{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T22:41:11Z","timestamp":1788475271365,"version":"build-2803163510"},"reference-count":42,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T00:00:00Z","timestamp":1652745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"King Saud University","award":["RSP-2021\/84"],"award-info":[{"award-number":["RSP-2021\/84"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>This cross-sectional study examines the influence of long-term gluten-free diet (GFD) consumption on nutritional status, body composition, and associated factors in adult Saudi females with celiac diseases (CD). Fifty-one patients who have been diagnosed with CD and have been on GFD for more than 1 year were included in this study where data regarding their dietary pattern, as well as a complete analysis of their anthropometric parameters, vitamins B12 and D levels, and complete blood count (CBC), were collected. Data have shown that all included patients showed a reduced intake in all micro and macro-nutrients, as well as vitamin D, folate, calcium, and iron. However, the vast majority of all measured hematological parameters and blood indices were within the expected reference range. In addition, 51%, 43.1%, and 60.8% of the patients showed low waist\/hip ratio (WHR), decreased level of total body fat (BF), and decreased level of visceral fat (VF), respectively, whereas 33.3% were slim. The poor educational level and some psychosocial factors were associated with the poor nutritional status of the patients. In conclusion, the GFD-dependent intake by female patients with CD adversely affects their nutritional intake and anthropometric indices and leads to a deficiency in major nutrients, vitamins, and ions.<\/jats:p>","DOI":"10.3390\/nu14102090","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T08:34:29Z","timestamp":1652776469000},"page":"2090","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Long-Term Effect of Gluten-Free Diets on Nutritional Status, Body Composition, and Associated Factors in Adult Saudi Females with Celiac Disease"],"prefix":"10.3390","volume":"14","author":[{"given":"Aeshah Ibrahim","family":"Alhosain","sequence":"first","affiliation":[{"name":"Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2043-1209","authenticated-orcid":false,"given":"Ghedeir M.","family":"Alshammari","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barakat Lafi","family":"Almoteri","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Buraidah Central Hospital, Ministry of Health, Buraydah 52361, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9737-2297","authenticated-orcid":false,"given":"Mohammed A.","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manal Abdulaziz","family":"Binobead","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5665-9600","authenticated-orcid":false,"given":"Mohammed Abdo","family":"Yahya","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1111\/1750-3841.13612","article-title":"Physiopathology and management of gluten-induced celiac disease","volume":"82","author":"Kumar","year":"2017","journal-title":"J. Food Sci."},{"key":"ref_2","first-page":"6865917","article-title":"The epidemiology of CDin the general population and high-risk groups in Arab countries: A systematic review","volume":"2020","author":"Toivola","year":"2020","journal-title":"BioMed Res. Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1177\/0884533611399773","article-title":"Nutritional and dietary aspects of celiac disease","volume":"26","author":"Lucendo","year":"2011","journal-title":"Nutr. Clin. Pract."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1056\/NEJMra071600","article-title":"Celiac disease","volume":"357","author":"Green","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/01.mpg.0000228102.89454.eb","article-title":"Nutritional management of the gluten-free diet in young people with CD in The Netherlands","volume":"43","author":"Hopman","year":"2006","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1159\/000348850","article-title":"Inadequate nutrient intake in patients with celiac disease: Results from a German dietary survey","volume":"87","author":"Martin","year":"2013","journal-title":"Digestion"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1038\/ejcn.2015.114","article-title":"A comparison of the nutritional status between adult celiac patients on a long-term, strictly gluten-free diet and healthy subjects","volume":"70","author":"Barone","year":"2016","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"16","DOI":"10.3390\/nu2010016","article-title":"The gluten-free diet: Safety and nutritional quality","volume":"2","author":"Saturni","year":"2010","journal-title":"Nutrients"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Melini, V., and Melini, F. (2019). Gluten-free diet: Gaps and needs for a healthier diet. Nutrients, 11.","DOI":"10.3390\/nu11010170"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Polzonetti, V., Pucciarelli, S., Vincenzetti, S., and Polidori, P. (2020). Dietary intake of vitamin D from dairy products reduces the risk of osteoporosis. Nutrients, 12.","DOI":"10.20944\/preprints202002.0465.v1"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"154","DOI":"10.4321\/S1130-01082013000300006","article-title":"Bone mineral density in adult coeliac disease: An updated review","volume":"105","author":"Lucendo","year":"2013","journal-title":"Rev. Esp. Enferm. Dig."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1080\/003655200750024146","article-title":"Three years\u2019 follow-up of bone density in adult coeliac disease: Significance of secondary hyperparathyroidism","volume":"35","author":"Valdimarsson","year":"2000","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2252","DOI":"10.1111\/j.1532-5415.2008.02039.x","article-title":"Association between changes in habitual physical activity and changes in bone density, muscle strength, and functional performance in elderly men and women","volume":"56","author":"Daly","year":"2008","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1093\/ajcn\/72.4.937","article-title":"Body composition and dietary intakes in adult CD patients consuming a strict gluten-free diet","volume":"72","author":"Bardella","year":"2000","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"5515","DOI":"10.3390\/nu7075234","article-title":"Analysis of body composition and food habits of Spanish celiac women","volume":"7","author":"Churruca","year":"2015","journal-title":"Nutrients"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1111\/apt.14910","article-title":"Increased risk of nonalcoholic fatty liver disease in patients with coeliac disease on a gluten-free diet: Beyond traditional metabolic factors","volume":"48","author":"Tovoli","year":"2018","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.dld.2005.11.013","article-title":"Anti-ganglioside antibodies in coeliac disease with neurological disorders","volume":"38","author":"Volta","year":"2006","journal-title":"Dig. Liver Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/S1590-8658(00)80354-0","article-title":"Prevalence of silent coeliac disease in atopics","volume":"32","author":"Zauli","year":"2000","journal-title":"Dig. Liver Dis."},{"key":"ref_19","unstructured":"World Health Organization (WHO) (1997). Obesity: Preventing and Managing the Global Epidemic: Report of a WHO Consultation on Obesity, World Health Organization."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1016\/j.clnu.2004.06.004","article-title":"Bioelectrical impedance analysis\u2014Part I: Review of principles and methods","volume":"23","author":"Kyle","year":"2004","journal-title":"Clin. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1038\/ejcn.2009.139","article-title":"Body fat distribution and noncommunicable diseases in populations: Overview of the 2008 WHO Expert Consultation on Waist Circumference and Waist\u2013Hip Ratio","volume":"64","author":"Nishida","year":"2010","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/j.1467-789X.2011.00952.x","article-title":"Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardio-metabolic risk factors: Systematic review and meta-analysis","volume":"13","author":"Ashwell","year":"2012","journal-title":"Obes. Rev."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1007\/s11130-011-0244-2","article-title":"Chemical composition and starch digestibility of different gluten-free breads","volume":"66","author":"Segura","year":"2011","journal-title":"Plant Foods Hum. Nutr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1007\/s00394-018-1685-2","article-title":"Gluten-free-rendered products contribute to imbalanced diets in children and adolescents with celiac disease","volume":"58","author":"Larretxi","year":"2019","journal-title":"Eur. J. Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1016\/j.clnu.2016.05.002","article-title":"Gluten free diet and nutrient deficiencies: A review","volume":"35","author":"Vici","year":"2016","journal-title":"Clin. Nutr."},{"key":"ref_26","first-page":"129","article-title":"Prevalence of bone loss in adult CD and associated factors: A control case study","volume":"90","author":"Younes","year":"2012","journal-title":"Tunis Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/j.thromres.2011.05.007","article-title":"Normal range of mean platelet volume in healthy subjects: Insight from a large epidemiologic study","volume":"128","author":"Demirin","year":"2011","journal-title":"Thromb. Res."},{"key":"ref_28","first-page":"745","article-title":"Platelet distribution width (PDW): A putative marker for threatened preterm labour","volume":"30","author":"Ulkumen","year":"2014","journal-title":"Pak. J. Med. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1080\/14737159.2018.1407244","article-title":"Novel applications for serum procalcitonin testing in clinical practice","volume":"18","author":"Choi","year":"2018","journal-title":"Expert Rev. Mol. Diagn."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1097\/MCG.0b013e318266f81b","article-title":"Vitamin D status and concomitant autoimmunity in celiac disease","volume":"47","author":"Tavakkoli","year":"2013","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.numecd.2011.10.002","article-title":"Changes of body mass index in celiac children on a gluten-free diet","volume":"23","author":"Brambilla","year":"2013","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_32","first-page":"11","article-title":"Patients with coeliac disease are increasingly overweight or obese on presentation","volume":"21","author":"Tucker","year":"2012","journal-title":"J. Gastrointest. Liver Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1038\/ejcn.2010.161","article-title":"CD and obesity: Need for nutritional follow-up after diagnosis","volume":"64","author":"Valletta","year":"2010","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_34","first-page":"374","article-title":"Is compliance with gluten-free diet sufficient? Diet composition of celiac patients","volume":"57","author":"Balamtekin","year":"2015","journal-title":"Turk. J. Pediatr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1159\/000116772","article-title":"Affective and psychiatric disorders in celiac disease","volume":"26","author":"Addolorato","year":"2008","journal-title":"Dig. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.jad.2006.08.032","article-title":"Coeliac disease and risk of mood disorders\u2014A general population-based cohort study","volume":"99","author":"Ludvigsson","year":"2007","journal-title":"J. Affect. Disord."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1080\/00365520701768802","article-title":"Social phobia in coeliac disease","volume":"43","author":"Addolorato","year":"2008","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.dld.2006.01.004","article-title":"Psychological well-being of adult coeliac patients treated for 10 years","volume":"38","author":"Roos","year":"2006","journal-title":"Dig. Liver Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1111\/j.1365-2036.2006.03227.x","article-title":"Predictors of reduced health-related quality of life in adults with coeliac disease","volume":"25","author":"Stallmach","year":"2007","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Joelson, A.M., Geller, M.G., Zylberberg, H.M., Green, P.H., and Lebwohl, B. (2018). The effect of depressive symptoms on the association between gluten-free diet adherence and symptoms in celiac disease: Analysis of a patient powered research network. Nutrients, 10.","DOI":"10.3390\/nu10050538"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1177\/1742395311417639","article-title":"Psychiatric comorbidities in women with celiac disease","volume":"8","author":"Arigo","year":"2012","journal-title":"Chronic Illn."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Zysk, W., G\u0142\u0105bska, D., and Guzek, D. (2018). Social and emotional fears and worries influencing the quality of life of female celiac disease patients following a gluten-free diet. Nutrients, 10.","DOI":"10.3390\/nu10101414"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/10\/2090\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:11:41Z","timestamp":1760137901000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/10\/2090"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,17]]},"references-count":42,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["nu14102090"],"URL":"https:\/\/doi.org\/10.3390\/nu14102090","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,17]]}}}