Factors Associated with Dietary Adherence in Celiac Disease: A Nationwide Study
Abstract
Aims Diagnostics and follow-up of celiac disease have gradually shifted from tertiary centers to secondary and primary health care. In order to establish whether this has affected the success of treatment, and to identify predictors for dietary non-adherence, we carried out a study in a nationwide cohort of treated celiac patients. Patients and methods 843 biopsy-proven patients, 94 children and 749 adults, were enrolled and interviewed. Adherence to a gluten-free diet was determined by means of an interview and serological testing. Results Altogether, 88% were on a strict gluten-free diet; the rest had occasional dietary transgressions. Younger age at diagnosis, being currently a teenager, and current symptoms were associated with non-adherence. There was no association between non-adherence and place of diagnosis, gender, disease phenotype or severity of symptoms before diagnosis, presence of comorbidities, family history of celiac disease, smoking, duration of diet, use of oats, self-efficacy for the diet or lack of follow-up. Conclusions Good dietary adherence can be achieved also in patients diagnosed and followed in primary health care. In a country with a high prevalence and good general knowledge of celiac disease, only age at diagnosis and age at present would appear to be major determinants for adherence.
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Adherence to a gluten-free diet in children with coeliac disease may vary between 45% and 90%.
“reinforcing at each visit the importance of dietary compliance which may vary between 45-90% (6-9).”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [6]
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Self-citation
- Authors
- Kurppa, K., Lauronen, O., Collin, P., Ukkola, A., Laurila, K., Huhtala, H., Mäki, M., & Kaukinen, K.
- Affiliations
- Tampere University Hospital (FI)
- Tampere University (FI)
- Venue
- Digestion
- Publisher
- S. Karger AG
- Published
- 2012
- Volume
- 86
- Issue
- 4
- Pages
- 309-314
- ISSN
- 0012-2823 (ISSN-L)
- 1421-9867
- OpenAlex
- W1989374602
- Cited by
- 139
- References
- 36
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 8 · 2023: 10 · 2022: 12 · 2021: 13 · 2020: 10 · 2019: 12 · 2018: 12 · 2017: 10 · 2016: 6 · 2015: 8 · 2014: 19 · 2013: 9
- FWCI
- 11.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Digestion (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pirkanmaan Sairaanhoitopiiri
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Surgery › Eosinophilic Esophagitis
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- celiac disease, dietary adherence, gluten-free diet, age at diagnosis, primary care, secondary care, serological testing, children and adolescents, self-efficacy
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Celiac Disease, Child, Child, Preschool, Female, Finland, Humans, Interviews as Topic, Male, Middle Aged, Patient Compliance, Primary Health Care, Serologic Tests, Cohort Studies, Age of Onset, Diet, Gluten-Free, Young Adult
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