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Celiac Disease in Normal-weight and Overweight Children: Clinical Features and Growth Outcomes Following a Gluten-free Diet

Reilly, Norelle Rizkalla*; Aguilar, Kathleen; Hassid, Benjamin G.; Cheng, Jianfeng; DeFelice, Amy R.*; Kazlow, Philip*; Bhagat, Govind§; Green, Peter H.

Journal of Pediatric Gastroenterology & Nutrition: November 2011 - Volume 53 - Issue 5 - p 528–531
doi: 10.1097/MPG.0b013e3182276d5e
Original Article: Gastroenterology

Objectives: There are few data on pediatric celiac disease in the United States. The aim of our study was to describe the presentation of celiac disease among children with a normal and an elevated body mass index (BMI) for age, and to study their BMI changes following a gluten-free diet (GFD).

Patients and Methods: One hundred forty-two children (age 13 months–19 years) with biopsy-proven celiac disease, contained in a registry of patients studied at our center from 2000 to 2008, had follow-up growth data available. Patients’ height, weight, and BMI were converted to z scores for age and grouped by BMI as underweight, normal, and overweight. Compliance was confirmed using results of serological assays, and data of noncompliant patients were analyzed separately. Data were analyzed during the observation period and were expressed as change in height, weight, and BMI z score per month of dietary treatment.

Results: Nearly 19% of patients had an elevated BMI at diagnosis (12.6% overweight, 6% obese) and 74.5% presented with a normal BMI. The mean duration of follow-up was 35.6 months. Seventy-five percent of patients with an elevated BMI at diagnosis decreased their BMI z scores significantly after adherence to a GFD, normalizing it in 44% of cases. Of patients with a normal BMI at diagnosis, weight z scores increased significantly after treatment, and 13% became overweight.

Conclusions: Both normal weight and overweight frequently occur in North American children presenting with celiac disease. A GFD may have a beneficial effect upon the BMI of overweight and obese children with celiac disease.

*Division of Pediatric Gastroenterology, Hepatology, and Nutrition

Department of Medicine, Columbia University Medical Center, New York

Virginia Commonwealth University, Richmond

§Department of Pathology, Columbia University Medical Center, New York, NY.

Address correspondence and reprint requests to Norelle Rizkalla Reilly, MD, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Columbia University Medical Center, 3959 Broadway, CHC 7-702, New York, NY 10032 (e-mail:

Received 14 January, 2011

Accepted 2 June, 2011

This project was supported by grant no. UL1 RR024156 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research.

The authors report no conflicts of interest.

Copyright 2011 by ESPGHAN and NASPGHAN