{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T20:25:54Z","timestamp":1789503954393,"version":"build-2803163510"},"reference-count":75,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2019,7,13]],"date-time":"2019-07-13T00:00:00Z","timestamp":1562976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: A strictly gluten-free diet (GFD) is the basis for managing celiac disease (CD). Numerous studies have reported nutritional deficiencies\/imbalances ascribable to a GFD. The aim of this review is to describe nutritional deficiencies observed in children with celiac disease on a GFD, to discuss the clinical consequences related to these nutritional imbalances, and to identify strategies that may be adopted to treat them. Methods: We reviewed the MEDLINE and EMBASE databases between January 1998 and January 2019. Results: Children are, regardless of whether they are on a gluten-free diet or not, at risk of consuming too much fat and insufficient fiber, iron, vitamin D, and calcium. These imbalances may be exacerbated when children are on a gluten-free diet. In particular, the intake of folate, magnesium, zinc, and foods with a high glycemic index in children with CD who are on a GFD is significantly altered. Conclusions: Therapeutic protocols should include nutritional education to help teach subjects affected by disorders such as CD the importance of labels, the choice of foods, and the combination of macro- and micronutrients. Children with CD on a GFD should be encouraged to rotate pseudo-cereals, consume gluten-free commercial products that have been fortified or enriched, and use foods that are local and naturally gluten-free.<\/jats:p>","DOI":"10.3390\/nu11071588","type":"journal-article","created":{"date-parts":[[2019,7,15]],"date-time":"2019-07-15T04:55:27Z","timestamp":1563166527000},"page":"1588","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":140,"title":["Nutritional Deficiencies in Children with Celiac Disease Resulting from a Gluten-Free Diet: A Systematic Review"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9026-7758","authenticated-orcid":false,"given":"Giovanni","family":"Di Nardo","sequence":"first","affiliation":[{"name":"Chair of Pediatrics, School of Medicine and Psychology, NESMOS Department, Sapienza University of Rome, S. Andrea University Hospital, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Pia","family":"Villa","sequence":"additional","affiliation":[{"name":"Chair of Pediatrics, School of Medicine and Psychology, NESMOS Department, Sapienza University of Rome, S. Andrea University Hospital, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Conti","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Translational Medicine, Sant\u2019Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giusy","family":"Ranucci","sequence":"additional","affiliation":[{"name":"Pediatric Unit, AORN Santobono-Pausilipon, 80129 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Pacchiarotti","sequence":"additional","affiliation":[{"name":"Chair of Pediatrics, School of Medicine and Psychology, NESMOS Department, Sapienza University of Rome, S. Andrea University Hospital, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Principessa","sequence":"additional","affiliation":[{"name":"Chair of Pediatrics, School of Medicine and Psychology, NESMOS Department, Sapienza University of Rome, S. Andrea University Hospital, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Raucci","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Department, Bambino Ges\u00f9 Children Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9042-8120","authenticated-orcid":false,"given":"Pasquale","family":"Parisi","sequence":"additional","affiliation":[{"name":"Chair of Pediatrics, School of Medicine and Psychology, NESMOS Department, Sapienza University of Rome, S. Andrea University Hospital, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,7,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2419","DOI":"10.1056\/NEJMcp1113994","article-title":"Celiac disease","volume":"367","author":"Fasano","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/j.1536-4801.2005.tb00917.x","article-title":"North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Guideline for the diagnosis and treatment of celiac disease in children: Recommendations of the North American Society or Pediatric Gastroenterology, Hepatology and Nutrition","volume":"40","author":"Hill","year":"2005","journal-title":"J. Pediatr. Gastroenterol. 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