Child Obes. 2023 Aug 14. doi: 10.1089/chi.2022.0035. Online ahead of print.

Rachele De Giuseppe ¹, Francesca Bergomas ², Federica Loperfido ^1 3, Francesca Giampieri ⁴, Giorgia Preatoni ¹, Valeria Calcaterra ^5 6, Hellas Cena ^1 7

Author information

¹Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia. Pavia, Italy.

²Scuola di Specializzazione in Scienza dell'Alimentazione, Università degli Studi di Milano, Milano, Italy.

³Scuola di Specializzazione in Scienza dell'Alimentazione, Università degli Studi di Pavia, Pavia, Italy.

⁴Research Group on Food, Nutritional Biochemistry, and Health, Universidad Europea del Atlántico, Santander, Spain.

⁵Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, Pavia, Italy.

⁶Pediatric Unit, "V. Buzzi" Children's Hospital, Milano, Italy.

⁷Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, Pavia, Italy.

Abstract

Background: Celiac disease (CD) is a multifactorial, immune-mediated enteropathic disorder that may occur at any age with heterogeneous clinical presentation. In the last years, unusual manifestations have become very frequent, and currently, it is not so uncommon to diagnose CD in subjects with overweight or obesity, especially in adults; however, little is known in the pediatric population. This systematic review aims to evaluate the literature regarding the association between CD and overweight/obesity in school-age children. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. An electronic database search of articles published in the last 20 years in English was carried out in Web of Sciences, PubMed, and Medline. The quality of the included studies was assessed by using the STrengthening the Reporting of OBservational studies in Epidemiology statement. Results: Of the 1396 articles identified, 9 articles, investigating overweight/obesity in children/adolescents affected by CD or screening CD in children/adolescents with overweight/obesity, met the inclusion criteria. Overall, the results showed that the prevalence of overweight or obesity in school-age children (6-17 years) affected by CD ranged between 3.5% and 20%, highlighting that the coexistence of CD with overweight/obesity in children is not uncommon as previously thought. Conclusion: Although CD has been historically correlated with being underweight due to malabsorption, it should be evaluated also in children with overweight and obesity, especially those who have a familiar predisposition to other autoimmune diseases and/or manifest unusual symptoms of CD.