Celiac Disease and the Gluten-free Diet: Registered Dietitian Nutritionists’ Self-reported Knowledge Varies

Abstract

Background: Adherence to the gluten-free diet is the only treatment for celiac disease (CD) and some patients report lack of expertise among registered dietitian nutritionists (RDNs). Objective: To measure RDN self-reported celiac disease (CD) knowledge and preferences for resources for self-education and patient education. Methods: A cross-sectional research design was used to recruit RDNs from participating state affiliates Alaska, Colorado, Connecticut, Delaware, Montana, Nebraska, and North Dakota in 2013. A 35 item internet-based survey was distributed via Survey Monkey and included Likert scale questions based on a previous RDN allergy survey. Demographic and gluten-free diet and CD multiple-choice questions were also included. Results: Four-hundred and five registered dietitians (RDNs) who volunteered from the seven participating affiliates responded to the survey. Chi-squares were used to determine frequencies and differences in responses per variable. Pearson correlation analyses were performed to determine the correlation of age, education level, years of practice, or number of CD patients seen per week and CD self-reported knowledge. RDNs reported either moderate or high levels of knowledge for all seven self-reported knowledge topics. Over 85% of RDNs selected correct answers for five CD knowledge questions. Professional and academic publications were the most commonly used resources by RDNs for self-education whereas handouts were the most commonly used resource by RDNs for patient education. Conclusion: RDNs may need more reinforcement on identification and treatment of nutritional deficiencies of CD management.

Knowledge of Health Students Regarding Nutritional Deficiencies in Patients With Celiac Disease in Jazan Region: A Cross-Sectional Study

“…In Australia, dietitians had a 73% score in the knowledge about appropriate food for CeD and 69% in the knowledge related to screening and diagnosis of the disease [ 26 ]. In the United States, 85% of dietitian nutritionists were knowledgeable when assessed in five knowledge questions [ 27 ].…”

Gluten-free Diet - Tough Alley in Torrid Time

“…The actual surge in incidence, wheat content, gluten intake, CD-related T-cell stimulatory epitopes in wheat, usage in the processed food industries, nutritional deficiencies, changing phenotype and the fact that gluten is potentially detrimental to humankind health, make the RDNs role more complex, difficult but challenging. The most recent self-reported knowledge of the RDNs in GFD concluded that "RDNs may need more reinforcement on identification and treatment of nutritional deficiencies of CD" [5], but it seems that their role in the CD team is much vaster and GFD is a tough alley in a torrid time. As said, GFD for the RDNs dealing with CD is neither a solved problem nor a "closed case".…”

“…The cellulars' app is expanding and it becomes difficult to monitor, review, and compare them for their reliability and accuracy [8,9,10,11,12]. This problem is expanded due to the fact that the internet is the preferred resource for RDNs self and patients educations [5,13]. More than 20 on-line sources of information on CD and GFD are available [14].…”

“…Not only the malabsorptive or the nutritional habits, but GFD itself is associated with numerous nutritional deficiencies like: low B vitamins, folate, calcium, vitamin D, iron, zinc, magnesium, carnitine and fiber [5,54,55,56].…”

“…But the other way around, the dietitian's perspectives toward the patients was scarcely investigated. This is the raison why Gieger et al should be congratulated for measuring RDN self-reported CD knowledge and preferences for resources intendant for self and patient educations [5]. Based on 405 RDNs from 7 states in the USA, 35 item internet-based surveys, they concluded that RDNs may need more reinforcement on identification and treatment of nutritional deficiencies of CD management.…”