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Evidence Analysis Center
Nutrition Assessment, Interventions, and Monitoring for Patients with Celiac Disease: An Evidence Analysis Center Scoping Review

https://doi.org/10.1016/j.jand.2019.09.019Get rights and content

Abstract

The objectives of this scoping review were to identify and characterize studies examining nutrition assessment, interventions, and measures to monitor gluten-free diet (GFD) adherence/compliance in patients with celiac disease (CD). An electronic literature search of four databases (Cochrane Database for systematic reviews, CINAHL, Embase, and Ovid MEDLINE) was conducted to identify articles examining nutrition care in CD individuals. Except for narrative review, grey literature, and case study/report, all types of peer-reviewed articles published between January 2007 and August 2018 were eligible. There were a total of 10,823 records; 10,368 were excluded during the first round of screening due to irrelevancy and/or duplication. Of the 455 full-text articles that were assessed, 292 met the criteria and were included. Most of the studies were observational studies (n=212), followed by experimental trials (n=50), evidence-based practice guideline (EBPG)/report/statement (n=16), and systematic review (SR) (n=14). Nine original studies examined assessment, focusing mainly on different tools/ways to assess GFD adherence. The majority of the included original articles (n=235) were in the nutrition intervention category with GFD, oats, and prebiotics/probiotics as the top-three most studied interventions. There were eight SRs on GFD and five on oats. One SR and 21 original studies investigated the effectiveness of different measures to monitor GFD adherence/compliance. Although recent CD EBPGs were identified, different methods with varying levels of rigor, in terms of literature search and assessment of evidence strength, were used. Based on this scoping review, interventions focused on gluten-free diet and oats have been significantly covered by either SRs or EBPGs. Studies related to prebiotics/probiotics and education program/counseling focused interventions, as well as assessment, in CD patients have increased in recent years. Thus, it might be beneficial to conduct SRs/EBPGs focused on these topics to guide practitioners.

Section snippets

Protocol

This scoping review used and adapted the methodological framework from the works of Arskey and O’Malley,10 Levac and colleagues (updated version),8 and the Joanna Briggs Institute,11 and also followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.12

Findings

The literature search resulted in 10,810 articles with 13 additional studies identified through other sources. A total of 6,647 and 3,721 records were removed because of duplication and lack of relevancy, respectively (Figure 2). Of the 455 full-text articles that were assessed, 292 met the a priori inclusion criteria and were included in this scoping review.

The majority of the studies were observational studies (ie, cohort, case-control, cross-sectional, or validation studies) (n=212),

Conclusions and Future Direction

This scoping review completed a comprehensive literature search to examine the availability of literature on the validity and reliability of nutrition assessment methods, nutrition interventions, and tools/measures to monitor adherence/compliance among individuals with CD.

Based on the scoping review, some topics (eg, gluten-free diet, oats) were already covered by either a recent guideline or systematic review. For instance, a 2017 systematic review on consumption of oat241 included 12 of the

Acknowledgements

The authors would like to thank Anne Lee, EdD, RDN, LD (content advisor), Mary Sharrett, MS, RD, LD, CNSC (content advisor), and Margaret Foster, MS, MPH, AHIP (librarian) for their contributions to this project. The authors would also like to thank the Academy of Nutrition and Dietetics, Medical Nutrition Practice Group DPG, and the Academy of Nutrition and Dietetics Foundation for their financial support.

Author Contributions

Both authors were involved in the data collection and manuscript writing.

F. W. Cheng is a nutrition researcher, Evidence Analysis Center, Academy of Nutrition and Dietetic, Chicago, IL.

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    F. W. Cheng is a nutrition researcher, Evidence Analysis Center, Academy of Nutrition and Dietetic, Chicago, IL.

    D. Handu is senior scientific director, Evidence Analysis Center, Academy of Nutrition and Dietetic, Chicago, IL.

    STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.

    FUNDING/SUPPORT Funding provided by the Academy of Nutrition and Dietetics, Medical Nutrition Practice Group DPG, Academy of Nutrition and Dietetics Foundation.

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