Does gluten-free diet lead to weight gain in adults with celiac disease?

A gluten-free diet (GFD), which involves higher sugar and fat intakes, may result in greater BMI in some patients with celiac disease (CD), according to a study. 

A systematic search of Medline, Scopus, and Embase databases led to the identification of 1,565 potential abstracts and studies. Those that analysed CD patients under a GFD with recorded BMI before and after dietary intervention were included in the meta-analysis. 

Researchers also conducted subgroup analyses based on the study design and BMI categories. They calculated the pooled odds ratios (ORs) and 95 percent confidence intervals (CIs) for the proportion of patients in each BMI group based on the World Health Organization definitions after GFD using fixed and random effect meta-analysis. 

Ten studies and 38 substudies/datasets met the eligibility criteria. A total of 2,450 patients from five countries were included. 

BMI did not significantly change after GFD (pooled OR, 0.972, 95 percent CI, 0.858–1.101; p=0.65), but this was not the case in the subgroup analysis. Underweight (OR, 0.588, 95 percent CI, 0.479–0.723; p<0.001) and overweight patients (OR, 1.332, 95 percent CI, 1.167–1.521; p<0.001) were more likely to have a change in their BMI category following GFD. 

Of note, publication bias was not observed, and there was a moderate amount of heterogeneity (I2, 54.13) between studies. 

"Although crucial in patients with CD, GFD is associated with increased BMI in some CD patient populations,” the researchers said. “Accordingly, special considerations and follow-up should be maintained in overweight patients with CD after GFD.”