First Department of Pediatrics, Gastroenterology Unit, Athens University, Aghia Sophia Children's Hospital, Athens, Greece.
J Hum Nutr Diet. 2010 Apr;23(2):176-82. doi: 10.1111/j.1365-277X.2009.01036.x. Epub 2010 Feb 12.
Coeliac disease (CD) is common and requires a permanent strict gluten-free diet (GFD). However, data concerning how the situation is experienced by children are limited. The present study aimed to investigate the compliance with a GFD and the impact of CD and GFD on the lifestyle of patients and their families, together with proposed recommendations for improvement of quality of life.
Children with biopsy confirmed CD were recruited consecutively from the outpatient gastroenterology clinic. Participants were evaluated by a special questionnaire for compliance with the GFD, patients' knowledge about CD, and the well-being and lifestyle of children and their families. Comparisons between discrete variables were performed by a chi-square test.
Seventy-three children of median age 9.4 (interquartile range = 5-14.5) years were evaluated. Compliance to diet was reported by 58%. Reasons for noncompliance were: poor palatability (32%), dining outside home (17%), poor availability of products (11%), and asymptomatic disease diagnosed by screening (11%). The acceptance of the GFD was reported as good in 65%, whereas avoidance of travelling and restaurants was stated by 17% and 46% of families, respectively. Most families experienced difficulties detecting gluten from the food label. Proposed factors for improvement of quality of life were: better labelling of gluten-containing ingredients (76%) and more gluten-free (GF) foods in supermarkets (58%) and restaurants (42%).
Children with CD have low compliance with the GFD. Better education about the disease, the availability of GF products, and appropriate food labelling could improve compliance and quality of life.
乳糜泻（CD）较为常见，需要严格的无麸质饮食（GFD）。然而，关于儿童的情况，数据有限。本研究旨在调查儿童对 GFD 的依从性以及 CD 和 GFD 对患者及其家庭生活方式的影响，同时提出改善生活质量的建议。
从消化科门诊连续招募活检证实为 CD 的儿童。通过专门的问卷评估患者对 GFD 的依从性、对 CD 的认识、儿童及其家庭的健康状况和生活方式。通过卡方检验比较离散变量。
共评估了 73 名中位年龄为 9.4 岁（四分位距=5-14.5 岁）的儿童。58%的患者报告了对饮食的依从性。不依从的原因包括：口感不佳（32%）、外出就餐（17%）、产品供应不足（11%）和筛查诊断无症状疾病（11%）。65%的家庭认为 GFD 可接受，而 17%和 46%的家庭分别表示避免旅行和外出就餐。大多数家庭在从食品标签中检测到麸质方面存在困难。改善生活质量的建议因素包括：更好地标注含麸质成分（76%）、超市（58%）和餐馆（42%）提供更多无麸质（GF）食品。
CD 患儿对 GFD 的依从性较低。更好地了解疾病、提供 GF 产品和适当的食品标签可以提高依从性和生活质量。
