{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:42:10Z","timestamp":1791812530841,"version":"4.3.4"},"reference-count":75,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T00:00:00Z","timestamp":1660089600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Obesity is a significant risk factor for many pathological conditions. Whether a gluten-free diet (GFD) is a risk factor for overweight or obesity remains controversial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The primary aim of this study was to assess the prevalence of body mass index (BMI) categories at disease presentation and the variation in BMI category from underweight\/normal to overweight\/obese and vice versa during a GFD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data Sources<\/jats:title>\n                  <jats:p>PubMed, Scopus, and Web of Science databases were searched through February 2021 for retrospective, cross-sectional, and prospective studies reporting BMI categories at disease diagnosis and during a GFD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data Extraction<\/jats:title>\n                  <jats:p>Data were extracted by 2 reviewers independently. Disagreements were resolved by consensus; a third reviewer was consulted, if necessary. Risk of bias was assessed with the Cochrane ROBINS-I tool.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data Analysis<\/jats:title>\n                  <jats:p>Subgroup analysis based on age (pediatric\/adult patients), study design (prospective, cross-sectional, retrospective), and duration of GFD was performed.. Forty-five studies were selected (7959 patients with celiac disease and 20\u200a524 healthy controls). The mean BMI of celiac patients at presentation was significantly lower than that of controls (P\u2009&amp;lt;\u20090.001). During a GFD, the mean BMI increased significantly (mean difference\u2005=\u20051.14 kg\/m2 [95%CI, 0.68\u20131.60\u2009kg\/m2]; I2\u2005=\u200582.8%; P\u2009&amp;lt;\u20090.001), but only 9% of patients (95%CI, 7%\u201312%; I2\u2005=\u200580.0%) changed from the underweight\/normal BMI category to the overweight\/obese category, while 20% (95%CI, 11%\u201329%; I2\u2005=\u200585.8%) moved into a lower BMI category.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Most celiac patients had a normal BMI at presentation, although the mean BMI was significantly lower than that of controls. A GFD does not increase the risk of becoming overweight\/obese, especially in children. The quality of several studies was suboptimal, with moderate or high overall risk of bias and heterogeneity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/nutrit\/nuac052","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T19:15:07Z","timestamp":1660158907000},"page":"252-266","source":"Crossref","is-referenced-by-count":32,"title":["Risk of obesity during a gluten-free diet in pediatric and adult patients with celiac disease: a systematic review with meta-analysis"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8284-5127","authenticated-orcid":false,"given":"Michele","family":"Barone","sequence":"first","affiliation":[{"name":"Gastroenterology Unit, Department of Emergency and Organ Transplantation, University of Bari \u201cAldo Moro,\u201d are with the Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Iannone","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Emergency and Organ Transplantation, University of Bari \u201cAldo Moro,\u201d are with the Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5849-8110","authenticated-orcid":false,"given":"Fernanda","family":"Cristofori","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, Pediatric Section, University of Bari \u201cAldo Moro,\u201d are with the Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa Nadia","family":"Dargenio","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, Pediatric Section, University of Bari \u201cAldo Moro,\u201d are with the Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Indrio","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Scientific Institute \u201cCasa Sollievo della Sofferenza,\u201d is with the Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvira","family":"Verduci","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Ospedale dei Bambini \u201cVittore Buzzi,\u201d is with the Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2026-1200","authenticated-orcid":false,"given":"Alfredo","family":"Di Leo","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Emergency and Organ Transplantation, University of Bari \u201cAldo Moro,\u201d are with the Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruggiero","family":"Francavilla","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, Pediatric Section, University of Bari \u201cAldo Moro,\u201d are with the Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,8,10]]},"reference":[{"key":"2024020920591799500_nuac052-B1","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1111\/j.1365-2036.2007.03502.x","article-title":"Increasing prevalence of coeliac disease over time","volume":"26","author":"Lohi","year":"2007","journal-title":"Aliment Pharmacol Ther."},{"key":"2024020920591799500_nuac052-B2","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/j.cgh.2017.06.037","article-title":"Global prevalence of celiac disease: systematic review and meta-analysis","volume":"16","author":"Singh","year":"2018","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2024020920591799500_nuac052-B3","first-page":"5","article-title":"Growth changes after gluten free diet in pediatric celiac patients: a literature-review","volume":"89","author":"Ghiselli","year":"2018","journal-title":"Acta Biomed."},{"key":"2024020920591799500_nuac052-B4","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1136\/gutjnl-2011-301346","article-title":"The Oslo definitions for coeliac disease and related terms","volume":"62","author":"Ludvigsson","year":"2013","journal-title":"Gut"},{"key":"2024020920591799500_nuac052-B5","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.dld.2019.11.010","article-title":"Therapeutic options for coeliac disease: what else beyond gluten-free diet?","volume":";52","author":"Caio","year":"2020","journal-title":"Dig Liver Dis"},{"key":"2024020920591799500_nuac052-B6","doi-asserted-by":"crossref","first-page":"170","DOI":"10.3390\/nu11010170","article-title":"Gluten-free diet: gaps and needs for a healthier diet","volume":"11","author":"Melini","year":"2019","journal-title":"Nutrients"},{"key":"2024020920591799500_nuac052-B7","first-page":"341","article-title":"Does a gluten-free diet increase body mass index and lipid profile in celiac patients? 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