J Pediatr Gastroenterol Nutr. 2024 Jan 30. doi: 10.1002/jpn3.12079. Online ahead of print.

Veronica Luque ^1 2, Paula Crespo-Escobar ^3 4, Elin M Hård Af Segerstad ^5 6, Tunde Koltai ⁷, Lorenzo Norsa ⁸, Enriqueta Roman ⁹, Anita Vreugdenhil ¹⁰, Ricardo Fueyo-Díaz ¹¹, Carmen Ribes-Koninckx ¹²

Author information

¹Serra Húnter, Universitat Rovira i Virgili, Reus, Spain.

²Paediatric Nutrition and Development Research Unit, IISPV, Reus, Spain.

³Health Sciences Department, ADVISE Research Group, Miguel de Cervantes European University, Valladolid, Spain.

⁴Nutrition and Dietetics Unit, Hospital Recoletas Campo Grande, Valladolid, Spain.

⁵Paediatric Department, Skane University Hospital, Malmoe, Sweden.

⁶Department of Clinical Sciences, Celiac Disease and Diabetes Unit, Faculty of Medicine, Lund University, Malmoe, Sweden.

⁷Direction Board, Association of European Coeliac Societies, Brussels, Belgium.

⁸Paediatric Hepatology, Gastroenterology and Transplantation, ASST Papa Giovanni XXIII, Bergamo, Italy.

⁹Paediatric Gastroenterology and Nutrition, Hospital Universitario Puerta de Hierro, Majadahonda, Spain.

¹⁰Department of Pediatrics, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands.

¹¹Department of Psychology and Sociology, Aragonese Primary Care Research Group (GAIAP, B21_20R), University of Zaragoza, Zaragoza, Spain.

¹²Paediatric Gastroenterology, Hepatology and Nutrition, La Fe University Hospital & La Fe Research Institute, Valencia, Spain.

Abstract

Background and objective: Coeliac disease is a chronic, immune-mediated disorder for which the only treatment consists of lifelong strict adherence to gluten-free diet (GFD). However, there is a lack of evidence-based guidelines on the GFD dietary management of coeliac disease. This position paper, led by the Special Interest Group in coeliac disease of the European Society of Pediatric, Gastroenterology Hepatology, and Nutrition, supported by the Nutrition Committee and the Allied Health Professionals Committee, aims to present evidence-based recommendations on the GFD as well as how to support dietary adherence.

Methods: A wide literature search was performed using the MeSH Terms: "diet, gluten free," "gluten-free diet," "diets, gluten-free," "gluten free diet," and "coeliac disease" in Pubmed until November 8th, 2022.

Results: The manuscript provides an overview of the definition of the GFD, regulations as basis to define the term "gluten-free," which foods are naturally gluten-free and gluten-containing. Moreover, it provides recommendations and educational tips and infographics on suitable food substitutes, the importance of reading food labels, risk of gluten cross-contact at home and in public settings, nutritional considerations as well as factors associated to dietary adherence based on available evidence, or otherwise clinical expertise.

Conclusions: This position paper provides guidance and recommendations to support children with coeliac disease to safely adhere to a GFD.