectively. These reduced levels accounted for 33% of the variation of the total plasma homocysteine level.
Celiac patients also had mean intakes of folate and vitamin B-12, although not of vitamin B-6, that were significantly lower than in controls.
Professor C. Hallert, one of the authors of the report, said, "Half of the adult celiac patients carefully treated with a gluten-free diet for several years showed signs of a poor vitamin status."
He added, "This may have clinical implications considering the linkage between vitamin deficiency, elevated total plasma homocysteine levels and cardiovascular disease."
"The results may suggest that, when following up adults with celiac disease, their vitamin status should be reviewed."