Nutrition assessment and management in celiac disease.

CeD is the most common immune condition affecting the gastrointestinal tract; it is triggered by gluten and the only available treatment is a strict gluten-free diet (GFD). Therefore, for patients with CeD, adopting a GFD is not a lifestyle choice. The major problem is that a GFD is restrictive, and like all restrictive diets, it has the potential for adverse nutritional outcomes, especially if adopted for a long-term. It is well known that GFD can be nutritionally inadequate and is frequently associated with vitamin and mineral deficiencies; it is, also, associated with excessive sugar and fat intake, particularly when gluten-free substitutes are consumed. Consequently, people with CeD are affected by higher rates of overweight and obesity, and metabolic complications such as fatty liver and cardiovascular disease. Therefore, assessment of nutritional status and diet quality upon diagnosis, and during long-term GFD is key in the management of CeD. This narrative review addresses nutritional considerations in CeD and management of common challenges associated with a gluten-free diet.