Self-Report of Adherence to Gluten-Free Diet in Patients with Celiac Disease Versus Expert Evaluation

Abstract

Background: 

Consuming gluten can lead to the immune-mediated condition known as celiac disease (CD) in genetically-prone people. Presently, the only approved and available treatment is stringent and lifetime devotion to a gluten-free diet (GFD). This study aimed to assess GFD adherence in patients with CD in Golestan province, northeast Iran.

Materials and Methods: 

All cases with confirmed CD registered in the Golestan Registry of Celiac (N=220) were selected for this cross-sectional study. 87 patients volunteered to take part in the interviews and completed the questionnaire. Since the day of diagnosis, all patients in this center had been treated with a GFD, but their adherence to the regime was unknown. Celiac Dietary Adherence Test (CDAT) and the Standardized Dietician Evaluation (SDE) were used to evaluate their adherence to GFD. 

Results: 

Among the 85 individuals who responded in depth to the CDAT, the mean (standard deviation) age was 32.41 (15.45) years, 32 (36.8%) were male, and 72 (32.8%) adhered to the diet according to their self-expression. However, in the SDE, only 52 (30.23%) exhibited great to good adherence.

Conclusions: 

The adherence and weak adherence groups had similar mean ages. However, non-adherence was associated with higher mean age. Although women had stronger adherence, there was no difference in sex. The elderly and males exhibited low GFD adherence.