Effects of a 60-day gluten-free chapatti intervention on hematologic and renal biomarkers in celiac disease: pre-post analysis

Celiac disease (CD) often coexists with anemia and biochemical abnormalities and requires a lifelong gluten-free (GF) diet to prevent adverse health effects. This study explores the changes in hematologic and biochemical markers during a 60-day GF chapatti intervention and characterizes the product’s composition. In a prospective, single-arm pre-post study (n = 130; 65 male, 65 female), participants consumed a GF chapatti formulated from corn, chickpea, and rice flour (40 %, 50 %, and 10 %). Venous blood was collected at baseline and follow-up visits (Days 0, 15, 30, 45, and 60). Primary endpoints included hemoglobin (Hb) and hematocrit (HCT); secondary endpoints included red-blood-cell indices, urea, creatinine (Cr), bilirubin fractions, ferritin, serum iron, TIBC, and sTfR. Single-arm pre-post blood glucose (BG) was measured under nonfasting conditions. Proximate analysis revealed that chickpea and corn flours provided higher protein (17.58% and 11.37%, respectively) and fiber (8.16% in corn) compared to rice and wheat. Posttreatment chapatti showed improved nutritional content (13% protein, 1.6% fiber). Volunteers exhibited gradual increases in weight and height. Hb levels were significantly high, and glucose levels were stabilized. Iron status recovered markedly: Ferritin and serum iron increased considerably in both sexes (p < 0.001), while TIBC and sTfR also rose (p < 0.001), indicating improved erythropoiesis. Inflammation declined: Both hs-CRP and AGP had a p-value of < 0.001. Kidney function improved (decline in urea and Cr). Liver markers (bilirubin, alkaline phosphatase (ALP), and SGPT-ALT) also showed favorable trends, indicating no adverse hepatic effects. A 60-day GF chapatti intervention was associated with improvements in anemia-related markers and no adverse trends in renal/hepatic function.