title: Dietary compliance and life style of children with coeliac disease.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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%).
  
  
  CONCLUSIONS
  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.
authors.affiliation: First Department of Pediatrics, Gastroenterology Unit, Athens University, Aghia Sophia Children's Hospital, Athens, Greece. roma2el@otenet.gr
authors.forename: E
authors.initials: E
authors.lastname: Roma
authors.forename: A
authors.initials: A
authors.lastname: Roubani
authors.forename: E
authors.initials: E
authors.lastname: Kolia
authors.forename: J
authors.initials: J
authors.lastname: Panayiotou
authors.forename: A
authors.initials: A
authors.lastname: Zellos
authors.forename: V P
authors.initials: VP
authors.lastname: Syriopoulou
mesh_terms: D000293:Adolescent; D002446:Celiac Disease / Q000178:diet therapy* / Q000523:psychology; D016009:Chi-Square Distribution; D002648:Child; D055050:Diet, Gluten-Free; D005190:Family; D005247:Feeding Behavior; D005260:Female; D005515:Food Labeling; D005523:Food Supply; D005983:Glutens; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D009042:Motivation; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D011788:Quality of Life; D012147:Restaurants; D011795:Surveys and Questionnaires; D055697:Taste Perception; D014195:Travel
chemical_list: D005983:Glutens