title: Evaluation of the impact of celiac disease and its dietary manipulation on children and their caregivers.
abstract: BACKGROUND
  Lifelong dietary abstinence of gluten is the only treatment available for celiac disease. This is not only challenging but also leads to several psychosocial morbidities and affects the quality of life of children and their parents.
  
  
  METHODS
  An observational study was conducted on 50 children (5-18 years) diagnosed with celiac disease on gluten-free diet for at least 6 months and their parents to evaluate of the impact of celiac disease and its dietary manipulation on them. The quality of life was assessed by applying celiac disease-specific questionnaire. Dietary compliant and noncompliant groups were compared to assess the factors leading to poor compliance. Anthropometric parameters were utilized to ascertain clinical response.
  
  
  RESULTS
  Fifty children with a mean age of 9.06 years were enrolled. Seventy-four percent of the children were compliant. In the compliant group, height and weight correlated with dietary compliance (p = 0.0087 and p = 0.023). Dietary compliance was found to be better in adolescent males and single child and those living in nuclear families. Quality of life was found to be higher among parents of noncompliant children (quality of life score: 63) as compared to the compliant children (quality of life score: 59). The acceptance of celiac disease was better among children whose parents had a higher level of education. The scale diet proved to be a useful indicator for evaluating compliance among children (p = 0.0036).
  
  
  CONCLUSIONS
  Noncompliance to gluten-free diet was noted in 24 % of children with celiac disease.
authors.affiliation: Division of Genetics, Department of Pediatrics, Maulana Azad Medical College, Associated Lok Nayak Hospital, Bahadur Shah Zafar Marg, New Delhi, 110 002, India.
authors.forename: Bisman
authors.initials: B
authors.lastname: Khurana
authors.forename: Avinash
authors.initials: A
authors.lastname: Lomash
authors.forename: Sumaira
authors.initials: S
authors.lastname: Khalil
authors.forename: Malvika
authors.initials: M
authors.lastname: Bhattacharya
authors.forename: K
authors.initials: K
authors.lastname: Rajeshwari
authors.forename: Seema
authors.initials: S
authors.lastname: Kapoor
mesh_terms: D000293:Adolescent; D017028:Caregivers; D002446:Celiac Disease / Q000178:diet therapy* / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D055050:Diet, Gluten-Free; D004522:Educational Status; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D064887:Observational Studies as Topic; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011788:Quality of Life; D018401:Sample Size; D012657:Self-Help Groups; D011795:Surveys and Questionnaires