Cultural Adaptation and Reliability Testing of the Coeliac Disease Food Attitudes and Behaviours Scale in Brazil

Background: Coeliac disease (CD) is an autoimmune chronic condition that requires a strict diet without gluten as a single effective treatment. However, adherence to a life-long gluten-free diet (GFD) may promote psychological suffering and disordered eating. The Coeliac Disease Food Attitudes and Behaviours Scale (CD-FAB) is the only instrument specifically designed to evaluate these aspects in individuals with CD. Objective: This study aimed to translate the CD-FAB and test its reliability in the Brazilian population. Methods: The research was conducted in three stages: (i) translation and cultural adaptation of CD-FAB into Brazilian Portuguese; (ii) pretesting with Brazilian individuals diagnosed with CD to assess item understanding; and (iii) psychometric evaluation through reproducibility (test-retest reliability) via intraclass correlation coefficient (ICC) and internal consistency via Cronbach's alpha. Results: The CD-FAB was successfully adapted to the Brazilian CD population (Child CD-FAB-BR) and demonstrated strong internal consistency (α = 0.807) and an intraclass correlation coefficient (ICC = 0.928). Conclusions: The Brazilian version of CD-FAB proved to be reliable for assessing food attitudes and behaviours in people with CD, potentially allowing for the identification of factors to guide research and clinical practice by driving behaviour-based strategies to improve nutritional education and strategic policies for coeliac patients. Studies with larger and more diverse samples are recommended to provide external validation of the instrument.