Sa1303 The Gluten-Free Diet Produces an Increased Body Mass Index and an Abnormal Waist Circumference Which Is Not Related to the Composition of Food Intake

Background/Aims: A gluten-free diet (GFD) is the only available long-life therapy for celiac disease (CD). Clinical presentation is diverse with few patients with underweight, while the great majority has either normal or overweight. In the general population, overweight causes increase in the waist circumference (WC), an anthropometric measurement associated to the cardiometabolic risk. However, this association has not been established in CD patients. Moreover, there are several evidences that suggest that these anthropometric changes are due to an unbalanced GFD as consequence of an inadequate food selection by patients. Our aims were double: (1) to determine body mass index (BMI) at diagnosis of CD, and (2) to assess changes in the BMI induced by treatment, and the WC and composition the food intake at least two-years after initiation of a GFD. Materials and methods: From July to November 2013, all adult patients with CD attending the ambulatory celiac disease clinic were enrolled in the study if they were on a GFD for at least 2 years. BMI (normal: 18.524.9 kg/m2) and WC (normal: women < 80 cm; men < 94 cm) were determined according to conventional measurements. The composition of food intake was estimated according to conventional formulas based on a food questionnaire by an expert nutritionist. Results: 56 consecutive patients (52 women; median age 48 years [range: 20-65]; time on a GFD: 5 years [range: 2-15]) were enrolled in the study. At diagnosis, 59% of patients had normal BMI, 25% had overweight or were obese, and 16% had underweight. Compared with findings at diagnosis, 93% of GFD treated CD patients had a significantly increased BMI (21 kg/m2 [range: 14-36] vs. 24 kg/m2 [range: 17-37], respectively; p<0.0001). Migration to a higher category was shown in 41% of patients. Twenty four out of 56 patients (43%) showed an abnormally high WC with an highly significant correlation with the final BMI ( r=0.86; 95% CI: 0.77-0.92; p<0.0001). Our dietary analysis has showed that 71% and 86% of patients did not cover the daily recommendation of vegetables and fruits, and that 48% and 71% reported a higher cereal and simple sugar consumption than recommended, respectively. Nevertheless, anthropometric measures did not correlated with the composition of food intake. Conclusions: Our study evidences that a long-term GFD significantly increases BMI generating a migration to higher categories. The WC, an anthropometric surrogate of cardiovascular risk, correlated with overweight and is abnormal in 43% of patients. According to our observations, these anthropometric findings did not seem to be associated to the inadequate composition of food intake.