Department of Food and Human Nutritional Sciences (Mudryj, Waugh, Slater, Riediger), Faculty of Agricultural and Food Sciences, University of Manitoba; Department of Internal Medicine (Duerksen, Bernstein), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Department of Community Health Sciences (Slater, Riediger), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
CMAJ Open. 2021 Apr 1;9(2):E317-E323. doi: 10.9778/cmajo.20200082. Print 2021 Apr-Jun.
A gluten-free diet (GFD) is required for the management of some conditions, whereas some Canadians may follow a GFD for discretionary reasons. We sought to estimate the prevalence of Canadians who adhere to a GFD, identify factors associated with adherence to a GFD, and describe and compare the location of food preparation and consumption for those who follow a GFD, those who report no dietary avoidances and those reporting other dietary avoidances.
We used cross-sectional data from the 2015 Canadian Community Health Survey - Nutrition ( = 20 487). Demographic variables included sex, age group, ethnicity, highest level of household education and income adequacy. The relations between respondent characteristics and report of a GFD were estimated using logistic regression. Respondents were further categorized as avoiding dietary gluten, other dietary avoidances and no dietary avoidances.
An estimated 1.9% of Canadians follow a GFD. Women had 2 times higher odds (odds ratio [OR] 2.08, 95% confidence interval [CI] 1.32 to 3.27) of reporting a GFD than men. After adjustment for income adequacy, household education, sex, age group and ethnicity, residents of Ontario and Quebec had about half the odds (OR 0.52, 95% CI 0.31 to 0.87, and OR 0.55, 95% CI 0.32 to 0.94, respectively) of reporting a GFD compared with residents of Atlantic Canada. Canadians who followed a GFD consumed significantly fewer calories from foods prepared at restaurants than both Canadians who reported no dietary avoidances and those who reported dietary avoidances other than gluten. Canadians following a GFD reported that 2.0% (95% CI 1.1% to 2.9%) of their daily kilocalories were from foods prepared at restaurants, compared with 6.7% (95% CI 5.4% to 7.9%) for Canadians reporting 1 or more dietary avoidances other than gluten, and 6.4% (95% CI 6.0% to 6.9%) for those reporting no avoidances.
The estimated 1.9% prevalence of dietary gluten avoidance likely includes individuals with celiac disease, wheat allergies and nonceliac gluten sensitivity, as well as individuals excluding gluten in the management of irritable bowel syndrome or for reasons related to dietary trends. Canadians eating GFDs consume fewer daily calories from restaurant-prepared foods than other Canadians, which may have social implications.
一些情况下需要遵循无麸质饮食（GFD），而有些加拿大人可能出于随意的原因遵循 GFD。我们旨在估计遵循 GFD 的加拿大人的比例，确定与遵循 GFD 相关的因素，并描述和比较遵循 GFD、报告无饮食禁忌和报告其他饮食禁忌的人的食物准备和消费地点。
我们使用了 2015 年加拿大社区健康调查-营养（=20487）的横断面数据。人口统计学变量包括性别、年龄组、族裔、家庭受教育程度和收入充足率的最高水平。使用逻辑回归估计受访者特征与 GFD 报告之间的关系。受访者进一步分为避免食用含麸质的饮食、其他饮食禁忌和无饮食禁忌。
估计有 1.9%的加拿大人遵循 GFD。与男性相比，女性报告 GFD 的可能性高 2 倍（优势比[OR]2.08，95%置信区间[CI]1.32 至 3.27）。在调整收入充足率、家庭教育、性别、年龄组和族裔后，安大略省和魁北克省的居民报告遵循 GFD 的可能性分别为大西洋省份居民的一半（OR 0.52，95%CI 0.31 至 0.87，OR 0.55，95%CI 0.32 至 0.94）。遵循 GFD 的加拿大人从餐厅准备的食物中摄入的卡路里明显少于报告无饮食禁忌和报告除麸质以外的其他饮食禁忌的加拿大人。遵循 GFD 的加拿大人报告说，他们每天从餐厅准备的食物中摄入的卡路里有 2.0%（95%CI 1.1%至 2.9%），而报告除麸质以外的 1 种或多种饮食禁忌的加拿大人则为 6.7%（95%CI 5.4%至 7.9%），报告无饮食禁忌的加拿大人为 6.4%（95%CI 6.0%至 6.9%）。
估计的 1.9%的饮食麸质回避率可能包括乳糜泻、小麦过敏和非乳糜泻麸质敏感性患者，以及在管理肠易激综合征或由于饮食趋势而排除麸质的个体。遵循 GFD 的加拿大人从餐厅准备的食物中摄入的每日卡路里少于其他加拿大人，这可能具有社会意义。
