Vol. 2 No. 3 (2023): infermieristica journal: your heart, our beat
Articles

The factors obstaculating adherence to the gluten free diet in the youth bands: an observational study

PDF
  • Bartolomeo Rinaldi,
  • Vittoria Vallana,
  • Silvia Vallese,
  • Benedetta Musso,
  • Giorgio Bergesio,
  • Andrea Strocco
Bartolomeo Rinaldi
Infermiere
DOI: https://doi.org/10.36253/if-2096

Published 2023-10-31

Keywords

  • Celiac Disease,
  • Gluten-Free Foods,
  • Gluten Free Diet,
  • Adherence Difficulties

Copyright (c) 2023 Bartolomeo Rinaldi, Vittoria Vallana, Silvia Vallese, Benedetta Musso, Giorgio Bergesio, Andrea Strocco

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

ABSTRACT

Introduction

Celiac Disease (CD) affects the small intestine and it’s characterized by a high sensitivity to gluten. Among the main signs and symptoms, there are typical or intestinal ones such as abdominal pain, abdominal swelling, diarrhea, weight loss, atrophy of the intestinal villi. At the moment, the only effective therapy is to follow a gluten-free diet during a long-life. The aim of the study is to investigate the difficulties of adherence to GFD in young people with CD.

Materials and methods

A questionnaire was administered to the population under study (15-30 years), between 9 July 2022 and 29 August 2022. The interviewees answered 28 questions: 5 concerning the socio-demographic variable, 23 concerning the difficulties of adherence to the GFD.

Results

227 people answered the questionnaire. Among them, a low percentage was sent to the attention of a dietician or psychologist. 78.8% prepare their own meal independently. 78.4% believe they know very well the foods they can eat and 93% say they follow the diet stringently.

Discussion

Following the GF diet is a challenge for most young people with CD. Restaurants offering GF meals are limited and this could be a reason for giving up leisure and socializing, or in the worst-case scenario, the person with CD is forced not to join the GFD. The risk of contamination that can involve fear, isolation, embarrassment in asking questions, is another factor to always keep in mind.

Conclusion

Adherence difficulties begins with the CD diagnosis and the taking charge. The main problem in related to the social setting of young people, who wants to live without complications due to crance of places with GF food. Literature should investigate about adherence difficulties, instead of quality of life and behaviour CD related. It’s necessary to improve the attention on GF world to decrease discomfort about medical conditions.

Keywords

FD, celiac disease, gluten-free foods, therapy, adherence difficulties.

PDF

References

  1. Bibliography
  2. Fok CY, Holland KS, Gil-Zaragozano E, Paul SP. The role of nurses and dietitians in managing paediatric coeliac disease. Br J Nurs. 2016;25(8):449– 55.
  3. Robinson BL, Davis SC, Vess J, Lebel J. Primary care Management of celiac disease. Nurse Pract. 2015;40(2):28–34.
  4. Hujoel IA, Reilly NR, Rubio-Tapia A. Celiac Disease: Clinical Features and Diagnosis. Gastroenterol Clin North Am [Internet]. 2019;48(1):19–37.
  5. Dominguez Castro P, Harkin G, Hussey M, Christopher B, Kiat C, Liong Chin J, et al. Changes in Presentation of Celiac Disease in Ireland From the 1960s to 2015. Clin Gastroenterol Hepatol [Internet]. 2017;15(6):864-871.e3.
  6. Volta U, Caio G, Stanghellini V, De Giorgio R. The changing clinical profile of celiac disease: A 15-year experience (1998-2012) in an Italian referral center. BMC Gastroenterol. 2014;14(1):1–8.
  7. Al-Toma A, Volta U, Auricchio R, Castillejo G, Sanders DS, Cellier C, et al. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United Eur Gastroenterol J. 2019;7(5):583–613.
  8. Caio G, Volta U, Sapone A, Leffler DA, De Giorgio R, Catassi C, et al. Celiac disease: A comprehensive current review. BMC Med. 2019;17(1).
  9. Oxentenko, Amy S. and AR-T. Celiac Disease. Mayo Clin Proc. 2019;94:2556+.
  10. Meyer S, Rosenblum S. Daily experiences and challenges among children and adolescents with celiac disease: Focus group results. J Pediatr Gastroenterol Nutr. 2018;66(1):58–63.
  11. Arnone J, Fitzsimons V. Adolescents with celiac disease: A literature review of the impact developmental tasks have on adherence with a gluten-free diet. Gastroenterol Nurs. 2012;35(4):248–54.
  12. Silvester JA, Weiten D, Graff LA, Walker JR, Duerksen DR. Living gluten-free: Adherence, knowledge, lifestyle adaptations and feelings towards a gluten- free diet. J Hum Nutr Diet. 2016;29(3):374–82.
  13. Biagi F, Andrealli A, Bianchi PI, Marchese A, Klersy C, Corazza GR. A gluten- free diet score to evaluate dietary compliance in patients with coeliac disease. Br J Nutr. 2009;102(6):882–7.
  14. Leffler DA, Dennis M, Edwards George JB, Jamma S, Magge S, Cook EF, et al. A Simple Validated Gluten-Free Diet Adherence Survey for Adults With Celiac Disease. Clin Gastroenterol Hepatol [Internet]. 2009;7(5):530-536.e2.
  15. Black JL, Orfila C. Impact of coeliac disease on dietary habits and quality of life. J Hum Nutr Diet. 2011;24(6):582–7.
  16. Lins MTC, Tassitano RM, Brandt KG, Antunes MMDC, Silva GAP Da. Translation, cultural adaptation, and validation of the celiac disease DUX (CDDUX). J Pediatr (Rio J) [Internet]. 2015;91(5):448–54.
  17. Fueyo-Díaz R, Gascón-Santos S, Asensio-Martínez Á, Sánchez-Calavera MA, Magallón-Botaya R. Transcultural adaptation and validation of the Celiac Dietary Adherence Test. A simple questionnaire to measure adherence to a gluten-free diet. Rev Esp Enferm Dig. 2016;108(3):138–44.
  18. Wessels MMS, te Lintelo M, Vriezinga SL, Putter H, Hopman EG, Mearin ML. Assessment of dietary compliance in celiac children using a standardized dietary interview. Clin Nutr [Internet]. 2018;37(3):1000–4.
  19. Biagi F, Bianchi PI, Marchese A, Trotta L, Vattiato C, Balduzzi D, et al. A score that verifies adherence to a gluten-free diet: A cross-sectional, multicentre validation in real clinical life. Br J Nutr. 2012;108(10):1884–8.
  20. Rodrigo L, Pérez-Martinez I, Lauret-Braña E, Suárez-González A. Descriptive study of the different tools used to evaluate the adherence to a gluten-free diet in celiac disease patients. Nutrients. 2018;10(11).
  21. Edwards George JB, Leffler DA, Dennis MD, Franko DL, Blom-Hoffman J, Kelly CP. Psychological correlates of gluten-free diet adherence in adults with celiac disease. J Clin Gastroenterol. 2009;43(4):301–6.
  22. Estévez V, Ayala J, Vespa C, Araya M. The gluten-free basic food basket: A problem of availability, cost and nutritional composition. Eur J Clin Nutr. 2016;70(10):1215–7.
  23. Dowd AJ, Tamminen KA, Jung ME, Case S, Mcewan D, Beauchamp MR. Motives for adherence to a gluten-free diet: A qualitative investigation involving adults with coeliac disease. J Hum Nutr Diet. 2014;27(6):542–9.
  24. Panzer RM, Dennis M, Kelly CP, Weir D, Leichtner A, Leffler DA. Navigating the gluten-free diet in college. J Pediatr Gastroenterol Nutr. 2012;55(6):740– 4.
  25. Holbein CE, Carmody JK, Hommel KA. Topical Review: Adherence Interventions for Youth on Gluten-Free Diets. J Pediatr Psychol. 2018;43(4):392–401.
  26. Czaja-Bulsa G, Bulsa M. Adherence to gluten-free diet in children with celiac disease. Nutrients. 2018;10(10):1–9.
  27. Bacigalupe G, Plocha A. Celiac Is a Social Disease : Family Challenges and Strategies. 2015;33(1):46–54.
  28. Villafuerte-Galvez J, Vanga RR, Dennis M, Hansen J, Leffler DA, Kelly CP, et al. Factors governing long-term adherence to a gluten-free diet in adult patients with coeliac disease. Aliment Pharmacol Ther. 2015;42(6):753–60.