Systematic review: the evidence base for long‐term management of coeliac disease

Haines, Melissa; Anderson, Robert P.; Gibson, Peter R.

doi:10.1111/j.1365-2036.2008.03820.x

Cited by 182 publications

(161 citation statements)

References 341 publications

(225 reference statements)

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“…Furthermore, assessment of the level of non-adherence at which possible interventions would be deemed to be most beneficial is also problematic, as the potential individual and societal health benefit of small changes in gluten consumption is difficult to estimate. The risk of malignancy, for example, is now believed to be much lower than previously estimated and the influence of occasional non-adherence is unclear (Akobeng & Thomas, 2008;Catassi et al, 2007;Green et al, 2003;Haines, Anderson, & Gibson, 2008;Kaukinen et al, 1999;Silano et al, 2007). Diagnostic delay may have an influence on the likelihood of long term complications beyond treatment adherence (Silano et al, 2007) although the evidence for this is mixed (Haines et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Intentional and inadvertent non-adherence in adult coeliac disease. A cross-sectional survey

2013

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Publisher's copyright statement: NOTICE: this is the author's version of a work that was accepted for publication in Appetite. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be re ected in this document. Changes may have been made to this work since it was submitted for publication. A de nitive version was subsequently published in Appetite, 68, 2013Appetite, 68, , 10.1016Appetite, 68, /j.appet.2013 Additional information: Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-pro t purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. ABSTRACTAdherence to a gluten-free diet is the mainstay of treatment for coeliac disease. Nonadherence is common as the diet is restrictive and can be difficult to follow. This study aimed to determine the rates of intentional and inadvertent non-adherence in adult coeliac disease and to examine the factors associated with both. A self-completion questionnaire was mailed to adult coeliac patients identified from the computer records of 31 family practices within the North East of England. We received 287 responses after one reminder. Intentional gluten consumption was reported by 115 (40%) of respondents. 155 (54%) had made at least one known mistaken lapse over the same period and 82 (29%) reported neither intentional nor mistaken gluten consumption.Using logistic regression analysis, low self-efficacy, perceptions of tolerance to gluten and intention were found to be independently predictive of intentional gluten consumption. A statistical model predicted 71.8% of cases reporting intentional lapses.Intentional non-adherence to the GFD was found to be common but not as frequent as inadvertent lapses. Distinguishing the factors influencing both intentional and inadvertent non-adherence is useful in understanding dietary self-management in coeliac disease.

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Section: Discussionmentioning

confidence: 99%

Intentional and inadvertent non-adherence in adult coeliac disease. A cross-sectional survey

2013

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“…This haplotype is also associated with type 1 diabetes, Addison syndrome, and Sjögren's syndrome (Haines, Anderson, & Gibson, 2008). Homozygocity for the HLA phenotypes is much more efficient at expressing antigens to gluten than heterozygous HLA, which may explain the varying degree and severity of symptoms in active celiac disease (Vader, et al, 2003).…”

Section: Chapter II Review Of Literature Celiac Diseasementioning

confidence: 99%

“…Serological testing relies on antibodies produced in response to gluten ingestion. Recent advances in serological antibody testing have shown that celiac disease is much more common than once thought (Haines, et al, 2008).…”

Section: Chapter II Review Of Literature Celiac Diseasementioning

confidence: 99%

Formulation and Sensory Evaluation of Gluten-Free Muffins Containing Flax

Woodyard

Tidwell

Schilling

et al. 2012

Journal of the Academy of Nutrition and Dietetics

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Celiac disease is characterized by an allergic reaction to gluten that causes inflammation of the small intestine and can lead to malabsorption and malnutrition.Gluten-free products are being developed that meet dietary needs of individuals with celiac disease. However, these products often lack whole grains and fiber. Fortification of gluten-free products with flax can increase nutritional value and alleviate inflammation. Sensory analysis (N=152) was conducted to evaluate the acceptability of gluten-free muffins with moderate (3.8%) and high (7.4%) amounts of added flax.Results indicated that consumers preferred (p<0.05) the muffin without flax or the highflax muffin more than the muffin with the moderate-flax treatment. The high-flax and control treatments were rated 6.7, between like slightly and moderately like; the muffins from the moderate-flax treatment were rated 6.4 on a nine-point hedonic scale. Producers of gluten-free products could potentially formulate muffins that include flax and are acceptable to consumers.ii ACKNOWLEDGEMENTS

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“…Long-term complications of untreated CD are among others diarrhoea, abdominal pain, perinatal problems, osteoporosis and cancer. 1,4 CD has a strong genetic component, as 90% of CD patients carry the class II HLA-DQ2 haplotype, about 5% the HLA-DQ8 molecule [5][6][7][8] and the rest usually the half of the HLA-DQ2 heterodimer.The HLA-DQ2 and DQ8 haplotypes are present in over 25% of the general population, 6 but only 1% actually develops CD. 1 This indicates that HLA-DQ2 and -DQ8 haplotypes are necessary but not sufficient for disease development.…”

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confidence: 99%

Impact on parents of HLA-DQ2/DQ8 genotyping in healthy children from coeliac families

Wessels

Vriezinga

Koletzko³

et al. 2014

Eur J Hum Genet

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on behalf of the PreventCD study groupDue to the association of coeliac disease and HLA-specificities DQ2 and DQ8, HLA-typing can be used for risk determination of the disease. This study was designed to evaluate the knowledge of parents from coeliac families regarding HLA-typing and the impact of HLA-typing on the perception of the health of their children. A structured questionnaire was sent to the Dutch, Spanish and German parents participating with their child in the European PreventCD study on disease prevention in high-risk families, addressing parents' understanding of and attitude towards HLA-typing, distress related to HLA-typing and perceived health and health-related quality of life of their children. Sixty-eight percent of parents of 515 children returned the questionnaires, with 85% of children being DQ2/DQ8 positive. The majority of all parents answered the questions on knowledge correctly. Forty-eight percent of parents of DQ2/DQ8-negative children thought their child could develop coeliac disease. More distress was reported by parents of DQ2/DQ8-positive children (Po0.001). All parents showed few regrets and would repeat HLA-typing in future children. Perceived health and health-related quality of life were similar. In conclusion, we can say that misinterpretation of DQ2/DQ8-negative results by parents is frequent. DQ2/DQ8-positive results do not affect perceived health and health-related quality of life of children but may cause temporary negative feelings among parents. Parents of coeliac families seem to support HLA-typing. INTRODUCTIONCoeliac disease (CD) is the most common intolerance to a dietary component in children and adults. 1 In genetically predisposed individuals, CD is precipitated by the ingestion of gluten, which are storage proteins in wheat (gliadin), rye (secalin) and barley (hordein). 1,2 T-cells in the lamina propria of the small intestines recognize the gluten peptides when they are bound to the human leukocyte antigen (HLA) class II specificities DQ2 and/or DQ8 on antigen-presenting cells. 2 Screening for CD can be done by measuring CD-specific antibodies against the enzyme tissue transglutaminase type 2, endomysium and deamidated gliadin peptides. 3 CD is treated with a gluten-free diet. Long-term complications of untreated CD are among others diarrhoea, abdominal pain, perinatal problems, osteoporosis and cancer. 1,4 CD has a strong genetic component, as 90% of CD patients carry the class II HLA-DQ2 haplotype, about 5% the HLA-DQ8 molecule [5][6][7][8] and the rest usually the half of the HLA-DQ2 heterodimer.The HLA-DQ2 and DQ8 haplotypes are present in over 25% of the general population, 6 but only 1% actually develops CD. 1 This indicates that HLA-DQ2 and -DQ8 haplotypes are necessary but not sufficient for disease development. Around 40% of the heritability of CD is explained by HLA-DQ2 and/or -DQ8. First-degree family members of CD patients who are HLA-DQ2 and/or DQ8 positive (DQ þ ) have an increased risk of approximately 10% to develop CD. 9

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Systematic review: the evidence base for long‐term management of coeliac disease

Abstract: SUMMARY BackgroundWhile gluten-free diet is an effective treatment for coeliac disease, the need for and goals of long-term management of patients are poorly defined.

Cited by 182 publications

References 341 publications

Intentional and inadvertent non-adherence in adult coeliac disease. A cross-sectional survey

Intentional and inadvertent non-adherence in adult coeliac disease. A cross-sectional survey

Formulation and Sensory Evaluation of Gluten-Free Muffins Containing Flax

Impact on parents of HLA-DQ2/DQ8 genotyping in healthy children from coeliac families

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