Improving gluten free diet adherence by youth with celiac disease

Author(s):  
Dory Sample ◽  
Justine Turner

Abstract Introduction Celiac disease (CD) is a gluten-triggered autoimmune disorder of the small intestine, which can occur in genetically susceptible individuals at any age. A strict life-long gluten free diet (GFD) is the only medically approved treatment, and non-adherence is associated with significant morbidity. However, gluten use is widespread, complicating efforts to follow the diet. Youth with CD are especially challenged with dietary adherence, as they strive for peer acceptance and personal autonomy in the context of managing a chronic disease. Methods A scoping review was conducted to identify mechanisms to assist youth with remaining gluten free. Results There is a paucity of literature regarding best approaches to improve diet adherence by youth, however, lessons can also be learned by borrowing ideas from self-management approaches of other chronic diseases. Several mechanisms for improving GFD adherence among youth are identified, including regular engagement of the youth with CD and their family with an experienced multidisciplinary team, electronic tool utilization and awareness of accurate resources for self-guided education and resources. Conclusions Improvement in GFD adherence by youth is achievable and may influence long-term health outcomes.

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 357
Author(s):  
Alfonso Rodríguez-Herrera ◽  
Joaquín Reyes-Andrade ◽  
Cristina Rubio-Escudero

The assessment of compliance of gluten-free diet (GFD) is a keystone in the supervision of celiac disease (CD) patients. Few data are available documenting evidence-based follow-up frequency for CD patients. In this work we aim at creating a criterion for timing of clinical follow-up for CD patients using data mining. We have applied data mining to a dataset with 188 CD patients on GFD (75% of them are children below 14 years old), evaluating the presence of gluten immunogenic peptides (GIP) in stools as an adherence to diet marker. The variables considered are gender, age, years following GFD and adherence to the GFD by fecal GIP. The results identify patients on GFD for more than two years (41.5% of the patients) as more prone to poor compliance and so needing more frequent follow-up than patients with less than 2 years on GFD. This is against the usual clinical practice of following less patients on long term GFD, as they are supposed to perform better. Our results support different timing follow-up frequency taking into consideration the number of years on GFD, age and gender. Patients on long term GFD should have a more frequent monitoring as they show a higher level of gluten exposure. A gender perspective should also be considered as non-compliance is partially linked to gender in our results: Males tend to get more gluten exposure, at least in the cultural context where our study was carried out. Children tend to perform better than teenagers or adults.


2011 ◽  
Vol 140 (5) ◽  
pp. S-437-S-438 ◽  
Author(s):  
Gregor J. Brown ◽  
James Daveson ◽  
Joanne K. Marjason ◽  
Rose A. Ffrench ◽  
Danielle Smith ◽  
...  

2010 ◽  
Vol 138 (5) ◽  
pp. S-307
Author(s):  
Fabio D. Nachman ◽  
Emilia Sugai ◽  
Horacio Vázquez ◽  
Andrea F. Gonzalez ◽  
Paola J. Andrenacci ◽  
...  

2007 ◽  
Vol 102 ◽  
pp. S200
Author(s):  
Daniel A. Leffler ◽  
Jessica B. Edwards-George ◽  
Melinda Dennis ◽  
Detlef Schuppan ◽  
Ciaran P. Kelly

2012 ◽  
Vol 107 (10) ◽  
pp. 1563-1569 ◽  
Author(s):  
Ilus Tuire ◽  
Lähdeaho Marja-Leena ◽  
Salmi Teea ◽  
Haimila Katri ◽  
Partanen Jukka ◽  
...  

2014 ◽  
Vol 49 (11) ◽  
pp. 1311-1317 ◽  
Author(s):  
Dimitrios Tapsas ◽  
Karin Fälth-Magnusson ◽  
Lotta Högberg ◽  
Tony Forslund ◽  
Tommy Sundqvist ◽  
...  

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2877
Author(s):  
Aner Cardo ◽  
Itziar Churruca ◽  
Arrate Lasa ◽  
Virginia Navarro ◽  
Maialen Vázquez-Polo ◽  
...  

Celiac disease (CD) is a chronic autoimmune disorder of the small intestine, whose only effective treatment is a gluten-free diet (GFD). It is characterized by the atrophy of the intestinal villi that leads to altered nutrient absorption. This study describes the nutritional imbalances which may be found in adults with CD following a GFD. During the first year of treatment, deficiencies will overcome as the intestinal mucosa recovers. Thus, biochemical data will show this progression, together with the decrease in symptoms. In contrast, in the long term, when a strict GFD is followed and mucosal recovery is achieved, analyzing nutrient intake makes more sense. Macronutrient consumption is characterized by its low complex carbohydrate and fiber intakes, and high fat (especially SFA) and sugar intakes. This profile has been related to the consumption of GFP and their nutritional composition, in addition to unbalanced dietary habits. The most notable deficiencies in micronutrients are usually those of iron, calcium and magnesium and vitamin D, E and some of group B. It is necessary to follow up patients with CD and to promote nutritional education among them, since it could help not only to achieve a gluten free but also a balanced diet.


2019 ◽  
Vol 51 (8) ◽  
pp. 1096-1100 ◽  
Author(s):  
Emma M. Clerx ◽  
Jocelyn Silvester ◽  
Daniel Leffler ◽  
Maya DeGroote ◽  
Laurie N. Fishman

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