Muhammad Humayun, Reeves Sue, Ishaq Sauid, Mayberry John, Jeanes Yvonne M
Health Sciences Research Centre, University of Roehampton, London SW15 4JD, UK.
Gastroenterology, University Hospitals of Leicester, Leicester LE1 5WW, UK.
Nutrients. 2017 Jul 6;9(7):705. doi: 10.3390/nu9070705.
Treatment of coeliac disease requires a strict gluten-free (GF) diet, however, a high proportion of patients do not adhere to a GF diet. The study explores the practical challenges of a GF diet and dietary adherence in Caucasian and South Asian adults with coeliac disease. Patients with biopsy- and serology-proven coeliac disease were recruited from a hospital database. Participants completed a postal survey ( = 375), including a validated questionnaire designed to measure GF dietary adherence. Half of Caucasians (53%) and South Asians (53%) were adhering to a GF diet. The quarter of patients ( = 97) not receiving GF foods on prescription had a lower GF dietary adherence score compared with those receiving GF foods on prescription (12.5 versus 16.0; < 0.001). Not understanding food labelling and non-membership of Coeliac UK were also associated with lower GF dietary adherence scores. A higher proportion of South Asian patients, compared with Caucasians, reported difficulties understanding what they can eat (76% versus 5%; < 0.001) and understanding of food labels (53% versus 4%; < 0.001). We recommend retaining GF foods on prescription, membership of a coeliac society, and regular consultations with a dietitian to enable better understanding of food labels. Robust studies are urgently needed to evaluate the impact of reducing the amount of GF foods prescribed on adherence to a GF diet in all population groups.
乳糜泻的治疗需要严格的无麸质（GF）饮食，然而，很大一部分患者并未坚持无麸质饮食。本研究探讨了患有乳糜泻的白种人和南亚成年人在遵循无麸质饮食及饮食依从性方面面临的实际挑战。经活检和血清学证实患有乳糜泻的患者从医院数据库中招募。参与者完成了一项邮寄调查（n = 375），包括一份经过验证的旨在测量无麸质饮食依从性的问卷。一半的白种人（53%）和南亚人（53%）坚持无麸质饮食。与那些通过处方获得无麸质食品的患者相比，四分之一未通过处方获得无麸质食品的患者（n = 97）的无麸质饮食依从性得分较低（12.5对16.0；P < 0.001）。不理解食品标签以及未加入英国乳糜泻协会也与较低的无麸质饮食依从性得分相关。与白种人相比，更高比例的南亚患者表示在理解可以吃什么（76%对5%；P < 0.001）和理解食品标签（53%对4%；P < 0.001）方面存在困难。我们建议继续通过处方提供无麸质食品、加入乳糜泻协会，并定期咨询营养师，以更好地理解食品标签。迫切需要进行有力的研究来评估减少无麸质食品处方量对所有人群遵循无麸质饮食的影响。
