## 5 Nutritional Tips for an Adequate and Balanced Diet
### Increase Polyunsaturated Fatty Acid Intake  
The associations between metabolic diseases and dietary fat quality and quantity are well-known. Several studies assessed positive associations between saturated fatty acids (SFAs) intake and increased body weight [67; 68]. On the other hand, both positive [68; 69] and negative [70] relationships between monounsaturated fatty acids (MUFAs) intake and risk of obesity have been assessed. As regards polyunsaturated fatty acids (PUFAs), inverse [71; 72], null [68; 73], and positive [68; 74] associations have been reported between their consumption and risk of obesity. PUFAs are classified in n-3 fatty acids and n-6 fatty acids. Omega-3 fatty acids hold great promise in the prevention and management of obesity [75]. Furthermore, a randomized controlled trial showed that, unlike the SFA-rich diet, an n-6 PUFA-rich diet was associated with improvements in blood lipids and fasting insulin [76]. More specifically, a low ratio of n-6/omega-3 fatty acids intake may reduce the risk of many of various chronic diseases [77]. Thus, regular consumption of flaxseed, nuts, fish and vegetable oils, such as olive and canola oil, may be useful to deal with obesity and to improve the lipid profile. The study by [PERSON] et al., enrolling Swedish celiac children, observed a relatively high mean intake of SFAs and a low intake PUFAs (respectively 14% and less than 4% of the total calorie intake) [44]. [PERSON] et al. [12] studied the nutritional intake of 71 patients following a strict GFD and 142 healthy control subjects matched by sex and age. The diet of the CD patients was unbalanced, with a higher percentage of energy as fat and a lower percentage of energy as carbohydrates than healthy controls [12]. Another study [46] examined the dietary intake of 47 adolescents with CD compared with 47 healthy age-matched control subjects. Patients with CD and control subjects both consumed a normocaloric diet; however, lipid and protein consumption was higher and that of carbohydrates lower in CD patients compared with controls [46].  
As regards fatty lipid profiles of GFPs, a recent study evaluated the composition of 35 bakery GFPs [78]. In such products, the main lipid constituents were MUFAs (57%), followed by SFAs (30%) and PUFAs (13%) [78]. Less than half of the 35 GFPs provided adequate energy intake, while in 11 samples, SFAs were found to supply more energy than that recommended by the European Food Safety Authority (EFSA). Moreover, high-value GFPs manufacturers also use palm oils, whereas the local producers generally contain the finest raw materials, such as olive oil [78]. Another study evaluated the quality of the lipid fraction of gluten-free biscuits [79]. The fatty fraction of gluten-free biscuits, present as mean amounts of 15% of total energy, indicated a high content of triacylglycerglycerol oligopolymers (0.46%) and oxidized triacylglycerlycerols (0.80%), as well as, in some cases, high levels of oleic acid trans isomers (reaching of 9.39%). All these substances have been shown to negatively impact health [80]. Since the diet of celiac patients often contains a high consumption of packaged GFPs (such as snacks, bakery products, and biscuits), this should be seriously considered.  
All these findings raise the question of an appropriate quantity and quality intake of lipids in celiac patients following GFD to maintain a healthy blood lipid profile and prevent metabolic diseases.