Challenges of monitoring the gluten-free diet adherence in the management and follow-up of patients with celiac disease

Celiac disease (CD) is a chronic gluten-responsive immune mediated enteropathy and is treated with a gluten-free diet (GFD). However, a strict diet for life is not easy due to the ubiquitous nature of gluten. This review aims at examining available evidence on the degree of adherence to a GFD, the m...

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Autores: Wieser, Herbert, Ruiz Carnicer, Ángela, Segura Montero, Verónica, Comino Montilla, Isabel María, Sousa Martín, Carolina
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/129001
Acceso en línea:https://hdl.handle.net/11441/129001
https://doi.org/10.3390/nu13072274
Access Level:acceso abierto
Palabra clave:Celiac disease
Dietary adherence
Gluten-free diet
Patients with CD
Symptoms
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spelling Challenges of monitoring the gluten-free diet adherence in the management and follow-up of patients with celiac diseaseWieser, HerbertRuiz Carnicer, ÁngelaSegura Montero, VerónicaComino Montilla, Isabel MaríaSousa Martín, CarolinaCeliac diseaseDietary adherenceGluten-free dietPatients with CDSymptomsCeliac disease (CD) is a chronic gluten-responsive immune mediated enteropathy and is treated with a gluten-free diet (GFD). However, a strict diet for life is not easy due to the ubiquitous nature of gluten. This review aims at examining available evidence on the degree of adherence to a GFD, the methods to assess it, and the barriers to its implementation. The methods for monitoring the adherence to a GFD are comprised of a dietary questionnaire, celiac serology, or clinical symptoms; however, none of these methods generate either a direct or an accurate measure of dietary adherence. A promising advancement is the development of tests that measure gluten immunogenic peptides in stools and urine. Causes of adherence/non-adherence to a GFD are nu-merous and multifactorial. Inadvertent dietary non-adherence is more frequent than intentional non-adherence. Cross-contamination of gluten-free products with gluten is a major cause of inadvertent non-adherence, while the limited availability, high costs, and poor quality of certified gluten-free products are responsible for intentionally breaking a GFD. Therefore, several studies in the last decade have indicated that many patients with CD who follow a GFD still have difficulty controlling their diet and, therefore, regularly consume enough gluten to trigger symptoms and damage the small intestine.Junta de Andalucía AT17_5489_USE, PI-0053-2018Multidisciplinary Digital Publishing Institute (MDPI)Microbiología y Parasitología2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/129001https://doi.org/10.3390/nu13072274reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésNutrients, 13 (7), 2274.AT17_5489_USEPI-0053-2018https://doi.org/10.3390/nu13072274info:eu-repo/semantics/openAccessoai:idus.us.es:11441/1290012026-06-17T12:51:07Z
dc.title.none.fl_str_mv Challenges of monitoring the gluten-free diet adherence in the management and follow-up of patients with celiac disease
title Challenges of monitoring the gluten-free diet adherence in the management and follow-up of patients with celiac disease
spellingShingle Challenges of monitoring the gluten-free diet adherence in the management and follow-up of patients with celiac disease
Wieser, Herbert
Celiac disease
Dietary adherence
Gluten-free diet
Patients with CD
Symptoms
title_short Challenges of monitoring the gluten-free diet adherence in the management and follow-up of patients with celiac disease
title_full Challenges of monitoring the gluten-free diet adherence in the management and follow-up of patients with celiac disease
title_fullStr Challenges of monitoring the gluten-free diet adherence in the management and follow-up of patients with celiac disease
title_full_unstemmed Challenges of monitoring the gluten-free diet adherence in the management and follow-up of patients with celiac disease
title_sort Challenges of monitoring the gluten-free diet adherence in the management and follow-up of patients with celiac disease
dc.creator.none.fl_str_mv Wieser, Herbert
Ruiz Carnicer, Ángela
Segura Montero, Verónica
Comino Montilla, Isabel María
Sousa Martín, Carolina
author Wieser, Herbert
author_facet Wieser, Herbert
Ruiz Carnicer, Ángela
Segura Montero, Verónica
Comino Montilla, Isabel María
Sousa Martín, Carolina
author_role author
author2 Ruiz Carnicer, Ángela
Segura Montero, Verónica
Comino Montilla, Isabel María
Sousa Martín, Carolina
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Microbiología y Parasitología
dc.subject.none.fl_str_mv Celiac disease
Dietary adherence
Gluten-free diet
Patients with CD
Symptoms
topic Celiac disease
Dietary adherence
Gluten-free diet
Patients with CD
Symptoms
description Celiac disease (CD) is a chronic gluten-responsive immune mediated enteropathy and is treated with a gluten-free diet (GFD). However, a strict diet for life is not easy due to the ubiquitous nature of gluten. This review aims at examining available evidence on the degree of adherence to a GFD, the methods to assess it, and the barriers to its implementation. The methods for monitoring the adherence to a GFD are comprised of a dietary questionnaire, celiac serology, or clinical symptoms; however, none of these methods generate either a direct or an accurate measure of dietary adherence. A promising advancement is the development of tests that measure gluten immunogenic peptides in stools and urine. Causes of adherence/non-adherence to a GFD are nu-merous and multifactorial. Inadvertent dietary non-adherence is more frequent than intentional non-adherence. Cross-contamination of gluten-free products with gluten is a major cause of inadvertent non-adherence, while the limited availability, high costs, and poor quality of certified gluten-free products are responsible for intentionally breaking a GFD. Therefore, several studies in the last decade have indicated that many patients with CD who follow a GFD still have difficulty controlling their diet and, therefore, regularly consume enough gluten to trigger symptoms and damage the small intestine.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/129001
https://doi.org/10.3390/nu13072274
url https://hdl.handle.net/11441/129001
https://doi.org/10.3390/nu13072274
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Nutrients, 13 (7), 2274.
AT17_5489_USE
PI-0053-2018
https://doi.org/10.3390/nu13072274
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Multidisciplinary Digital Publishing Institute (MDPI)
publisher.none.fl_str_mv Multidisciplinary Digital Publishing Institute (MDPI)
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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