Adherence to the Gluten‐free Diet and Health‐related Quality of Life in an Ethnically Diverse Pediatric Population With Celiac Disease
Abstract
Objectives: Celiac disease (CD) is an autoimmune disease that requires lifelong adherence to a gluten-free diet (GFD). Adherence to the GFD in childhood may be poor and adversely influence health-related quality of life (HRQOL). The study purpose was to determine sociodemographic and socioeconomic factors influencing adherence to the GFD and HRQOL in a multiethnic cohort of youth with CD. Methods: A multisite (Edmonton, Hamilton, Toronto) study examining child-parent HRQOL in youth with CD (n = 243) and/or mild gastrointestinal complaints (GI-CON; n = 148) was conducted. Sociodemographic (age, child-parental age/education/ethnicity/place of birth), anthropometric (weight, height, body mass index), disease (diagnosis, age at diagnosis, duration, Marsh score, serology), household characteristics (income, family size, region, number of children/total household size), HRQOL (Peds TM4.0/KINDL and Celiac Disease DUX), GI Complaints (PedsQL: Gastrointestinal Symptom Scale) and gluten intake were measured. Results: Younger age (<10 years), non-Caucasian ethnicity (parent/child), and presence of GI symptoms were associated with the highest rates of adherence to the GFD in CD children (P < 0.05). CD children (parent/child) had higher HRQOL (average, composite domains) than GI-CON (P < 0.05), but CD children were comparable to healthy children. Lack of GI symptoms, non-Caucasian ethnicity and age (<10 years) were associated with increased HRQOL in composite/average domains for CD (P < 0…
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Nine studies found similar health-related quality of life in children with celiac disease as in control children.
“Nine of these studies found similar HRQOL in children with CD as in control children (4, 82, 95, 96, 99, 100, 102, 103, 106).”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [100]
Five of six studies using celiac disease-specific health-related quality of life questionnaires found that the health-related quality of life of children and adolescents with celiac disease was poor or neutral.
“However, five of the six studies using CD-specific HRQOL questionnaires (CDDUX, CDQL, CDQOL Scale-KINDL, CDPQOL) found that the HRQOL of children and adolescents with CD was poor or neutral (82, 96, 100, 105, 109).”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [100]
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Germone, M. M., Quiñones, E. C., Meyer, S., Nagle, S., Nelson, C., Robbertz, A. S., Vagadori, J., Vitale, A., Wesley, K. M., & Coburn, S. S. (2024) · Springer eBooks · doi:10.1007/978-3-031-32046-0_27-1 · Cited by 1 · see citing works
Gluten‐free oats and diet quality in children and youth with celiac disease
Mager, D. R., Jiang, Z., Rashke, S., & Turner, J. M. (2025) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1002/jpn3.70168 · Cited by 1 · see citing works
Self-citationDiagnosis of gluten-related disorders: A new and challenging public health problem
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Beurteilung der Adhärenz und methodologische Überlegungen
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Celiac Disease in the Pediatric Setting: Anxiety, Depression, and Beyond
Germone, M. M., Quiñones, E. C., Meyer, S., Nagle, S., Nelson, C., Robbertz, A. S., Vagadori, J., Vitale, A., Wesley, K. M., & Coburn, S. S. (2025) · Springer eBooks · doi:10.1007/978-3-031-73363-5_27
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- Authors
- Mager, D. R., Marcon, M., Brill, H., Liu, A., Radmanovich, K., Mileski, H., Nasser, R., Alzaben, A., Carroll, M. W., Yap, J., Persad, R., & Turner, J. M.
- Affiliations
- University of Alberta (CA)
- Hospital for Sick Children (CA)
- McMaster Children's Hospital (CA)
- Saskatchewan Health Authority (CA)
- Corresponding author
- Mager, Diana R.
- Liu, Amanda
- Radmanovich, Kristin
- Alzaben, Abeer
- ORCID
- Venue
- Journal of Pediatric Gastroenterology and Nutrition
- Publisher
- Wiley
- Published
- 2018-06
- Volume
- 66
- Issue
- 6
- Pages
- 941-948
- ISSN
- 0277-2116 (ISSN-L)
- 1536-4801
- OpenAlex
- W2777187806
- Cited by
- 56
- References
- 46
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 6 · 2023: 11 · 2022: 7 · 2021: 8 · 2020: 7 · 2019: 9 · 2018: 1
- FWCI
- 4.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Pediatric Gastroenterology and Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Division of Orthopaedic Surgery, University of Alberta
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Health Sciences › Medicine › Surgery › Eosinophilic Esophagitis
- Keywords
- celiac disease, gluten-free diet adherence, health-related quality of life, pediatric celiac disease, gastrointestinal symptoms, ethnicity, socioeconomic factors, sociodemographic factors, age at diagnosis, gluten intake, multi-ethnic cohort
- MeSH terms
- Adolescent, Age Factors, Celiac Disease, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Male, Patient Compliance, Quality of Life, Socioeconomic Factors, Multivariate Analysis, Diet, Gluten-Free
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