Date of Award

5-2025

Document Type

Thesis

Degree Name

Master of Science in Nutrition Science

Department

Health Science and Human Ecology

First Reader/Committee Chair

Teolar-Peterson, Terezie

Abstract

Celiac disease (CD) is a chronic autoimmune disease triggered by the ingestion of gluten in genetically susceptible individuals, leading to villous atrophy, nutrient malabsorption, and a range of systemic complications. Although adherence to a strict gluten-free diet (GFD) remains the only effective treatment, growing evidence suggests that the GFD alone may be insufficient in meeting the long-term nutritional and psychosocial needs of adults with CD. This systematic review evaluates the prevalence and persistence of micronutrient deficiencies—including iron, calcium, vitamin D, folate, vitamin B12, magnesium, and zinc—in adult CD populations following a GFD. It also examines the psychological burden associated with lifelong dietary restriction, including food-related anxiety, social isolation, and disordered eating behaviors. The review aims to (1) assess the prevalence of specific micronutrient deficiencies in celiac patients adhering to a GFD, (2) evaluate dietary strategies such as supplementation and diversification, and (3) explore the effects of dietary restriction on nutrient status. Seven peer-reviewed studies published between 2016 and 2025 were selected according to PRISMA guidelines. Across all studies, micronutrient deficiencies remained prevalent despite dietary adherence. Psychosocial impacts were found to exacerbate dietary challenges and reduce quality of life. The findings emphasize the critical role of registered dietitians and systemic changes to support optimal outcomes.

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