Br J Nutr. 2025 Nov 5:1-33. doi: 10.1017/S0007114525105618. Online ahead of print.
ABSTRACT
Children with Coeliac disease (CD) on a gluten-free diet (GFD) often have poor dietary quality (DQ). A Gluten-Free Food Guide (GFFG) was developed to address this. This pilot randomized controlled trial evaluated the impact of GFFG dietary counselling on DQ and ultra-processed food (UPF) intake in newly diagnosed CD children. Child-parent pairs were randomized to the standard of care only (CON: n = 20) or the intervention (INT: standard of care + GFFG; n = 20). Primary outcomes included DQ (Healthy Eating Index-Canadian) and UPF intake (NOVA classification), assessed at baseline (BL), 3 and 6 months. In INT, dietary variety scores, a subcomponent of DQ, increased between BL-3mo (BL: 6.7 [3.3-6.7] vs. 3mo: 10 [10-10]; p = 0.01), and in higher variety scores than CON at 3 months (p < 0.01). Total DQ and UPF intake remained unchanged. Increased dietary variety in INT was associated with increases in dairy (BL: 7.5 ± 3.6% vs. 3mo: 12.4 ± 6.7%; p = 0.01) and unsweetened milk (BL: 2.5 ± 2.2% vs. 3mo: 4.7 ± 3.0%; p = 0.01) servings, consumed as a percentage of the total food group servings. These improvements were not observed at 6 months. A greater number of INT children met the GFFG protein recommendation at 3 months (BL: 0/19 vs. 3 mo: 5/19; p = 0.01), with no change in CON. A single GFFG session improved short-term dietary variety and unsweetened milk intake. Ongoing work addressing the GF-food environment, dietitian access, and policies to improve DQ is needed.
PMID:41190444 | DOI:10.1017/S0007114525105618
