Antioxidant Consumption in Adults With Celiac Disease: A Cross-Sectional Evaluation

Yıl 2025, Cilt: 7 Sayı: 3, 884 - 893, 19.12.2025

Esma Oguz , Fatma Esra Güneş

https://doi.org/10.46413/boneyusbad.1670137

Öz

Aim: This study aimed to evaluate the antioxidant intake of adult celiac patients and healthy individuals based on their dietary records and responses to an antioxidant consumption frequency questionnaire.
Material and Method: This cross-sectional descriptive study was conducted between February and June 2021 at the Association of Living with Celiac in Türkiye. A total of 32 adult celiac patients and 33 healthy individuals were included. Dietary intake data were collected using three-day food records and a Food Frequency Questionnaire (FFQ). Total Antioxidant Status (TAS) was calculated from dietary records (dietary TAS) and FFQ responses (FFQ TAS) based on the antioxidant content of reported foods.
Results: The proportion of energy derived from fat was significantly higher in celiac patients (p=0.001), whereas carbohydrate and fiber intakes were higher in healthy controls. Intakes of thiamine, pyridoxine, folate, potassium, magnesium, phosphorus, and vitamin C were significantly lower in celiac patients, while no significant differences were observed for vitamins A and E, selenium, or zinc. Both dietary TAS and FFQ-derived TAS values were significantly higher in healthy individuals compared to celiac patients (dietary TAS: p=0.031; FFQ TAS: p=0.027). A positive correlation was observed between dietary TAS and zinc intake in celiac patients, and between dietary TAS and vitamin A intake in healthy controls.
Conclusion: Celiac patients had significantly lower antioxidant intake compared to healthy individuals. These findings underscore the need for further research to assess antioxidant status and its long-term health implications in this population.

Anahtar Kelimeler

Celiac disease , Antioxidants , Gluten-free diet , Food frequency questionnaire

Proje Numarası

28.01.2021/8

Yetişkin Çölyak Hastalarında Antioksidan Alımı: Kesitsel Bir Değerlendirme

Öz

Amaç: Bu çalışma, yetişkin çölyak hastalarının ve sağlıklı bireylerin antioksidan alımını, diyet kayıtları ve antioksidan tüketim sıklığı anketine yanıtları temel alarak değerlendirmeyi amaçlamıştır.
Gereç ve Yöntem: Kesitsel tanımlayıcı nitelikteki bu çalışma, Şubat–Haziran 2021 tarihleri arasında Türkiye’de Çölyakla Yaşam Derneği’nde yürütülmüştür. Çalışmaya 32 yetişkin çölyak hastası ve 33 sağlıklı birey dahil edilmiştir. Besin tüketim verileri, üç günlük besin kayıtları ve FFQ aracılığıyla elde edilmiştir. Toplam Antioksidan Durumu (TAS), bildirilen besinlerin antioksidan içerikleri esas alınarak diyet kayıtları (diyet TAS) ve FFQ yanıtları (FFQ TAS) üzerinden hesaplanmıştır.
Bulgular: Çölyak hastalarının enerji alımlarında yağdan gelen oran anlamlı düzeyde yüksek bulunurken (p=0.001), sağlıklı bireylerde karbonhidrat ve posa alımları daha yüksek saptanmıştır. Çölyak hastalarının tiyamin, pridoksin, folat, potasyum, magnezyum, fosfor ve C vitamini alımları anlamlı olarak düşük bulunmuş, A vitamini, E vitamini, selenyum ve çinko açısından ise gruplar arasında farklılık gözlenmemiştir. Hem diyet TAS hem de FFQ-TAS değerleri sağlıklı bireylerde çölyak hastalarına kıyasla anlamlı düzeyde yüksek bulunmuştur (diyet TAS: p=0.031; FFQ TAS: p=0.027). Çölyak grubunda diyet TAS ile çinko alımı, kontrol grubunda ise diyet TAS ile A vitamini alımı arasında pozitif ilişki saptanmıştır.
Sonuç: Çölyak hastalarının, sağlıklı bireylere kıyasla antioksidan alımının anlamlı düzeyde daha düşük olduğu saptanmıştır. Bu popülasyonda antioksidan durumunun ve uzun dönem sağlık sonuçlarının araştırılması için ileri çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Çölyak hastalığı , Antioksidanlar , Glutensiz diyet , Gıda Sıklığı Anketi

Proje Numarası

28.01.2021/8

Kaynakça

• Amarowicz, R., & Pegg, R. B. (2019). Natural antioxidants of plant origin. In Advances in Food and Nutrition Research (Vol. 90, pp. 1–81). Academic Press. doi:10.1016/bs.afnr.2019.02.011
• Barone, M., Della Valle, N., Rosania, R. E. A., Facciorusso, A., Trotta, A., Cantatore, F. P., ... & Francavilla, R. (2016). A comparison of the nutritional status between adult celiac patients on a long-term, strictly gluten-free diet and healthy subjects. European Journal of Clinical Nutrition, 70(1), 23–27. doi:10.1038/ejcn.2015.107
• Bianchi, P. I., Aronico, N., Santacroce, G., Broglio, G., Lenti, M. V., & Di Sabatino, A. (2024). Nutritional consequences of celiac disease and gluten-free diet. Gastroenterology Insights, 15(4), 878–894. doi:10.3390/gastroent15040061
• Cardo, A., García-Moral, A., & Cebolla, Á. (2021). Nutritional imbalances in gluten-free diet in celiac disease. Nutrients, 13(11), 4008. doi:10.3390/nu13082877
• Carlsen, M. H., Halvorsen, B. L., Holte, K., Bøhn, S. K., Dragland, S., Sampson, L., ... Blomhoff, R. (2010). The total antioxidant content of more than 3100 foods, beverages, spices, herbs and supplements used worldwide. Nutrition Journal, 9, 1–11. doi:10.1186/1475-2891-9-3
• Colarusso, L., Serafini, M., Lagerros, Y. T., Nyren, O., La Vecchia, C., Rossi, M., ... Wolk, A. (2017). Dietary antioxidant capacity and risk for stroke in a prospective cohort study of Swedish men and women. Nutrition, 33, 234–239. doi:10.1016/j.nut.2016.07.009
• Deora, V., Aylward, N., Sokoro, A., & El-Matary, W. (2017). Serum vitamins and minerals at diagnosis and follow-up in children with celiac disease. Journal of Pediatric Gastroenterology and Nutrition, 65(2), 185–189. doi:10.1097/MPG.0000000000001475
• Fasano, A., & Catassi, C. (2012). Celiac disease. New England Journal of Medicine, 367(25), 2419 2426. doi:10.1056/NEJMcp1113994
• Ferretti, G., Bacchetti, T., Saturni, L., Manzella, N., Candelaresi, C., Benedetti, A., ... Dastoli, G. (2012). Lipid peroxidation and paraoxonase-1 activity in celiac disease. Journal of Lipids, 2012, 587479. doi:10.1155/2012/587479
• Ghunaim, M., Seedi, A., Alnuman, D., Aljohani, S., Aljuhani, N., Almourai, M., ... & Seedi, A. Jr. (2024). Impact of a gluten-free diet in adults with celiac disease: Nutritional deficiencies and challenges. Cureus, 16(12), e74983. doi:10.7759/cureus.74983
• Güneş, E., & İmeryüz, N. (2008). Besin Atlası. Istanbul: Ada Ofset.
• Habel, L., Frankenfeld, C. L., Gallo, S., Moshfegh, A. J., & Slavin, M. (2017). Differences in nutritional intake and bone health among adults with and without celiac disease: Data from the National Health and Nutrition Examination Survey, 2009–2012. The FASEB Journal, 31(1 Supplement), 315.6. doi:10.1096/fasebj.31.1_supplement.315.6
• Hegazy, A. M., El-Sayed, E. M., Ibrahim, K. S., & Abdel-Azeem, A. S. (2019). Dietary antioxidant for disease prevention corroborated by the Nrf2 pathway. Journal of Complementary and Integrative Medicine, 16(3), 20180161. doi:10.1515/jcim-2018-0161
• Janciauskiene, S. (2020). The beneficial effects of antioxidants in health and diseases. Chronic Obstructive Pulmonary Disease, 7(3), 182–202. doi:10.15326/jcopdf.7.3.2019.0152
• King, J. A., Jeong, J., Underwood, F. E., Quan, J., Panaccione, N., Windsor, J. W., ... Kaplan, G. G. (2020). Incidence of celiac disease is increasing over time: A systematic review and meta analysis. American Journal of Gastroenterology, 115(4), 507–525. doi:10.14309/ajg.0000000000000523
• Koehler, P., Wieser, H., & Konitzer, K. (2014). Celiac disease – a complex disorder. In P. Koehler, H. Wieser, & K. Konitzer (Eds.), Celiac Disease and Gluten (pp. 1–96). 1st ed. Boston: Academic Press.
• Mahmud, F. H., De Melo, E. N., Noordin, K., Assor, E., Sahota, K., Davies-Shaw, J., ... Harrington, J. (2015). The Celiac Disease and Diabetes-Dietary Intervention and Evaluation Trial (CD DIET) protocol: A randomized controlled study to evaluate treatment of asymptomatic coeliac disease in type 1 diabetes. BMJ Open, 5(5), e008097. doi:10.1136/bmjopen-2015 008097
• Mazzola, A. M., Zammarchi, I., Valerii, M. C., Spisni, E., Saracino, I. M., Lanzarotto, F., & Ricci, C. (2024). Gluten-free diet and other celiac disease therapies: Current understanding and emerging strategies. Nutrients, 16(7), 1006. doi:10.3390/nu16071006
• Melini, V., & Melini, F. (2019). Gluten-free diet: Gaps and needs for a healthier diet. Nutrients, 11(1), 170. doi:10.3390/nu11010170
• Montonen, J., Knekt, P., Järvinen, R., & Reunanen, A. (2004). Dietary antioxidant intake and risk of type 2 diabetes. Diabetes Care, 27(2), 362–366. doi:10.2337/diacare.27.2.362
• Moretti, S., Mrakic-Sposta, S., Roncoroni, L., Vezzoli, A., Dellanoce, C., Monguzzi, E., ... & Elli, L. (2018). Oxidative stress as a biomarker for monitoring treated celiac disease. Clinical and Translational Gastroenterology, 9(6), e157. doi:10.1038/s41424-018-0031-6
• Noori, E., Hashemi, N., Rezaee, D., Maleki, R., Shams, F., Kazemi, B., ... & Rahimi, F. (2024). Potential therapeutic options for celiac disease: An update on current evidence from gluten-free diet to cell therapy. International Immunopharmacology, 133, 112020. doi:10.1016/j.intimp.2024.112020
• Öztag, M., & Güneş, F. E. (2022). Validation of a food frequency questionnaire for assessing total antioxidant status. Clinical Nutrition ESPEN, 48, 351–355. doi:10.1016/j.clnesp.2022.01.019
• Penagini, F., Dilillo, D., Meneghin, F., Mameli, C., Fabiano, V., & Zuccotti, G. V. (2013). Gluten-free diet in children: An approach to a nutritionally adequate and balanced diet. Nutrients, 5(11), 4553–4565. doi:10.3390/nu5114553
• Piątek-Guziewicz, A., Mach, T., Zagrodzki, P., Paśko, P., Krośniak, M., & Zwolińska-Wcisło, M. (2017). Ferric reducing ability of plasma and assessment of selected plasma antioxidants in adults with celiac disease. Folia Medica Cracoviensia, 57(4), 43–57.
• Piazza, S., Colombo, F., Bani, C., Fumagalli, M., Vincentini, O., Sangiovanni, E., ... Dell’Agli, M. (2023). Evaluation of the potential anti-inflammatory activity of black rice in the framework of celiac disease. Foods, 12(1), 63. doi:10.3390/foods12010063
• Pizzino, G., Irrera, N., Cucinotta, M., Pallio, G., Mannino, F., Arcoraci, V., ... Bitto, A. (2017).Oxidative stress: Harms and benefits for human health. Oxidative Medicine and Cellular Longevity, 2017, 8416763. doi:10.1155/2017/8416763
• Rivera, E., Assiri, A., & Guandalini, S. (2013). Celiac disease. Oral Diseases, 19(7), 635-641. doi:10.1111/odi.12091
• Rybicka, I. (2018). The handbook of minerals on gluten-free diet. Nutrients, 10(11), 1683. doi:10.3390/nu10111683
• Satia, J. A., Watters, J. L., & Galanko, J. A. (2009). Validation of an antioxidant nutrient questionnaire in Whites and African Americans. Journal of the American Dietetic Association, 109(3), 502–508. doi10.1016/j.jada.2008.11.033
• Serena, G., Lima, R., & Fasano, A. (2019). Genetic and environmental contributors for celiac disease. Current Allergy and Asthma Reports, 19(9), 40. doi: 10.1007/s11882-019-0871-5
• Suárez-González, M., Bousoño-García, C., Jiménez-Treviño, S., & Díaz-Martín, J. J. (2021). Gluten-free diet: Nutritional strategies to improve eating habits in children with celiac disease: A prospective, single-arm intervention study. Nutrients, 13(4), 1108. doi:10.3390/nu13041108
• Thompson, T., Dennis, M., Higgins, L. A., Lee, A. R., & Sharrett, M. K. (2005). Gluten-free diet survey: Are Americans with coeliac disease consuming recommended amounts of fibre, iron, calcium and grain foods? Journal of Human Nutrition and Dietetics, 18(3), 163–169. doi:10.1111/j.1365-277X.2005.00607.x
• Ting, A., Katz, T., Sutherland, R., Liu, V., Tong, C. W., Gao, Y., ... & Ooi, C. Y. (2020). Evaluating the dietary intakes of energy, macronutrients, sugar, fiber, and micronutrients in children with celiac disease. Journal of Pediatric Gastroenterology and Nutrition, 71(2), 246–251. doi:10.1097/MPG.0000000000002743
• Unalp-Arida, A., Liu, R., & Ruhl, C. E. (2022). Nutrient intake differs among persons with celiac disease and gluten-related disorders in the United States. Scientific Reports, 12(1), 5566. doi:10.1038/s41598-022-09346-y
• van Megen, F., Fossli, M., Skodje, G. I., Carlsen, M. H., Andersen, L. F., Veierød, M. B., ... & Henriksen, C. (2023). Nutritional assessment of women with celiac disease compared to the general population. Clinical Nutrition ESPEN, 54, 251–257. doi10.1016/j.clnesp.2023.01.031
• Vici, G., Belli, L., Biondi, M., & Polzonetti, V. (2016). Gluten-free diet and nutrient deficiencies: A review. Clinical Nutrition, 35(6), 1236–1241. doi:10.1016/j.clnu.2016.05.002
• Wang, S., Teng, H., Zhang, L., & Wu, L. (2024). Association between dietary antioxidant intakes and chronic respiratory diseases in adults. World Allergy Organization Journal, 17(1), 100851. doi: 10.1016/j.waojou.2023.100851