Approximately 2 million Brazilians live with the disease; an expert explains how intestinal inflammation impacts health and metabolism

São Paulo, May 2026 – International Celiac Disease Day, observed on May 16th, is a global initiative that seeks to raise awareness about the condition that affects approximately 80 million people worldwide. Far beyond just gluten restriction, celiac disease has profound effects on the body, especially regarding metabolic health. Characterized by an immune response to gluten that damages the small intestine, the condition can lead to altered nutrient absorption, systemic inflammation, and significant changes in weight and body composition.

According to Dr. Alfio Souza Borghi, a nutritionist and coordinator of postgraduate studies in Nutrition at the São Leopoldo Mandic Faculty of Medicine, "celiac disease should not be seen merely as a gastrointestinal issue. There is a significant metabolic impact, which begins with intestinal inflammation and can affect the entire body. When the intestine does not function properly, the body becomes unbalanced."

A study published in the journal Intestinal Research showed that patients with celiac disease have a higher risk of developing metabolic syndrome and fatty liver disease, a risk that may increase after starting a gluten-free diet. After one year on the diet, the prevalence of metabolic syndrome rose from 11.4% to 18.2%, while cases of fatty liver disease increased from 14.3% to 29.5% among the patients evaluated.

Although classically associated with weight loss and malnutrition, celiac disease can also be related to the opposite scenario after diagnosis. This is because, upon starting a gluten-free diet and regaining intestinal absorption capacity, many patients begin to gain weight in an unregulated manner. The study itself points to a significant increase in weight, body mass index, and body fat after the introduction of a gluten-free diet.

“After diagnosis and starting a gluten-free diet, the patient usually experiences improved absorption. But this does not automatically mean metabolic balance. Often, there is weight gain associated with the excessive consumption of ultra-processed gluten-free products, which are nutritionally poor,” explains the specialist.

In this context, nutritional counseling becomes strategic. This specialty focuses on a detailed assessment of nutritional status, correction of deficiencies, individualized dietary adjustments, and monitoring of metabolic parameters throughout treatment. "Chronic inflammation of the intestinal mucosa compromises the absorption of essential nutrients, such as iron, vitamin B12, vitamin D, and proteins, all fundamental for energy metabolism and the maintenance of muscle mass. Furthermore, alterations in the gut microbiota can influence processes such as insulin resistance and appetite regulation," adds the doctor.

With approximately 2 million Brazilians living with celiac disease, the topic gains relevance as a public health challenge that goes beyond diet. Estimates from the National Federation of Celiac Associations of Brazil (Fenacelbra) indicate that a large proportion of cases remain invisible, which reinforces the importance of awareness and early diagnosis.

In this scenario, experts warn that treatment should not be limited to gluten exclusion. Proper nutritional and metabolic monitoring is essential to avoid complications and ensure quality of life: “It’s not enough to remove gluten. It’s necessary to rebalance the body as a whole. Nutrition comes in precisely to ensure that this patient recovers intestinal health without developing other problems, such as overweight, nutritional deficiencies, or metabolic disorders,” concludes Dr. Alfio.

About São Leopoldo Mandic

Considered one of the top ten higher education institutions in the country for 15 consecutive years according to the MEC's ​​General Course Index (IGC), the São Leopoldo Mandic Faculty in Campinas brings together a faculty of PhD professors with extensive scientific production, trained at the best educational institutions in Brazil and abroad. Structured with state-of-the-art laboratories, complete dental clinics, and practice settings in affiliated hospitals and Basic Health Units, the institution offers students practical experience in Dentistry and Medicine courses from the 1st year, as well as research activities and community service. It has realistic simulation laboratories, modern resources for diagnosis and training, and an innovation HUB, all serving undergraduate and postgraduate courses. It also has extension projects such as the Health Boat, which brings medical and dental care to underprivileged communities. The São Leopoldo Mandic Faculty is part of the Mandic Group, which has nine other postgraduate units distributed throughout the country and one in Portugal. The Group also includes three other undergraduate medical schools, located in the cities of Araras-SP, Limeira-SP, and the Sertão Medical School (FMS) in Arcoverde-PE.

Press Office of the Mandic Group Brazil:

Nayrim Pinheiro | InPress Porter Novelli – mandic@inpresspni.com.br  

Silvia Balbo Messias | São Leopoldo Mandic – silvia.balbo@slmandic.edu.br

Oriana Suprizzi | São Leopoldo Mandic – oriana.suprizzi@slmandic.edu.br