Dowd A J, Tamminen K A, Jung M E, Case S, McEwan D, Beauchamp M R
J Hum Nutr Diet. 2014 Dec;27(6):542-9. doi: 10.1111/jhn.12203.
Currently , the only treatment for coeliac disease is life long adherence to a strict gluten-free diet. Strict adherence to a gluten-free diet is challenging, with recent reports suggesting that adherence rates range from 42% to 91%. The present study aimed to: (i) identify motives for adhering to a gluten-free diet and (ii) explore factors implicated in adherence and non-adherence behaviour in terms of accidental and purposeful gluten consumption among adults with coeliac disease.
Two hundred and three adults with coeliac disease completed an online questionnaire. Using a qualitative design, relationships were examined between reported adherence and motivation to follow a gluten-free diet, as well as the onset, duration and severity of symptoms.
Feelings of desperation (‘hitting rock bottom’) and needing to gain or lose weight were associated with the strictest adherence to a gluten-free diet. Participants who accidentally consumed gluten over the past week developed symptoms the most quickly and reported the most pain over the past 6 months. Participants who consumed gluten on purpose over the past week reported a shorter duration of symptoms and less pain over the past 6 months.
Hitting rock bottom and needing to gain or lose weight were factors associated with the strictest adherence, when considered in the context of both accidental and purposeful gluten consumption. Future research is warranted to develop resources to help people with coeliac disease follow a strict gluten-free diet.
目前，乳糜泻的唯一治疗方法是终身严格坚持无麸质饮食。严格坚持无麸质饮食具有挑战性，最近的报告表明坚持率在42%至91%之间。本研究旨在：（i）确定坚持无麸质饮食的动机，以及（ii）从乳糜泻成人意外和故意摄入麸质的角度，探讨与坚持和不坚持行为相关的因素。
203名乳糜泻成人完成了一份在线问卷。采用定性设计，研究报告的坚持情况与遵循无麸质饮食的动机之间的关系，以及症状的发作、持续时间和严重程度。
绝望感（“跌至谷底”）以及需要增重或减重与最严格坚持无麸质饮食相关。在过去一周意外摄入麸质的参与者症状出现得最快，并且在过去6个月中报告的疼痛最多。在过去一周故意摄入麸质的参与者报告症状持续时间较短，并且在过去6个月中疼痛较少。
在意外和故意摄入麸质的背景下考虑，跌至谷底以及需要增重或减重是与最严格坚持相关的因素。有必要开展进一步研究以开发资源，帮助乳糜泻患者遵循严格的无麸质饮食。
