Adherence to the gluten free diet and health related quality of life in an ethnically diverse pediatric population with Celiac Disease

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Abstract

Objectives:

Celiac disease (CD) is an autoimmune disease that requires life-long adherence to a gluten-free diet (GFD). Adherence to the GFD in childhood may be poor and adversely influence health related quality of life (HRQOL). The study purpose was to determine socio-demographic and socio-economic factors influencing adherence to the GFD and HRQOL in a multi-ethnic cohort of youth with CD.

Methods:

A multi-site (Edmonton, Hamilton, Toronto) study examining child-parent HRQOL in youth with CD (n=243) and /or mild gastrointestinal complaints (GI-CON; n = 148) was conducted. Socio-demographic (age, child-parental age/education/ethnicity/place of birth), anthropometric (weight, height, BMI), disease (diagnosis, age at diagnosis, duration, Marsh score, serology), household characteristics (income, family size, region, number of children/total household size), HRQOL (Peds TM4.0/Kindl and CDDUX), GI Complaints (PedsQLTM:Gastrointestinal Symptom Scale [GSS]) and gluten intake were measured.

Results:

Younger age (<10 years), non-Caucasian ethnicity (parent/child) and presence of GI symptoms were associated with the highest rates of adherence to the GFD in CD children (p < 0.05). CD children (parent/child) had higher HRQOL (average, composite domains) than GI-CON (p < 0.05), but CD children were comparable to healthy children. Lack of GI symptoms, non-Caucasian ethnicity and age (<10 yrs) were associated with increased HRQOL in composite/average domains for CD (p < 0.05).

Conclusions:

Child-parent perceptions of HRQOL in a multiethnic population with CD are comparable to healthy reference populations, but significantly higher than in parent/child GI-CON. Adherence to the GFD in ethnically diverse youth with CD was related to GI symptoms, age of the child and ethnicity of the parent-child.

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