Self-Report of Adherence to Gluten-Free Diet in Patients with Celiac Disease Versus Expert Evaluation

Ali Jafari, Fazel Isapanah Amlashi, Zahra Norouzi, Iman ShahabiNasab, Sima Besharat, Puria Qadirian



Consuming gluten can lead to the immune-mediated condition known as celiac disease (CD) in genetically-prone people. Presently, the only approved and available treatment is stringent and lifetime devotion to a gluten-free diet (GFD). This study aimed to assess GFD adherence in patients with CD in Golestan province, northeast Iran.

Materials and Methods: 

All cases with confirmed CD registered in the Golestan Registry of Celiac (N=220) were selected for this cross-sectional study. 87 patients volunteered to take part in the interviews and completed the questionnaire. Since the day of diagnosis, all patients in this center had been treated with a GFD, but their adherence to the regime was unknown. Celiac Dietary Adherence Test (CDAT) and the Standardized Dietician Evaluation (SDE) were used to evaluate their adherence to GFD. 


Among the 85 individuals who responded in depth to the CDAT, the mean (standard deviation) age was 32.41 (15.45) years, 32 (36.8%) were male, and 72 (32.8%) adhered to the diet according to their self-expression. However, in the SDE, only 52 (30.23%) exhibited great to good adherence.


The adherence and weak adherence groups had similar mean ages. However, non-adherence was associated with higher mean age. Although women had stronger adherence, there was no difference in sex. The elderly and males exhibited low GFD adherence.


Gluten-Free Diet, Celiac Disease, Adherence

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