Barriers to Compliance to Gluten-free Diet in Celiac Disease: The Role of Depression and Motivation

Weiss, Guy A.; Lackner, Jeffrey M.; Keller, Craig E.; Gudleski, Greg; Hauck, Cliff; Sitrin, Michael D.

doi:10.14309/00000434-201310001-01562

Cited by 5 publications

(11 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The systematic search identified 1158 potentially relevant papers for inclusion; after duplicates were removed, 641 papers underwent screening (see Figure 1 for PRISMA flow chart). Following title and abstract screening, 84 papers were retained for full-text screening, which resulted in 8 studies (reported in 9 papers) being included in the meta-analysis (Arigo, Anskis, & Smyth, 2012;Edwards-George et al, 2009;Kerswell & Strodl, 2015;Mahadev, Gardner, Lewis, Lebwohl, & Green, 2015;Nachman et al, 2009;Nachman et al, 2010;Sainsbury, Mullan, & Sharpe, 2013a, 2013bWeiss et al, 2013). All 8 studies measured M A N U S C R I P T…”

Section: Study Selectionmentioning

confidence: 99%

“…Studies were published between 2009 and 2015, and included between 53 and 390 CD patients (total N=1644; median=188). Four studies were conducted in the USA (Arigo et al, 2012;Edwards-George et al, 2009;Mahadev et al, 2015;Weiss et al, 2013), three in Australia (Kerswell & Strodl, 2015;Sainsbury et al, 2013aSainsbury et al, , 2013b, and one in Argentina (one study published in two papers; Nachman et al, 2009;Nachman et al, 2010). Females were overrepresented in all samples (median=83.4% female; range=76.6-100%).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Seven studies used a cross-sectional design (Arigo et al, 2012;Kerswell & Strodl, 2015;Mahadev et al, 2015;Sainsbury et al, 2013aSainsbury et al, , 2013bWeiss et al, 2013). The remaining study was a prospective study with measurement at diagnosis and after 1-and 4-years on a GFD; the relationship of interest was analysed crosssectionally at both follow-up time points (Nachman et al, 2009;Nachman et al, 2010).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Five studies measured GFD adherence using the CDAT (Kerswell & Strodl, 2015;Mahadev et al, 2015;Sainsbury et al, 2013aSainsbury et al, , 2013bWeiss et al, 2013), two used a dietitian-rated assessment (Edwards-George et al, 2009;Nachman et al, 2009;Nachman et al, 2010), and one used the adapted Morisky adherence scale (Arigo et al, 2012). When reported, the mean scores for GFD adherence indicated that, on average, participants were highly adherent (Arigo et al, 2012;Edwards-George et al, 2009;Mahadev et al, 2015;Sainsbury et al, 2013aSainsbury et al, , 2013b.…”

Section: Gfd Adherence and Depressive Symptomsmentioning

confidence: 99%

See 3 more Smart Citations

The relationship between gluten free diet adherence and depressive symptoms in adults with coeliac disease: A systematic review with meta-analysis

Sainsbury¹,

Marques²

2017

Preprint

View full text Add to dashboard Cite

Purpose: Depressive symptoms are common in patients with coeliac disease (CD) and may represent a barrier to gluten free diet (GFD) adherence. The aims of this meta-analysis were: (1) to synthesise the evidence on the relationship between depression or depressive symptoms and degree of adherence to a GFD in patients with CD who are already attempting a GFD (i.e., post-diagnosis and onset of GFD), and (2) to summarise the direction of causation of any observed relationship. Methods: A random effects meta-analysis of 8 cross-sectional studies (N=1644) was conducted. Included studies measured self-reported depressive symptoms and GFD adherence using either a dietitian interview or validated self-report questionnaire that considered unintentional gluten consumption.Results: There was a moderate association between poorer GFD adherence and greater depressive symptoms (r=0.398, 95% CI=0.321-0.469), with marked heterogeneity in the effects (I2=66.8%). A sensitivity analysis excluding studies with a moderate/high (k=1) or unclear risk of bias (k=1) did not change the results. Conclusion: The low number of studies meeting inclusion criteria limits the strength of the conclusions. Available evidence suggests there is an association between poorer GFD adherence and self-reported depressive symptoms; however, studies using longitudinal and prospective designs, and reliable measures, particularly for adherence, are needed to confirm this association. The direction of causation between depression and adherence remains unclear.

show abstract

Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Gfd Adherence and Depressive Symptomsmentioning

confidence: 99%

See 2 more Smart Citations

The relationship between gluten free diet adherence and depressive symptoms in adults with coeliac disease: A systematic review with meta-analysis

Sainsbury¹,

Marques²

2017

Preprint

View full text Add to dashboard Cite

show abstract

“…Lifelong commitment of a strict gluten-free diet affects emotional and cognitive aspects, and interpersonal relationships. A recent study found a significant correlation between non-compliance and depression with a decrease in quality of life [ 64 ]. Barriers of compliance could minimize the therapeutic effect of the gluten-free diet.…”

Section: Opportunitiesmentioning

confidence: 99%

The Gluten-Free Diet in the 3rd Millennium: Rules, Risks and Opportunities

Welstead

2015

Diseases

View full text Add to dashboard Cite

The gluten-free diet has long been considered the standard treatment for celiac disease. However, a significant number of patients continue to experience persistent symptoms despite following a gluten-free diet. Inadvertent gluten ingestion, fermentable carbohydrates, cross-contamination, and social or financial burdens present obstacles to maintaining a gluten-free diet. Proper diet education and follow-up by an expert Registered Dietitian (RD) is essential to ensure adequate nutrition on the gluten-free diet. Patients may experience unintended weight gain or elevated cholesterol levels after initiating the gluten-free diet due to adequate absorption and healing of the intestines. This review deals with the evolving gluten-free diet, optimal recommendations while considering the overall health of patients, and multi-factorial aspects of the permanent lifestyle change.

show abstract