Nutrient supplementation in celiac disease

Supplementation is the supply of nutrients complementary to the diet. It is an important strategy for celiac patients. It may be necessary to correct specific deficiencies, such as deficiencies of iron, vitamin D, calcium, folic acid and vitamin B12, and any others.

Nutrient supplementation in celiac disease (CD) can be achieved through fortified and enriched foods, or with nutritional supplements. The latter are effective, for example, in the early stages of diagnosis, when the intestine has not yet healed, or in case of more serious malabsorption problems.

Fortified and fortified foods

Fortified foods are another option as a source of nutrients in celiac disease. Some foods lose vitamins, minerals, proteins, amino acids and essential fatty acids when processed. Most wheat-based products are fortified with folate, thiamin, ribiflavin and niacin. However, this option is difficult to find in foods made from gluten-free flours.

In most countries, there are no specific regulations for the fortification or enrichment of foods for celiacs. Some products are fortified with important nutrients to compensate for potential nutritional deficiencies, such as iron, vitamin B12 and vitamin D.

Fortified foods: is when nutrients are added to foods that do not contain them naturally or that have lost these properties due to processing. It is a mandatory food strategy to solve a nutritional deficiency in a given population.

It is usually different for each country because it depends on the deficiencies they have. It is an activity regulated by the government or food authorities. The foods chosen for fortification are commonly used, for example, edible oils, milk, salt, sugar, flour and rice.

Some examples of fortified foods for celiacs are:

• Bread and breakfast cereals fortified with B vitamins, iron, calcium and vitamin D.

• Lactose-free milk fortified with calcium and vitamin D.

• Gluten-free flours enriched with iron and folic acid.

• Gluten-free baked goods enriched with fiber, vitamins and minerals.

• Gluten-free cookies and protein bars enriched with vitamins and minerals.

Fortified foods: these foods have more of the vitamins, minerals, proteins, amino acids or essential fatty acids they already contain added to them. It is aimed at healthy people. It is done to address specific nutritional deficiencies, and manufacturers do it voluntarily to add value to their products. It is important to ensure that fortified foods are labeled as gluten-free to avoid cross-contamination.

There are some organizations and groups that promote food fortification for celiacs, such as the Foundation for Gluten Research and the Spanish Celiac Association, which have proposed fortification of certain foods to improve the nutritional quality of the diet of people with celiac disease.

Use of nutritional supplements

When the natural absorption of nutrients necessary for the proper functioning of the body is affected by celiac disease and non-celiac gluten sensitivity, it will be necessary to take supplements. This should be done under the supervision of a health professional.

You should always go to the doctor to confirm nutritional deficiencies and reconcile the proper dosage, as the needs are individual. An overdose of any vitamin or mineral brings its own set of health problems. They can become toxic and even damage organs, among other complications.

There is a wide variety of supplements available today. They are available for all deficiencies of vitamins, minerals, fatty acids and essential amino acids. They can be found individually or as multivitamins or botanicals. There are also different forms available for consumption, whether pills, tablets, gummies, bars, syrups or injections in case absorption by the body is particularly difficult.

In some cases, intestinal damage may be so severe that even oral nutritional supplements are not sufficient to correct nutritional deficiencies. In these cases, alternative therapies, such as intravenous administration of nutrients, may be necessary.

In addition, some oral nutritional supplements may contain traces of gluten, which can provoke an immune reaction in people with celiac disease and worsen the symptoms of the disease. Therefore, it is important that oral nutritional supplements