ArticleJournal of the Canadian Association of Gastroenterology2020
The Gluten Free Diet: Assessing Adherence in a Pediatric Celiac Disease Population.
Article in Journal of the Canadian Association of Gastroenterology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Irregular follow-up is associated with poorer dietary adherence and iron deficiency in children with celiac disease.European journal of pediatrics · 2026Observational
- Celiac disease is more prevalent among children and adolescents with systemic lupus erythematosus.Pediatric research · 2026Article
- Gluten-Free Product Recalls and Their Impact on Consumer Trust.Nutrients · 2023Article
- Celiac Disease and Targeting the Molecular Mechanisms of Autoimmunity in COVID Pandemic.International journal of molecular sciences · 2022Review
- An Evaluation of Nutritional Status and Problems with Dietary Compliance in Polish Patients with Celiac Disease.Nutrients · 2022Article
- Does a gluten-free diet lead to better glycemic control in children with type 1 diabetes? Results from a feasibility study and recommendations for future trials.Contemporary clinical trials communications · 2022Article
- The Experience of a Gluten-free Diet in Children with Type 1 Diabetes and Celiac Disease.Journal of the Canadian Association of Gastroenterology · 2022Article
- Nutrition in Patients with Lactose Malabsorption, Celiac Disease, and Related Disorders.Nutrients · 2021Review
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundA strict, lifelong, gluten-free diet (GFD) remains the sole treatment for celiac disease (CD). The assessment of adherence to the GFD in pediatric studies is often based on self-report and visual analogue scales which lack proven validity. We sought to compare parental-report of GFD adherence to expert registered dietitian (RD) assessments, the best available standard.
methodsParents of children with biopsy-proven CD scored their adherence to the GFD on a five-point Likert scale similar to that used in previous pediatric CD studies. Each family was then evaluated by an RD expert in CD management who conducted a comprehensive and standardized assessment and scored the family's adherence. The agreement between parents and the RD was assessed using paired t test and intraclass correlation coefficient (ICC) based on their scores.
resultsOne hundred twenty-two children and their families participated in the study, with a median of 32 months on a GFD. Excellent adherence (score 5 out of 5) was attributed to 60.5% of the sample by the RD. The parents scored adherence higher than the RD by an average difference of 0.41 scale points (95% CI, 0.28-0.54;
conclusionReliance on self-report through Likert scales for GFD adherence overestimates adherence and misses opportunities for patient and family education. Approximately 40% of children with CD have ongoing gluten exposure, highlighting the need for regular assessment by an RD expert in the GFD to identify education and counselling needs for children with CD.
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