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Factors that influence adherence to a gluten-free diet in adults with celiac disease
Daniel A Leffler1, Jessica Edwards-George, Melinda Dennis
1Department of Gastroenterology, The Celiac Center, Dana 501, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA. dleffler@caregroup.harvard.edu
Objective:
The only treatment for celiac disease is lifelong adherence to a gluten-free diet, yet adherence is limited and factors influencing adherence are poorly understood. The purpose of this study was to determine factors influencing gluten-free diet adherence in adults with celiac disease.
Methods:
A questionnaire was developed and administered to 154 adults with celiac disease who then underwent a standardized gluten-free diet evaluation by an experienced nutritionist. Multivariate analysis was conducted to determine factors associated with adherence level.
Results:
Thirteen factors hypothesized to contribute to gluten-free diet adherence were found to be significantly associated with improved adherence including: understanding of the gluten-free diet, membership of a celiac disease advocacy group, and perceived ability to maintain adherence despite travel or changes in mood or stress (P < 0.001).
Conclusions:
This study identified specific factors correlated with gluten-free diet adherence. These results provide a foundation for the design of educational interventions to improve adherence.
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