Topical Area: Medical Nutrition, Nutrition Translation
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