A Simple Validated Gluten-Free Diet Adherence Survey for Adults With Celiac Disease
Abstract
Background & aims Celiac disease is an increasingly prevalent disorder. To monitor response to treatment in clinical and research settings, it is essential to accurately measure gluten-free diet (GFD) adherence in a standardized manner. The aim of this study was to develop a valid and reliable Celiac Dietary Adherence Test (CDAT). Methods Items and domains believed to be essential for successful GFD adherence were used to develop an 85-item survey with input from patient focus groups. The survey was administered to 200 individuals with biopsy-proven celiac disease who underwent standardized dietician evaluation (SDE) and serologic testing. Results Of the initial 85 items, 41 were correlated highly with the SDE (P Conclusions The CDAT is a clinically relevant, easily administered, 7-item instrument that allows for standardized evaluation of GFD adherence and is superior to tissue transglutaminase serology. The CDAT may be useful in both research and clinical settings.
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The Biagi questionnaire and CDAT have been validated for use in adults only.
“However, both have been validated for use in adults only and have shown weak sensibility to detect dietary transgressions in children; however, they may be useful to detect dietary transgressions in adolescents (136,137).”
The Biagi questionnaire and the Coeliac Dietary Adherence Test (CDAT) are shorter self-reported questionnaires.
“Shorter self-reported questionnaires are the Biagi questionnaire (134) and the Coeliac Dietary Adherence Test (CDAT) (135).”
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Wolf, R. L., Lebwohl, B., Lee, A. R., Zybert, P., Reilly, N. R., Cadenhead, J., Amengual, C., & Green, P. H. R. (2018) · Digestive Diseases and Sciences · doi:10.1007/s10620-018-4936-4 · Cited by 206 · see citing works
Sainsbury, K., Mullan, B., & Sharpe, L. (2013) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2013.05.011 · Cited by 83 · see citing works
Halmos, E. P., Deng, M., Knowles, S. R., Sainsbury, K., Mullan, B., & Tye‐Din, J. A. (2018) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.14791 · Cited by 81 · see citing works
Sainsbury, K., Halmos, E. P., Knowles, S., Mullan, B., & Tye-Din, J. A. (2018) · Appetite · doi:10.1016/j.appet.2018.02.023 · Cited by 46 · see citing works
Paganizza, S., Zanotti, R., D'Odorico, A., Scapolo, P., & Canova, C. (2019) · Gastroenterology Nursing · doi:10.1097/sga.0000000000000368 · Cited by 43 · see citing works
Luque, V., Crespo‐Escobar, P., Hård af Segerstad, E. M., Koltai, T., Norsa, L., Roman, E., Vreugdenhil, A., Fueyo‐Díaz, R., & Ribes‐Koninckx, C. (2024) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1002/jpn3.12079 · Cited by 32 · see citing works
- Authors
- Leffler, D. A., Dennis, M., Edwards George, J. B., Jamma, S., Magge, S., Cook, E. F., Schuppan, D., & Kelly, C. P.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- Harvard University (US)
- Corresponding author
- Leffler, Daniel A.
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2009-05
- Volume
- 7
- Issue
- 5
- Pages
- 530-536.e2
- ISSN
- 1542-3565 (ISSN-L)
- OpenAlex
- W2091929117
- Cited by
- 327
- References
- 0
- Citations by year
- 2026: 21 · 2025: 20 · 2024: 33 · 2023: 24 · 2022: 24 · 2021: 42 · 2020: 23 · 2019: 23 · 2018: 21 · 2017: 14 · 2016: 11 · 2015: 17 · 2014: 14 · 2013: 13 · 2012: 10
- FWCI
- 8.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (K23DK082619, DK 07760)
- National Center for Research Resources (M01-RR-01032, M01RR001032)
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- celiac disease, gluten-free diet adherence, questionnaire validation, treatment response monitoring
- MeSH terms
- Adult, Celiac Disease, Data Collection, Feeding Behavior, Female, Humans, Male, Middle Aged, Patient Compliance, Random Allocation, Diet, Gluten-Free
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