Nutritional deficiencies in celiac disease

If people with celiac disease (CD) do not follow a strict gluten-free diet (GFD), they are exposed to inflammation and damage in the small intestine. The atrophy of the intestinal villi caused by this condition makes it difficult or impossible for the body to absorb nutrients from food. This malabsorption causes major deficiencies that sooner rather than later lead to serious health problems.

The supply of gluten-free products in stores is growing all the time. But many of these products are not healthy. This is especially true for foods in which gluten is substituted, such as baked goods and bakery products. There is no single ingredient that replaces the functionality of gluten; the industry must use various additives and ingredients to achieve the same organoleptic properties as their gluten analogues.

In order to make them more palatable despite the additives, nutritional quality is often sacrificed in the end result. They may have a high amount of saturated fats and sugars, as well as less fiber and vitamins than similar products with gluten. Maintaining a balanced diet is essential to avoid, for example, weight gain and triglycerides.

In addition to reading and interpreting labels for the presence or absence of gluten, coeliacs should pay attention to the nutritional content. Observe the amount of salt and calories from fats and sugars. As well as the fiber, vitamins and minerals they contain. Gluten-free whole grains such as amaranth, quinoa, millet, corn, rice, buckwheat, are natural sources of these nutrients.

Major nutritional deficiencies in CD

Among the most common nutritional deficiencies are:

• Fiber: fiber is an important nutrient for digestive and heart health. The most common symptoms of fiber deficiency include lack of energy, failure to satisfy hunger, constipation and difficulty losing weight.

• Omega 3: this fatty acid is essential for the proper functioning of the brain. Its proper absorption can be compromised by CD. Symptoms of this deficiency include brittle hair and nails, insomnia, fatigue and inability to focus. It can cause behavioral disturbances as well.

• Iron: Iron deficiency is common in people with celiac disease. Iron is essential for the production of red blood cells and the prevention of anemia. Symptoms of iron deficiency include fatigue, weakness and pallor.

• Calcium: Calcium deficiency or hypocalcemia can be a problem for people with celiac disease, which can increase the risk of osteoporosis, dental involvement, cataracts and bone fractures. They present symptoms such as pain, muscle cramps, pain or numbness in the extremities, fatigue, insomnia, brittle nails, alopecia, among others.

• Vitamin A: this vitamin is related to growth, the immune system, vision and the correct functioning of organs. It is an antioxidant like vitamin E. Deficiency of this vitamin can cause night blindness and leave the body exposed to infections.

• Vitamin D: Vitamin D malabsorption is common in people with celiac disease due to decreased fat absorption in the damaged intestine. Vitamin D deficiency can increase the risk of osteoporosis and weaken the immune and nervous systems. Symptoms are muscle pain or weakness and fatigue. Vitamin D is essential for proper calcium absorption.

• Vitamin B12: Vitamin B12 deficiency can cause anemia and neuropathy. Symptoms of vitamin B12 deficiency include fatigue, weakness and neurological problems ranging from loss of sensation and reflexes to inability to walk and confusion, among others. Celiacs who are vegans should be very aware of this deficiency since they do not consume foods derived from animals, a source of this vitamin.

• Vitamin E: it is an antioxidant present in all the cells of the organism. It helps the nervous and immune systems, and the proper functioning of muscles, among other functions. Symptoms of a deficiency of this vitamin may include muscle weakness, vision problems and numbness of the extremities.

• Vitamin K: is very important for bones. Deficiency can cause bruising, clotting problems and osteoporosis. Common symptoms include blood in the urine or stool.

• Folacin or vitamin B9: also known as folic acid. Folate malabsorption can increase the risk of neurological problems, among other symptoms. It is essential for brain development. It has been shown that folic acid intake is essential before and during pregnancy to reduce the risk of miscarriage, and provide a good development