title: Changes in body mass index on a gluten-free diet in coeliac disease: a nationwide study.
abstract: OBJECTIVE
  The clinical presentation of coeliac disease has changed and patients are often overweight at diagnosis. There is concern that patients might gain further weight while on a gluten-free diet (GFD). The aim of the study was to evaluate the impact of a GFD on the body mass index (BMI) in a nationwide cohort of coeliac patients and to determine variables predictive of favourable or unfavourable BMI changes.
  
  
  METHODS
  We prospectively investigated weight and disease-related issues in 698 newly detected adults diagnosed due to classical or extraintestinal symptoms or by screening. BMI at diagnosis and after one year on a GFD were assessed and compared with that in the general population.
  
  
  RESULTS
  At diagnosis, 4% of subjects were underweight, 57% normal, 28% overweight and 11% obese. On a GFD, 69% of underweight patients gained and 18% of overweight and 42% of obese lost weight; in the rest BMI remained stable. Changes were similar in both symptom- and screen-detected patients. The coeliac group had a more favourable BMI pattern than the general population. Favourable BMI changes were associated with subjects' self-rated expertise on GFD and young age at diagnosis, but not dietary counselling received.
  
  
  CONCLUSIONS
  BMI improved similarly in screen- and symptom-detected coeliac disease patients on a GFD.
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Anniina
authors.initials: A
authors.lastname: Ukkola
authors.forename: Markku
authors.initials: M
authors.lastname: Mäki
authors.forename: Kalle
authors.initials: K
authors.lastname: Kurppa
authors.forename: Pekka
authors.initials: P
authors.lastname: Collin
authors.forename: Heini
authors.initials: H
authors.lastname: Huhtala
authors.forename: Leila
authors.initials: L
authors.lastname: Kekkonen
authors.forename: Katri
authors.initials: K
authors.lastname: Kaukinen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002446:Celiac Disease / Q000178:diet therapy* / Q000503:physiopathology*; D055050:Diet, Gluten-Free; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D055815:Young Adult