Predictors of adherence to a gluten-free diet in celiac disease: Do knowledge, attitudes, experiences, symptoms, and quality of life play a role?

Eirini Dimidi; Bonita Kabir; Jaspreet Singh; Aikaterini Ageridou; Charlotte Foster; Paul Ciclitira; Patrick Dubois; Kevin Whelan

doi:10.1016/j.nut.2021.111249

Predictors of adherence to a gluten-free diet in celiac disease: Do knowledge, attitudes, experiences, symptoms, and quality of life play a role?

Eirini Dimidi, Bonita Kabir, Jaspreet Singh, Aikaterini Ageridou, Charlotte Foster, Paul Ciclitira, Patrick Dubois, Kevin Whelan^*

^*Corresponding author for this work

Nutritional Sciences

Research output: Contribution to journal › Article › peer-review

15 Citations (Scopus)

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Abstract

Objectives: This study aimed to identify the relationship between adherence to a gluten-free diet (GFD) and demographic characteristics, knowledge, attitudes, and beliefs regarding celiac disease (CD) and GFD, experiences of following a GFD, symptoms, and quality of life (QoL). Methods: Patients with CD were recruited from outpatient clinics. Adherence to GFD was assessed using the CD adherence test (CDAT) and GFD score (GFD-S). Knowledge, attitudes, experiences, symptoms, and QoL were assessed using existing questionnaires. A multivariate logistic regression was performed. Results: Overall, 116 patients with CD were included (48 ± 16 y; 70% female). Based on the CDAT, 58 patients (50%) were adequate adherers, but 86 patients (74%) were adequate adherers according to GFD-S. When adherence was measured using the CDAT, being female was associated with lower odds of adherence (odds ratio [OR]: 0.36; P = 0.028), and better emotional wellbeing was associated with higher odds of adherence (OR: 1.19; P < 0.001). When adherence was measured using GFD-S, membership in a support group (OR: 6.17; P = 0.002), stronger beliefs about the chronicity of CD (OR: 1.15; P = 0.059), and weaker beliefs on accident/chance causing CD (OR: 1.94; P = 0.05) were associated with greater odds of adherence. Difficulties when eating with family/friends (OR: 0.98; P = 0.005) and weaker beliefs on immunity causing CD (OR: 0.77; P = 0.031) were associated with lower odds of adherence. Conclusions: The association between gender, attending support groups, attitudes, experiences, and QoL with adherence to a GFD should be considered by health care professionals managing patients with CD.

Original language	English
Article number	111249
Journal	Nutrition
Volume	90
Early online date	26 Mar 2021
DOIs	https://doi.org/10.1016/j.nut.2021.111249
Publication status	Published - Oct 2021

Keywords

Barriers
Beliefs
Diet
Gut
Nutrition

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10.1016/j.nut.2021.111249

Predictors of adherence to_DIMIDI_Accepted15March2021Publishedonline26March2021_GREEN AAM Accepted author manuscript, 543 KBLicence: CC BY-NC-ND

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@article{355dff81efff4bab9c8f43217fb5ac7b,

title = "Predictors of adherence to a gluten-free diet in celiac disease: Do knowledge, attitudes, experiences, symptoms, and quality of life play a role?",

abstract = "Objectives: This study aimed to identify the relationship between adherence to a gluten-free diet (GFD) and demographic characteristics, knowledge, attitudes, and beliefs regarding celiac disease (CD) and GFD, experiences of following a GFD, symptoms, and quality of life (QoL). Methods: Patients with CD were recruited from outpatient clinics. Adherence to GFD was assessed using the CD adherence test (CDAT) and GFD score (GFD-S). Knowledge, attitudes, experiences, symptoms, and QoL were assessed using existing questionnaires. A multivariate logistic regression was performed. Results: Overall, 116 patients with CD were included (48 ± 16 y; 70% female). Based on the CDAT, 58 patients (50%) were adequate adherers, but 86 patients (74%) were adequate adherers according to GFD-S. When adherence was measured using the CDAT, being female was associated with lower odds of adherence (odds ratio [OR]: 0.36; P = 0.028), and better emotional wellbeing was associated with higher odds of adherence (OR: 1.19; P < 0.001). When adherence was measured using GFD-S, membership in a support group (OR: 6.17; P = 0.002), stronger beliefs about the chronicity of CD (OR: 1.15; P = 0.059), and weaker beliefs on accident/chance causing CD (OR: 1.94; P = 0.05) were associated with greater odds of adherence. Difficulties when eating with family/friends (OR: 0.98; P = 0.005) and weaker beliefs on immunity causing CD (OR: 0.77; P = 0.031) were associated with lower odds of adherence. Conclusions: The association between gender, attending support groups, attitudes, experiences, and QoL with adherence to a GFD should be considered by health care professionals managing patients with CD.",

keywords = "Barriers, Beliefs, Diet, Gut, Nutrition",

author = "Eirini Dimidi and Bonita Kabir and Jaspreet Singh and Aikaterini Ageridou and Charlotte Foster and Paul Ciclitira and Patrick Dubois and Kevin Whelan",

year = "2021",

month = oct,

doi = "10.1016/j.nut.2021.111249",

language = "English",

volume = "90",

journal = "Nutrition",

issn = "0899-9007",

publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Predictors of adherence to a gluten-free diet in celiac disease

T2 - Do knowledge, attitudes, experiences, symptoms, and quality of life play a role?

AU - Dimidi, Eirini

AU - Kabir, Bonita

AU - Singh, Jaspreet

AU - Ageridou, Aikaterini

AU - Foster, Charlotte

AU - Ciclitira, Paul

AU - Dubois, Patrick

AU - Whelan, Kevin

PY - 2021/10

Y1 - 2021/10

N2 - Objectives: This study aimed to identify the relationship between adherence to a gluten-free diet (GFD) and demographic characteristics, knowledge, attitudes, and beliefs regarding celiac disease (CD) and GFD, experiences of following a GFD, symptoms, and quality of life (QoL). Methods: Patients with CD were recruited from outpatient clinics. Adherence to GFD was assessed using the CD adherence test (CDAT) and GFD score (GFD-S). Knowledge, attitudes, experiences, symptoms, and QoL were assessed using existing questionnaires. A multivariate logistic regression was performed. Results: Overall, 116 patients with CD were included (48 ± 16 y; 70% female). Based on the CDAT, 58 patients (50%) were adequate adherers, but 86 patients (74%) were adequate adherers according to GFD-S. When adherence was measured using the CDAT, being female was associated with lower odds of adherence (odds ratio [OR]: 0.36; P = 0.028), and better emotional wellbeing was associated with higher odds of adherence (OR: 1.19; P < 0.001). When adherence was measured using GFD-S, membership in a support group (OR: 6.17; P = 0.002), stronger beliefs about the chronicity of CD (OR: 1.15; P = 0.059), and weaker beliefs on accident/chance causing CD (OR: 1.94; P = 0.05) were associated with greater odds of adherence. Difficulties when eating with family/friends (OR: 0.98; P = 0.005) and weaker beliefs on immunity causing CD (OR: 0.77; P = 0.031) were associated with lower odds of adherence. Conclusions: The association between gender, attending support groups, attitudes, experiences, and QoL with adherence to a GFD should be considered by health care professionals managing patients with CD.

AB - Objectives: This study aimed to identify the relationship between adherence to a gluten-free diet (GFD) and demographic characteristics, knowledge, attitudes, and beliefs regarding celiac disease (CD) and GFD, experiences of following a GFD, symptoms, and quality of life (QoL). Methods: Patients with CD were recruited from outpatient clinics. Adherence to GFD was assessed using the CD adherence test (CDAT) and GFD score (GFD-S). Knowledge, attitudes, experiences, symptoms, and QoL were assessed using existing questionnaires. A multivariate logistic regression was performed. Results: Overall, 116 patients with CD were included (48 ± 16 y; 70% female). Based on the CDAT, 58 patients (50%) were adequate adherers, but 86 patients (74%) were adequate adherers according to GFD-S. When adherence was measured using the CDAT, being female was associated with lower odds of adherence (odds ratio [OR]: 0.36; P = 0.028), and better emotional wellbeing was associated with higher odds of adherence (OR: 1.19; P < 0.001). When adherence was measured using GFD-S, membership in a support group (OR: 6.17; P = 0.002), stronger beliefs about the chronicity of CD (OR: 1.15; P = 0.059), and weaker beliefs on accident/chance causing CD (OR: 1.94; P = 0.05) were associated with greater odds of adherence. Difficulties when eating with family/friends (OR: 0.98; P = 0.005) and weaker beliefs on immunity causing CD (OR: 0.77; P = 0.031) were associated with lower odds of adherence. Conclusions: The association between gender, attending support groups, attitudes, experiences, and QoL with adherence to a GFD should be considered by health care professionals managing patients with CD.

KW - Barriers

KW - Beliefs

KW - Diet

KW - Gut

KW - Nutrition

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DO - 10.1016/j.nut.2021.111249

M3 - Article

AN - SCOPUS:85105553347

SN - 0899-9007

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JO - Nutrition

JF - Nutrition

M1 - 111249

ER -

Predictors of adherence to a gluten-free diet in celiac disease: Do knowledge, attitudes, experiences, symptoms, and quality of life play a role?

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Keywords

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