[Adherence factors to the gluten-free diet in people with celiac disease in Paraguay]

Introduction: The adherence to a gluten-free diet in people with celiac disease is a constant challenge for them and their family environment. Not everyone is able to adapt to the new eating style and may develop maladaptive behaviors. The objective was to evaluate the factors of adherence to the gluten-free diet in people with celiac disease in Paraguay in 2023. Methodology: We perform an observational, cross-sectional design in adolescent and adult subjects with celiac disease. A telematic questionnaire containing demographic and clinical data was applied. The adherence to the diet was evaluated with the Leffler questionnaire, eating attitudes and behaviors with the CD-FAB instrument, and family support with the family APGAR test. Descriptive and analytical statistics were applied with SPSS Statistics 25™ software. The research respected ethical aspects. Results: The final sample consisted of 292 people. The median age was 33 years and predominated the female sex (85.3%). Good adherence to the gluten-free diet was detected in 151 (51.7%) people and good adaptation to it in 164 (56.2%). In 141 cases (48.3%) it was stated that they had family support. The analysis showed that prolonged time since diagnosis and having family support were significantly associated with adherence to the gluten-free diet (p <0.05). Conclusions: In people with celiac disease, adherence to the gluten-free diet was related to a prolonged time since diagnosis and receiving family support. It is recommended to investigate the causes of maladaptive behaviors to the gluten-free diet.