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Cited by 34Celiac Disease Research and ManagementChild Nutrition and Feeding IssuesEosinophilic Esophagitis

Dietary compliance in Iranian children and adolescents with celiac disease

Open access
Taghdir, Maryam, Honar, Naser, Mazloomi, Seyed Mohammad, Sepandi, Mojtaba, Ashourpour, Mahkameh, Salehi, Musa·2016·Journal of Multidisciplinary Healthcare
DOI 10.2147/jmdh.s110605PMC PMC4993563
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Abstract

INTRODUCTION: Celiac disease (CD) is caused due to intake of gluten, a protein component in wheat, barley, and rye. The only treatment currently available for CD is strict lifetime adherence to a gluten-free diet (GFD) which is a diet that excludes wheat, barley, and rye. There is limited information on barriers to following a GFD. The present study aimed to investigate the compliance with a GFD, barriers to compliance, and the impact of compliance on the quality of life (QOL) in Iranian children and adolescents suffering from CD. METHODS: In this cross-sectional study, a total of 65 known cases of CD (both males and females), diagnosed in Namazi Hospital, a large referral center in south of Iran, selected by census were studied in 2014. Dietary compliance was assessed using a questionnaire. A disease-specific QOL questionnaire for children with CD (the celiac disease DUX [CDDUX]) was used. Comparisons between categorical variables were performed using chi-square test. RESULTS: Sixty-five patients, 38 females (58.5%) and 27 (41.5%) males, were surveyed. Mean (± standard deviation [SD]) age of the respondents was 11.3 (±3.8) years. Dietary compliance was reported by 35 (53.8%) patients. The mean (± SD) CDDUX score was higher in dietary-compliant patients (33.5 [±19.4] vs 26.7 [±13.6], respectively, P=0.23). The score of CDDUX in parents of patients in dietary-compliant group was more than the noncompliant patients (28.1 [±13.5] vs 22.1 [±14], respectively, P=0.1). Barriers to noncompliance were poor or unavailability (100%), high cost (96.9%), insufficient labeling (84.6%), poor palatability (76.9%), and no information (69.23%). CONCLUSION: Approximately half of the patients with CD reported dietary compliance. Poor or unavailability was found to be the most important barrier contributing to noncompliance. The QOL was better in compliant patients. Proposed strategies to improve compliance are greater availability of gluten-free products, better food labeling, and better education about the diet and condition.

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  • Patients perceive insufficient, confusing, unclear or unappealing labelling as a barrier for adherence to the gluten-free diet.

    “Patients perceive insufficient, confusing, unclear or unappealing labelling as a barrier for adherence to the GFD (45-47).”

    From Gluten-free diet for pediatric patients with coeliac disease: A position paper from the ESPGHAN gastroenterology committee, special interest group in coeliac disease. (2024) · cites this paper as [45]

    The Results report that 55 of 65 Iranian children and adolescents with celiac disease identified insufficient labeling as a barrier to dietary compliance. The paper does not report confusing, unclear, or unappealing labeling as separate patient-perceived barriers; its reference to poor palatability concerns food, not labels. (LLM, conf=0.88)

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Authors
Taghdir, M., Honar, N., Mazloomi, S. M., Sepandi, M., Ashourpour, M., & Salehi, M.
Affiliations
  • Shiraz University of Medical Sciences (IR)
  • Baqiyatallah University of Medical Sciences (IR)
Corresponding author
Salehi, Musa
ORCID
Venue
Journal of Multidisciplinary Healthcare
Publisher
Informa UK Limited
Published
2016-08
Volume
Volume 9
Pages
365-370
ISSN
1178-2390 (ISSN-L)
DOI
10.2147/jmdh.s110605
PMC
PMC4993563
OpenAlex
W2512054402
Cited by
34
References
1
Citations by year
2026: 3 · 2025: 3 · 2024: 6 · 2023: 2 · 2022: 2 · 2021: 7 · 2020: 6 · 2019: 2 · 2018: 1 · 2017: 2
FWCI
1.82
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Multidisciplinary Healthcare (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
Funders
  • Shiraz University of Medical Sciences
  • Shiraz University
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, dietary adherence, gluten-free diet, barriers to adherence, quality of life, children and adolescents, food labeling, food availability, nutrition education, Iranian patients

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