Original article—alimentary tractA Simple Validated Gluten-Free Diet Adherence Survey for Adults With Celiac Disease
Section snippets
Methods
An expert panel consisting of gastroenterologists, dieticians, psychologists, and individuals with CD was assembled to discuss the factors important in living with CD and influential in GFD adherence. Over a series of meetings, a set of 5 domains relevant to GFD adherence were elucidated ad hoc, including the following: (1) CD-related symptoms, (2) disease-specific knowledge, (3) self-efficacy, (4) reasons for keeping a GFD, and (5) perceived adherence to the GFD. From these domains, a bank of
Results
The demographic characteristics of the initial study population and the validation cohort were not significantly different than that of the overall CD population seen at Beth Israel Deaconess Medical Center (BIDMC) with the exception of classic symptoms at onset, which were reported less frequently in the overall BIDMC group than the study cohort (P = .04) (Table 1, Table 2). Overall, the population studied was highly adherent to the GFD with 74.6% having excellent or good GFD adherence as
Discussion
In recent years, CD has gone from being understood as a relatively infrequent disorder with a nearly optimal treatment to a very common disorder with frequent lack of GFD adherence and for which there is a great need for new therapies and rigorous evaluation of disease outcomes.18 Progress in both areas has been limited by the lack of validated disease-specific instruments. Although it is arguable that clinical symptoms of CD may be evaluated using a generic symptom index such as the
References (34)
- et al.
Clinical features and diagnosis of celiac disease
Gastroenterology
(2005) - et al.
Etiologies and predictors of diagnosis in nonresponsive celiac disease
Clin Gastroenterol Hepatol
(2007) - et al.
Etiology of nonresponsive celiac disease: results of a systematic approach
Am J Gastroenterol
(2002) - et al.
Reliability of antitransglutaminase antibodies as predictors of gluten-free diet compliance in adult celiac disease
Am J Gastroenterol
(2003) - et al.
Low-dose gluten challenge in celiac sprue: malabsorptive and antibody responses
Clin Gastroenterol Hepatol
(2005) - et al.
A prospective, double-blind, placebo-controlled trial to establish a safe gluten threshold for patients with celiac disease
Am J Clin Nutr
(2007) - et al.
Disappearance of endomysial antibodies in treated celiac disease does not indicate histological recovery
Am J Gastroenterol
(2000) Follow-up of patients with celiac disease: achieving compliance with treatment
Gastroenterology
(2005)- et al.
Characteristics of adult celiac disease in the USA: results of a national survey
Am J Gastroenterol
(2001) - et al.
Bone mineral density in children with celiac diseaseEffect of a gluten-free diet
Eur J Clin Nutr
(2006)
Malignancy and mortality in people with coeliac disease: population based cohort study
BMJ
Economic burden of a gluten-free diet
J Hum Nutr Diet
Gluten-free diet survey: are Americans with coeliac disease consuming recommended amounts of fibre, iron, calcium and grain foods?
J Hum Nutr Diet
Factors that influence adherence to a gluten-free diet in adults with celiac disease
Dig Dis Sci
“Controlled by food”—lived experiences of coeliac disease
J Hum Nutr Diet
Psychological support counselling improves gluten-free diet compliance in coeliac patients with affective disorders
Aliment Pharmacol Ther
Better dietary compliance in patients with coeliac disease diagnosed in early childhood
Scand J Gastroenterol
Cited by (0)
Conflicts of interest The authors disclose no conflicts.
Funding This study was supported by charitable donations from patients to the Celiac Center at Beth Israel Deaconess Medical Center (BIDMC), the Celiac Sprue Association, NIH T32 training grant DK07760, and the Harvard-Thorndike General Clinical Research Center M01 RR01032.