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Gluten-free diet adherence in children with screening-detected celiac disease using a prospective birth cohort study

Mehta, Pooja ; Li, Qian ; Stahl, Marisa ; Uusitalo, Ulla ; Lindfors, Katri ; Butterworth, Martha D. ; Kurppa, Kalle ; Virtanen, Suvi ; Koletzko, Sibylle and Aronsson, Carin LU orcid , et al. (2023) In PLoS ONE 18(2 February).
Abstract

Background Celiac disease has an increasing incidence worldwide and is treated with lifelong adherence to a gluten-free diet. We aimed to describe gluten-free diet adherence rates in children with screening-identified celiac disease, determine adherence-related factors, and compare adherence to food records in a multinational prospective birth cohort study. Methods Children in The Environmental Determinants of Diabetes in the Young study with celiac disease were included. Subjects had at least annual measurement of adherence (parent-report) and completed 3-day food records. Descriptive statistics, t-tests, Kruskal-Wallis tests and multivariable logistic and linear regression were employed. Results Two hundred ninety (73%) and 199 (67%)... (More)

Background Celiac disease has an increasing incidence worldwide and is treated with lifelong adherence to a gluten-free diet. We aimed to describe gluten-free diet adherence rates in children with screening-identified celiac disease, determine adherence-related factors, and compare adherence to food records in a multinational prospective birth cohort study. Methods Children in The Environmental Determinants of Diabetes in the Young study with celiac disease were included. Subjects had at least annual measurement of adherence (parent-report) and completed 3-day food records. Descriptive statistics, t-tests, Kruskal-Wallis tests and multivariable logistic and linear regression were employed. Results Two hundred ninety (73%) and 199 (67%) of subjects were always adherent to a gluten-free diet at 2 and 5 years post celiac disease diagnosis respectively. The percentage of children with variable adherence increased from 1% at 2 years to 15% at 5 years. Children with a first-degree relative with celiac disease were more likely to be adherent to the gluten-free diet. Gluten intake on food records could not differentiate adherent from nonadherent subjects. Adherent children from the United States had more gluten intake based on food records than European children (P < .001 and P = .007 at 2 and 5 years respectively). Conclusion Approximately three-quarters of children with screening-identified celiac disease remain strictly adherent to a gluten-free diet over time. There are no identifiable features associated with adherence aside from having a first-degree relative with celiac disease. Despite good parent-reported adherence, children from the United States have more gluten intake when assessed by food records. Studies on markers of gluten-free diet adherence, sources of gluten exposure (particularly in the United States), and effects of adherence on mucosal healing are needed.

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publishing date
type
Contribution to journal
publication status
published
subject
in
PLoS ONE
volume
18
issue
2 February
article number
e0275123
publisher
Public Library of Science (PLoS)
external identifiers
  • pmid:36730234
  • scopus:85147318953
ISSN
1932-6203
DOI
10.1371/journal.pone.0275123
language
English
LU publication?
yes
id
4266bcb3-be2f-41d1-b1e8-ac1dd2bb9ced
date added to LUP
2023-02-23 13:56:50
date last changed
2024-09-06 08:19:07
@article{4266bcb3-be2f-41d1-b1e8-ac1dd2bb9ced,
  abstract     = {{<p>Background Celiac disease has an increasing incidence worldwide and is treated with lifelong adherence to a gluten-free diet. We aimed to describe gluten-free diet adherence rates in children with screening-identified celiac disease, determine adherence-related factors, and compare adherence to food records in a multinational prospective birth cohort study. Methods Children in The Environmental Determinants of Diabetes in the Young study with celiac disease were included. Subjects had at least annual measurement of adherence (parent-report) and completed 3-day food records. Descriptive statistics, t-tests, Kruskal-Wallis tests and multivariable logistic and linear regression were employed. Results Two hundred ninety (73%) and 199 (67%) of subjects were always adherent to a gluten-free diet at 2 and 5 years post celiac disease diagnosis respectively. The percentage of children with variable adherence increased from 1% at 2 years to 15% at 5 years. Children with a first-degree relative with celiac disease were more likely to be adherent to the gluten-free diet. Gluten intake on food records could not differentiate adherent from nonadherent subjects. Adherent children from the United States had more gluten intake based on food records than European children (P &lt; .001 and P = .007 at 2 and 5 years respectively). Conclusion Approximately three-quarters of children with screening-identified celiac disease remain strictly adherent to a gluten-free diet over time. There are no identifiable features associated with adherence aside from having a first-degree relative with celiac disease. Despite good parent-reported adherence, children from the United States have more gluten intake when assessed by food records. Studies on markers of gluten-free diet adherence, sources of gluten exposure (particularly in the United States), and effects of adherence on mucosal healing are needed.</p>}},
  author       = {{Mehta, Pooja and Li, Qian and Stahl, Marisa and Uusitalo, Ulla and Lindfors, Katri and Butterworth, Martha D. and Kurppa, Kalle and Virtanen, Suvi and Koletzko, Sibylle and Aronsson, Carin and Hagopian, William A. and Rewers, Marian J. and Toppari, Jorma and Ziegler, Anette G. and Akolkar, Beena and Krischer, Jeffrey P and Agardh, Daniel and Liu, Edwin}},
  issn         = {{1932-6203}},
  language     = {{eng}},
  number       = {{2 February}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS ONE}},
  title        = {{Gluten-free diet adherence in children with screening-detected celiac disease using a prospective birth cohort study}},
  url          = {{http://dx.doi.org/10.1371/journal.pone.0275123}},
  doi          = {{10.1371/journal.pone.0275123}},
  volume       = {{18}},
  year         = {{2023}},
}