Nutrition Assessment, Interventions, and Monitoring for Patients with Celiac Disease: An Evidence Scoping Review (P12-003-19)

Abstract

Objectives To conduct an evidence scoping review to determine the need/scope for a systematic review (SR) and evidence-based practice guideline (EBPG). Main objectives were: To identify and characterize studies examining nutrition assessment, interventions, and measures to monitor adherence/compliance in patients with celiac disease (CD). Methods 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 patients. All types of peer-reviewed articles, except for narrative review, grey literature, and case study/report, published between January 2007 and August 2018 were eligible. Two content advisors reviewed the search plan and findings. Results The literature search resulted in 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. The majority of the studies were observational studies (n = 212), followed by experimental trials (n = 50), EBPG/report/statement (n = 16), and SR (n = 14). Nine original studies examined assessment, focusing mainly on different tools/ways to assess gluten-free diet (GFD) adherence. Most of the included original articles (n = 235) were in the nutrition intervention category with GFD, oat, and prebiotics/probiotics as the top-three most studied interventions. There were eight SRs on GFD and five on oat. 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. Conclusions Based on the scoping review, interventions focused on gluten-free diet and oats have been significantly covered by either SRs or EBPGs. In recent years, evidence related to prebiotics/probiotics and education program/counseling focused interventions, as well as assessment, in CD patients has increased. Thus, it might be beneficial to conduct SRs/EBPG focused on these topics to guide practitioners. Funding Sources Academy of Nutrition and Dietetics.