Effect of gluten‐free diet and compliance on quality of life in pediatric celiac disease patients

Abstract

Background Quality of life (QOL) in children with celiac disease (CD) has been sparsely studied. Aims We aimed to study QOL in pediatric CD and the effect of a gluten‐free diet (GFD) in a North Indian population. Methods QOL was assessed at baseline and 6 months after GFD using a pediatric symptom checklist (PSC) score. The effect of GFD was assessed using a CD‐specific questionnaire on domains such as dietary compliance, parental behavior and perceptions, children's feeling, and difficulty identifying gluten‐free foods. Results A total of 60 CD children (age 6.03 ± 0. 42 years, range: 2–12 years, M:F 2:1) were prospectively enrolled. The median PSC score at baseline was 11.5 (2–35), which showed a statistically significant improvement after GFD to 2.5 (0–34) (P < 0.001). Significant concerns regarding specific domains emerged: difficulty in maintaining GFD 26.2%, at school 14.3%, at parties 43.2%, poor taste 11.4%, special diet a burden 28.5%, felt left out at school or friend's home 40.9%, felt different from other kids 40.9%, felt embarrassed to bring GFD to parties 54.6%, felt angry about following a special diet 56.8%, felt not invited out for meals because of CD 13.6%, and difficulty determining if food available was gluten free in 75%. Conclusion GFD has a significant impact on emotional, behavioral, and psychosocial domains in children with CD. Proper labeling of commercially available food items, counseling, and patient support groups are the need of the hour.

Examining the Psychosocial Well‐Being of Children and Adolescents With Coeliac Disease

“…In relation, risk of cognitive, emotional, and behavioral difficulties were higher in children and adolescents with newly diagnosed CD than those in remission after GFD commencement (51). Two studies found that risk of psychosocial problems reduced after 6 months (4) and 1 year of a GFD (17). It is not clear from these findings whether this is due to time, or the process of psychological adjustment (ie, developing adaptive coping patterns and reducing negative illness identity).…”

“…Recent advances in food labeling and new policies, mostly in Western regions including the European Union and the United Kingdom (4,8), may increase awareness and assurance of GF foods to facilitate everyday life (55). It is reported there remains a need for stricter food labeling policies in Asia and the Indian subcontinent (4). While the advances in policy could suggest better psychosocial well-being in Western countries, this is inconsistent with our results comparing CDDUX scores between regions.…”

“…Children with CD and their parents negatively rated environments outside of home and school (38) and see home as the most comfortable coping environment (15,38). Some children and adolescents with CD reported feeling left out at school or a friend's home (29.3%-51.1%) (4,47,54), and believing they were not invited out for meals due to CD (14%-33%) (4,54). Children with CD participated significantly less, and liked participating significantly less in food-related activities than healthy controls (33).…”

Quality of Life in Teenagers and Adults With Coeliac Disease: From Newly Spanish Coeliac Disease Questionnaire Validation to Assessment in a Population-Based Study

“…The ubiquitous nature of gluten constitutes a global problem for coeliacs because the GFD restricts the choice of many foods, with a significant impact on the behavioral, emotional, and psychosocial domains of coeliacs ( 7 , 30 ). Assessing the HRQoL has been increasingly acknowledged in research and clinical studies in CD, thus, contributing to improved interventions and measures that can reduce the burden on the affected patients.…”

IV. Ikergazte. Nazioarteko ikerketa euskaraz. Kongresuko artikulu bilduma. Osasun Zientziak

“…Zenbait ikerkuntzetan baieztatu da osasun hezkuntza garatzea eta pertsona zeliakoei eskaintzea beharrezkoa dela euren egoera sozialari aurre egiteko Chellan et al, 2019). Horregatik guztiagatik, Nutrizio Hezkuntza programak osasun fisikoa eta soziala bilatu behar ditu.…”