Gluten-Free DietManual of Clinical Nutrition Management H- 5 Copyright © 2013 Compass Group, Inc.
Nutrition Evaluation and Monitoring
Persons with celiac disease may experience an improvement in symptoms after 3 to 6 days of consuming a
gluten-free diet, with full improvement of the intestinal mucosa within 6 months (23). Individuals with celiac
disease demonstrate improved quality of life after compliance with a gluten-free dietary pattern for at least 1
year (Grade II) (7). Celiac disease is a chronic disease. An asymptomatic state depends on lifelong maintenance
of the Gluten-Free Diet. Patients should be cautioned against ingesting gluten once they start to gain weight
and feel better. The ingestion of gluten damages the mucosa and causes recurrent symptoms, although
several weeks may lapse before the patient observes symptoms. Villous atrophy is significantly associated
with dietary compliance (Grade II) (7). Therefore, an assessment of dietary adherence is critical in determining
whether recurrent symptoms are related to gluten sensitivity or to an unrelated problem. Individuals who
are diagnosed with celiac disease and are not treated or do not adhere to a gluten-free diet are at greater risk
of developing osteoporosis and benign and malignant complications including lymphoma and other
autoimmune diseases such as type 1 diabetes mellitus (1-6).