Evidence map›Paper›PMID 29387990›Full record

ArticleDigestive diseases and sciences2018

Hypervigilance to a Gluten-Free Diet and Decreased Quality of Life in Teenagers and Adults with Celiac Disease.

Randi L Wolf, Benjamin Lebwohl, Anne R Lee, Patricia Zybert, Norelle R Reilly, Jennifer Cadenhead, Chelsea Amengual, Peter H R Green

Erratum issued Registry-linked trialAbstract readComparative Study
PubMed Publisher
In one paragraph

Article in Digestive diseases and sciences, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT05923346 (Educational Intervention on Celiac Disease and Gluten-free Diet Through Social Networks), which is not on this map. Cited by 97 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
97citing papers in PubMed, 4 pooled it
12.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05923346 nacompletednot on this mapstarted 2022, after this paper: background citation

Educational Intervention on Celiac Disease and Gluten-free Diet Through Social Networks (GLUTLEARN Project).

TypeinterventionalSponsorUniversity of the Basque Country (UPV/EHU)Ran2022 to 2023Enrolled93ConditionsCeliac DiseaseArmsGLUTLEARN
3 · Its place in the literature

Who cites it

97 citing papers in PubMed, 4 syntheses or guidelines pooled it, 185 citations in OpenAlex.

  1. Guideline
  2. Pooled it
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  5. Trial
  6. Trial
  7. Benefits From and Barriers to Portable Detection of Gluten, Based on a Randomized Pilot Trial of Patients With Celiac Disease.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2019
    Trial
  8. Article
  9. Article
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  13. 'It's not just about food': Living with celiac disease as a woman.International journal for equity in health · 2026
    Article
  14. Article
  15. Reported Availability, Additional Cost and Use of Methods to Limit Cross-Contact of Gluten-Free Foods in Restaurants in a Canadian Large Urban Centre.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026
    Article
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  18. Review
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37 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Randi L WolfDepartment of Health and Behavior Studies, Program in Nutrition, Teachers College, Columbia University, 525 West 120th Street, Box 137, New York, NY, 10027, USA. wolf@tc.columbia.edu.ORCID http://orcid.org/0000-0002-8155-3082
Benjamin LebwohlDepartment of Medicine, Celiac Disease Center, Columbia University Medical Center, Harkness Pavilion, 180 Fort Washington Avenue, New York, NY, 10032, USA.
Anne R LeeDepartment of Medicine, Celiac Disease Center, Columbia University Medical Center, Harkness Pavilion, 180 Fort Washington Avenue, New York, NY, 10032, USA.
Patricia ZybertDepartment of Health and Behavior Studies, Program in Nutrition, Teachers College, Columbia University, 525 West 120th Street, Box 137, New York, NY, 10027, USA.
Norelle R ReillyDepartment of Medicine, Celiac Disease Center, Columbia University Medical Center, Harkness Pavilion, 180 Fort Washington Avenue, New York, NY, 10032, USA.
Jennifer CadenheadDepartment of Health and Behavior Studies, Program in Nutrition, Teachers College, Columbia University, 525 West 120th Street, Box 137, New York, NY, 10027, USA.
Chelsea AmengualDepartment of Health and Behavior Studies, Program in Nutrition, Teachers College, Columbia University, 525 West 120th Street, Box 137, New York, NY, 10027, USA.
Peter H R GreenDepartment of Medicine, Celiac Disease Center, Columbia University Medical Center, Harkness Pavilion, 180 Fort Washington Avenue, New York, NY, 10032, USA.
Columbia University · USColumbia University Irving Medical Center · US

Funding

In part by Columbia University CTSA Grant UL1 TR000040
6 · The paper itself

Abstract

BACKGROUND AND

aimsAvoidance of gluten is critical for individuals with celiac disease (CD), but there is also concern that "extreme vigilance" to a strict gluten-free diet may increase symptoms such as anxiety and fatigue, and therefore, lower quality of life (QOL). We examined the associations of QOL with energy levels and adherence to, and knowledge about, a gluten-free diet.

methodsThis is a cross-sectional prospective study of 80 teenagers and adults, all with biopsy-confirmed CD, living in a major metropolitan area. QOL was assessed with CD-specific measures. Dietary vigilance was based on 24-h recalls and an interview. Knowledge was based on a food label quiz. Open-ended questions described facilitators and barriers to maintaining a gluten-free diet.

resultsThe extremely vigilant adults in our sample had significantly lower QOL scores than their less vigilant counterparts [(mean (SD): 64.2 (16.0) vs 77.2 (12.2), p = 0.004]. Extreme vigilance was also associated with greater knowledge [5.7 (0.7) vs 5.1 (0.8), p = 0.035]. Adults with lower energy levels had significantly lower overall QOL scores than adults with higher energy levels [68.0 (13.6) vs 78.9 (13.0), p = 0.006]. Patterns were similar for teenagers. Cooking at home and using internet sites and apps were prevalent strategies used by the hypervigilant to maintain a strict gluten-free diet. Eating out was particularly problematic.

conclusionThere are potential negative consequences of hypervigilance to a strict gluten-free diet. Clinicians must consider the importance of concurrently promoting both dietary adherence and social and emotional well-being for individuals with CD.

Indexed as

Adolescent BehaviorHealth Knowledge, Attitudes, PracticePatient ComplianceQuality of LifeAdolescentAdultAgedAge FactorsBiopsyCeliac DiseaseCost of IllnessCross-Sectional StudiesDiet, Gluten-FreeEmotionsEnergy MetabolismFemaleAdherenceAdultsCeliac diseaseGluten-free dietQuality of lifeTeenagers

Identifiers

PMID29387990
OpenAlexW2788415529

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.