scholarly journals Barriers to Long-Term Maintenance of a Gluten-Free Diet in People With Celiac Disease

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 958-958
Author(s):  
Hannah Amos ◽  
BeiLi Chng ◽  
Alexandra Kazaks ◽  
Terri Stilson ◽  
Maribeth Evezich
Keyword(s):  
Social Support ◽  
Celiac Disease ◽  
Online Survey ◽  
Eating Habits ◽  
Grocery Stores ◽  
Gluten Free ◽  
Food Accessibility ◽  
Research Survey ◽  
Food Knowledge ◽  
Knowledge Barriers

Abstract Objectives Currently the only treatment for celiac disease (CD), an autoimmune disease triggered by ingestion of the protein gluten, is a gluten-free (GF) diet. This study aimed to examine some barriers (GF food accessibility, social support, GF food knowledge) to maintaining a GF diet. Methods A deidentified online survey with REDCap was shared with people with celiac disease via social media (celiac disease group and research survey exchange group via Reddit, research survey exchange groups via Facebook, celiac disease Discord server). The survey included questions about diagnosis, symptoms, social support, eating habits, GF food access, disease impact, gluten-free knowledge, and demographics. Analysis included descriptive statistics and qualitative measures were used to determine themes. Results Of the 123 responses, 54.5% were diagnosed with CD by small intestine biopsy, 85.1% maintained a GF diet, and 35.2% had CD symptoms for 1–4 years before receiving a diagnosis. Concerning accessibility, 47.9% reported having some difficulty affording GF foods and 49.2% that local grocery stores had limited selection of GF foods. An analysis of GF bread cost in one Washington State county showed a mean cost per loaf of $6.52 which was $4.98 higher than the average cost of all bread in the U.S. When it came to checking food labels for gluten, 59% reported feeling very confident and most participants were able to correctly identify foods that may contain gluten; however, less than half (47.5%) identified kamut (a type of wheat) as a gluten containing grain. 46.7% reported feeling that having CD impacts their life daily. The majority (64.2%) of participants stated that family and friends are supportive of needs, and 62.3% also shared that they did not live in a home that was free of gluten. Conclusions The results from this study suggest that there may be several types of barriers to maintaining a GF diet in people with CD. This study aims to bring better awareness of the prevalence of food accessibility, social support, and GF food knowledge barriers to those living with CD, and to the nutrition professionals who provide their healthcare. Funding Sources Bastyr University Faculty Student Research Grant

scholarly journals Dietary Behavior and Risk of Orthorexia in Patients with Celiac Disease

2021 ◽  
Author(s):  
Karolina Kujawowicz ◽  
Iwona Mirończuk-Chodakowska ◽  
Anna Maria Witkowska
Keyword(s):  
Risk Factors ◽  
Eating Disorders ◽  
Celiac Disease ◽  
Test Scores ◽  
Eating Habits ◽  
Strong Association ◽  
Holistic Care ◽  
Gluten Free ◽  
Point Scale ◽  
Dietary Choices

Evidence points to a link between gluten-free diet or celiac disease and eating disorders, but not with orthorexia. This study is the first to examine adults with celiac disease in terms of the prevalence of risk of orthorexia. The study included 130 adults diagnosed with celiac disease. The standardized ORTHO-15 questionnaire was used to assess the risk of orthorexia. Cronbach's alpha test was used to determine the reliability of the ORTHO-15 questionnaire. Eating habits of the subjects were assessed using a questionnaire. The effect of celiac disease on diet was assessed on a 5-point scale. A risk of orthorexia was found in 69% of subjects with celiac disease. A statistically significant (p<0.005) positive correlation was observed between age and ORTHO-15 test scores (rho=0.37). In the group with orthorexia risk, meals were more often self-prepared (93.3%) compared to those without orthorexia (80%) (p=0.023). For 80% of those at risk for orthorexia versus 20% without risk, mood was a factor influencing dietary choices (p=0.001). The study observed a strong association between celiac disease and the presence of orthorexia risk. The numerous risk factors for orthorexia suggest the need for holistic care, including nutritional and psychological support among individuals with celiac disease.

scholarly journals Nutritional quality and costs of gluten-free products: a case-control study of food products on the Norwegian marked

2021 ◽  
Author(s):  
Mari C.W. Myhrstad ◽  
Marlene Slydahl ◽  
Monica Hellmann ◽  
Lisa Garnweidner-Holme ◽  
Knut E. A. Lundin ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Nutritional Quality ◽  
Saturated Fat ◽  
Rank Test ◽  
Grocery Stores ◽  
Gluten Free ◽  
Fiber Intake ◽  
Nutrient Adequacy ◽  
Signed Rank ◽  
Signed Rank Test

Background: Celiac disease is a chronic autoimmune disease triggered by gluten exposure in genetically predisposed individuals. A life-long intake of a gluten-free (GF) diet is required for its management. Wheat, rye and barley are eliminated in a GF diet and the nutritional adequacy of the diet has been questioned. In Norway, cereals and bread constitute a key role of the diet and are the main source of fiber intake. Gluten restrictions may therefore offer important implications for nutrient adequacy especially linked to fiber intake in people with celiac disease. Objective: The aim of the study was to investigate the nutritional quality and price of GF products and compare with gluten-containing counterparts available at instead of in the Norwegian market. Design: The macronutrient content of 423 unique GF products were compared with 337 equivalents with gluten. All products were selected from grocery stores and web-based shops, with the aim of including as many GF products as possible. Listed macronutrients content and price in 11 different food categories were compared to gluten-containing counterparts with Wilcoxon signed rank test. Results: The GF products contained less protein and fiber, and higher content of saturated fat, carbohydrate and salt compared to the gluten-containing products. The total amount of fat was not different between the groups. A similar pattern was found within several of the food categories. More gluten-containing products met the nutrition claim “high in fiber” (fiber > 6 g/100 g) compared to the GF products. The price of the GF products was higher; ranging from 46%–443% more expensive than the gluten-containing products. Conclusion: GF products are less nutritious and have a higher price compared to equivalent gluten-containing products. Knowing that an unhealthy diet is the most important risk factor for developing non-communicable diseases, the nutritional quality of a GF diet needs to be addressed and should be improved.

scholarly journals Gluten-Free Diet: Nutritional Strategies to Improve Eating Habits in Children with Celiac Disease: A Prospective, Single-arm Intervention Study

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1108
Author(s):  
Marta Suárez-González ◽  
Carlos Bousoño-García ◽  
Santiago Jiménez-Treviño ◽  
Juan José Díaz-Martín
Keyword(s):  
Celiac Disease ◽  
Nutrition Education ◽  
Fruits And Vegetables ◽  
Eating Habits ◽  
Pediatric Population ◽  
Pearson Correlation ◽  
Saturated Fat ◽  
Bowel Habit ◽  
Gluten Free ◽  
Lipid Panel

Background: Elimination of gluten-containing cereals and consumption of ultra-processed gluten-free foods might cause an unbalanced diet, deficient in fiber and rich in sugar and fat, circumstances that may predispose celiac children to chronic constipation. Aim: to evaluate if counseling with a registered dietitian (RD) was capable of improving eating and bowel habits in a celiac pediatric population. Methods: Dietetic, lipid profile and stool modifications were analyzed, comparing baseline assessments with those twelve months after receiving heathy eating and nutrition education sessions. At both time points, 3-day food records, a bowel habit record and a lipid panel were conducted. Calculated relative intake of macro- and micro-nutrients were compared with current recommendations by the European Food Safety Authority (EFSA). Student’s paired t-test, McNemar test, Mandasky test and Pearson correlation tests were used. Results: Seventy-two subjects (58.3% girls) with a mean (standard deviation (SD)) age of 10.2 (3.4) years were included. Baseline diets were imbalanced in macronutrient composition. Significant improvements were observed in their compliance with dietary reference values (DRVs), where 50% of the subjects met fat requirements after the education and 67% and 49% with those of carbohydrates and fiber, respectively (p < 0.001). Celiac children decreased red meat and ultra-processed foods consumption (p < 0.001) and increased fruits and vegetables intake (p < 0.001), leading to a reduction in saturated fat (p < 0.001) and sugar intake (p < 0.001). Furthermore, 92% of the patients achieved a normal bowel habit, including absence of hard stools in 80% of children constipated at baseline (p < 0.001). Conclusions: RD-led nutrition education is able to improve eating patterns in children with celiac disease (CD).

scholarly journals Impacts of Celiac Disease and the Gluten-Free Diet on the Eating Habits and Quality of Life of Algerian Celiac Patients

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 431-431
Author(s):  
Batoul Meghzili ◽  
Esma Foufou ◽  
Abdallah Bouasla
Keyword(s):  
Celiac Disease ◽  
Eating Habits ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Negative Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
University Center ◽  
Funding Sources

Abstract Objectives Celiac disease is an autoimmune disease with manifestations at different levels. It is a disease developed in people with genetic susceptibility and intolerance to certain protein fractions of gluten, a protein found in all forms of wheat, rye and barley and causing villus atrophy. In Algeria, more than 500 000 people have celiac disease and the only treatment for celiac disease is to follow a strict, lifelong gluten-free diet, the objective of our work is to study the eating habits and gluten-free diet of 109 celiac patients residing in Algeria. Methods We carried out a cross-sectional survey using a questionnaire that has two sections: a section on eating habits, a section on frequencies of food consumption. Results Overall, we found that 67.9% of patients strictly followed their diet which led to difficulty in eating out of home and the need to take food while traveling. The difficulties in purchasing gluten-free foods were also mentioned by most patients. In addition, the gluten-free diet interfered with the patients' ability to work and with their social activities. Regarding the diet of our patients, the main foods consumed were vegetables, fruits, pulses, rice, pancakes, eggs, chicken meat and milk. Conclusions The negative effects of celiac disease and the gluten-free diet on patients can be minimized by better patient management, especially by joining associations. Funding Sources The Institute of Nutrition, Food and Agri-Food Technologies, Hospital-University Center CONSTANTINE Benbadis polyclinic el arbi ben mhidi, Polyclinic Filali, Constantine SIDI MABROUK PIDIATRIC EHS Constantine Hospitals.

scholarly journals Canadian packaged gluten-free foods are less nutritious than their regular gluten-containing counterparts

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5875 ◽  
Author(s):  
Jennifer A. Jamieson ◽  
Mary Weir ◽  
Laura Gougeon
Keyword(s):  
Celiac Disease ◽  
New Products ◽  
Nutrient Content ◽  
Grocery Stores ◽  
Gluten Free ◽  
Nutritional Content ◽  
Rank Tests ◽  
Eastern Canada ◽  
Nutritional Adequacy ◽  
Micronutrient Fortification

Background A strict gluten-free (GF) diet is required for the management of celiac disease (CD). The nutritional adequacy of this diet has been questioned due to the elimination of wheat, an important vehicle for micronutrient fortification and source of fibre. While novel and/or reformulated packaged GF products have rapidly entered the marketplace, providing alternatives to wheat-based staples, it is unknown whether these new products are nutritionally comparable. Methods From a database of 3,851 foods collected across 21 grocery stores in Eastern Canada, we compared the nutrient content of 398 unique GF items with 445 gluten-containing (GC) equivalents. Wilcoxon rank tests were conducted on listed nutrient content (g, mg, µg) per 100 g of product and the nutrient contribution of iron, folate and fibre were evaluated using Health Canada’s nutrient claim regulations. Results GF staples (cereals, breads, flours, pastas) contained 1.3 times more fat and less iron (by 55%), folate (by 44%) and protein (by 36%), than GC counterparts (P < 0.0001). On average, GF pastas had only 37% of the fibre in GC pastas (P < 0.0001). Notably, GF and GC flours were equivalent in nutrient content. Despite GF and GC flours having similar nutritional content, the vast majority of the processed GF foods fell short in key nutrients. Discussion Packaged GF foods in Canada are generally less nutritious than their GC counterparts, suggesting that GF diets should not be promoted to those who do not require it. The use of nutrient-dense GF flours in homemade foods may improve nutrient intakes on the GF diet.

scholarly journals The Impact of Gluten-Free Diet on the Lifes of Individuals with Celiac Disease: A Turkish Perspective

2021 ◽  
pp. 1-9
Author(s):  
Yeliz Serin ◽  
Gamze Akbulut
Keyword(s):  
Nutrition Education ◽  
Online Survey ◽  
Gluten Free Diet ◽  
Support Network ◽  
Grocery Stores ◽  
Gluten Free ◽  
Cross Sectional ◽  
Free Products ◽  
Online Social Support ◽  
The Impact

Aim: The aim of this study was to evaluate the influence of gluten-free (GF) diet on social lives of patients. Subjects and Method: The design of the study was descriptive and cross-sectional. The questionnaire was designed as an online form. The online survey was announced on an online social support network called “Turkey Celiac Association” which has about 6000 members. The patients older than 18 years and diagnosed by a specialist doctor were enrolled in the study. Results: The study was completed with a total of 464 patients (114 males and 350 females). Difficulties often expressed by at least 50% of the respondents include: “limited purchasing power due to the high cost of gluten-free products (59.3%)”, “lack of accessibility to gluten-free products in grocery stores (51.9%)”, “lack of accessibility to gluten-free products in local stores (54.1%)”, and “inability to find shops and restaurants selling gluten-free foods during travelling (49.1%)”. Conclusion: Today, educating patients on a gluten-free diet is the cornerstone of treatment. In this article, the priorities of gluten-free nutrition education by the dietitians and recommendations of solution for the barriers affecting the sustainability of the diet are emphasized.

Evaluation of a pediatric gluten-free food guide by children and youth with celiac disease, their parents and health care professionals

2021 ◽  
pp. 1-34
Author(s):  
Diana R. Mager ◽  
Samantha Cyrkot ◽  
Christine Lirette ◽  
Herbert Brill ◽  
Jenna Dowhaniuk ◽  
...  
Keyword(s):  
Health Care ◽  
Celiac Disease ◽  
Health Care Professionals ◽  
Online Survey ◽  
Food Selection ◽  
Free Food ◽  
Gluten Free ◽  
Cross Sectional ◽  
Study Objective ◽  
Survey Questions

Abstract There are currently no universal evidence-based nutrition guidelines that address the gluten-free (GF) diet for children/youth (4-18 years). A GF food guide was created to help children/youth with celiac disease (CD) and their families navigate the complexities of following a GF diet. Guide formation was based on pre-guide stakeholder consultations and an evaluation of nutrient intake and dietary patterns. The study objective was to conduct an evaluation on guide content, layout, feasibility and dissemination strategies from end-stakeholder users (children/youth with CD, parents/caregivers, health care professionals). This is a cross-sectional study using a multi-method approach of virtual focus groups and an online survey to conduct stakeholder evaluations. Stakeholders included children/youth (4-18 years), their parents/caregivers in the celiac community (n=273) and health care professionals (n=80) with both pediatric and CD experience from across Canada. Thematic analysis was performed on focus group responses and open-ended survey questions until thematic saturation was achieved. Chi-square and Fisher’s exact statistical analyses were performed on demographic and close-ended survey questions. Stakeholders positively perceived the guide for content, layout, feasibility, ethnicity and usability. Stakeholders found the material visually appealing and engaging with belief that it could effectively be used in multi-ethnic community and clinical-based settings. Guide revisions were made in response to stakeholder consultations to improve food selection (e.g. child-friendly foods), language (e.g. clarity) and layout (e.g. organization). The evaluation by end-stakeholders provided practical and patient-focused feedback on the guide to ensure that uptake is successful in community and clinical-based settings.

A Clinical and Histochemical Study of Celiac Disease Before and During a Gluten-Free Diet

1965 ◽  
Vol 48 (2) ◽  
pp. 155-172 ◽  
Author(s):  
I. Michael Samloff ◽  
John S. Davis ◽  
Eric A. Schenk
Keyword(s):  
Celiac Disease ◽  
Histochemical Study ◽  
Gluten Free Diet ◽  
Gluten Free

Testing the Strain Theory of Suicide – The Moderating Role of Social Support

Crisis ◽  
2020 ◽  
Vol 41 (2) ◽  
pp. 82-88 ◽  
Author(s):  
Bob Lew ◽  
Ksenia Chistopolskaya ◽  
Yanzheng Liu ◽  
Mansor Abu Talib ◽  
Olga Mitina ◽  
...  
Keyword(s):  
Social Support ◽  
Suicidal Behavior ◽  
Online Survey ◽  
Perceived Social Support ◽  
Strain Theory ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Psychological Strains ◽  
Moderating Role

Abstract. Background: According to the strain theory of suicide, strains, resulting from conflicting and competing pressures in an individual's life, are hypothesized to precede suicide. But social support is an important factor that can mitigate strains and lessen their input in suicidal behavior. Aims: This study was designed to assess the moderating role of social support in the relation between strain and suicidality. Methods: A sample of 1,051 employees were recruited in Beijing, the capital of China, through an online survey. Moderation analysis was performed using SPSS PROCESS Macro. Social support was measured with the Multidimensional Scale of Perceived Social Support, and strains were assessed with the Psychological Strains Scale. Results: Psychological strains are a good predictor of suicidality, and social support, a basic need for each human being, moderates and decreases the effects of psychological strains on suicidality. Limitations: The cross-sectional survey limited the extent to which conclusions about causal relationships can be drawn. Furthermore, the results may not be generalized to the whole of China because of its diversity. Conclusion: Social support has a tendency to mitigate the effects of psychological strains on suicidality.

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