I Can’t Eat That! Sticking to a Gluten-Free Diet

Abstract

Despite the beneits of a gluten-free diet (GFD), rates for strict adherence range from 42% to 91%. Studies have established the maximum tolerable daily dose at 50 mg/day and led the European Union to restrict labelling 'gluten-free' products to those with less than 20 mg/kg. Qualitative studies have determined that patients experience social problems in ive areas: eating in the workplace, shopping, travelling, eating out and eating at home with others. These situations may lead to negative emotions and afect relationships. Therefore, further research into investigating the underlying factors behind efective adherence is essential, as is the need for a theoretical framework to design programmes to improve adherence and quality of life in coeliac patients. Albert Bandura´s Social Cognitive Theory can provide a beter understanding of adherence and, moreover, a theoretical framework to design self-management programmes. Within this framework, the Health Action Process Approach (HAPA) model could provide a theoretical mechanism to beter understand GFD adherence. The main aim of this paper is to review the factors related to GFD adherence and to present the HAPA model as a useful framework for the design of interventions to improve perceived self-eicacy, adherence to the diet and, thus, enhance quality of life in coeliac patients.

Development and Validation of a Specific Self-Efficacy Scale in Adherence to a Gluten-Free Diet

“…New intervention models in health place emphasis on patients' responsibility and their empowerment to direct their treatment and improve their quality of life (Holman and Lorig, 2000 , 2004 ; Bodenheimer et al, 2002 ; Carey and Doherty, 2012 ). The aim of this research was to provide tools to study these psychosocial factors in order to establish the bases for the design of self-management programs for sufferers of celiac disease (Fueyo-Díaz et al, 2017 ).…”