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What happens to food choices when a gluten-free diet is required?: A prospective longitudinal population-based study among Swedish adolescent with coeliac disease and their peers
Umeå University, Faculty of Social Sciences, Department of Food and Nutrition. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.ORCID iD: 0000-0001-8944-2558
Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.ORCID iD: 0000-0002-3731-6565
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2014 (English)In: Journal of Nutritional Science, ISSN 2048-6790, Vol. 3, no e2Article in journal (Refereed) Published
Abstract [en]

A dietary survey was performed during a large screening study in Sweden among 13-year-old adolescents. The aim was to study how the intake of food groups was affected by a screening-detected diagnosis of celiac disease (CD) and its gluten-free (GF) treatment. Food intake, was reported using a food frequency questionnaires (FFQ) and intake reported by the adolescents who was screened to CD was compared with the intake of two same-aged referent groups: i) adolescents diagnosed to CD prior screening and ii) adolescents without CD.. The food intake groups were measured at baseline before the screening-detected cases were aware of their CD, and 12-18 months later.

The result showed that the food intakes are affected by a screen detected CD and its dietary treatment. Many flour-based foods were reduced such as pizza, fish fingers, and pastries. The result also indicated that the bread intake was lower before the screened diagnosis compared to the other studied groups, but increased afterwards. Specially manufactured GF-products (e.g. pasta and bread) were frequently used in the screened CDgroup after changing to a GF-diet. Our results suggest that changing to a GF-diet reduces the intake of some popular foods, and the ingredients on the plate are altered, but this do not necessarily include a change of food groups. The availability of manufactured GF-replacement products makes it possible for adolescents to keep many of their old food habits when diagnosed with CD in Sweden.

Place, publisher, year, edition, pages
Cambridge University Press, 2014. Vol. 3, no e2
Keyword [en]
celiac disease, gluten-free diet, food choices, screening
National Category
Gastroenterology and Hepatology
URN: urn:nbn:se:umu:diva-86027DOI: 10.1017/jns.2013.24OAI: diva2:696962
Available from: 2014-02-17 Created: 2014-02-14 Last updated: 2015-11-04Bibliographically approved
In thesis
1. Is it the gluten-free diet that matters the most?: Food, gender and celiac disease
Open this publication in new window or tab >>Is it the gluten-free diet that matters the most?: Food, gender and celiac disease
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: The only treatment for celiac disease consists of excluding gluten. Gluten is a protein complex found in wheat, rye, and barley, which are cereals commonly used in bread, pasta, pizza, etc. The overall aims of this thesis were to study; what happens with food choices and nutrient intakes when individuals are prescribed a gluten-free diet and what consequences this has on the everyday lives of young women and young men dealing with this disease.

Methods: A food frequency questionnaire (FFQ) was used to study nutrient intake and how food choices were affected after a change to a gluten-free diet. The FFQ was sent to 12-13 years-old adolescents who took part in a large Swedish celiac screening study. The following three groups were studied: previously diagnosed with celiac disease, screening-diagnosed and non-celiac controls. The first FFQ was sent out before the screening-diagnosed adolescents had been told they had celiac disease, and the second was sent 12-18 months after they had been prescribed the gluten-free treatment. Semi-structured interviews were performed five years later in order to study how everyday life was affected by celiac disease in seven young women and seven young men. The interviews were analyzed by content analysis.

Results: The previously diagnosed celiac disease group reported a nutrient intake in line with the non-celiac control group. Most of the participants reported nutrient intakes above the estimated average requirements. A diagnosis of celiac disease altered the intake of some foods, and this was shown by comparing the results from the baseline FFQ before the diagnosis and the follow-up FFQ after. The young women and young men reported similar experiences of the gluten-free food, but the perceived consequences of living with celiac disease differed between genders.

Conclusion: This thesis shows that after a diagnosis of celiac disease food changes are necessary in order to be compliant with the gluten-free diet. One common effect is that food options will be reduced. However, as long the food intake is gluten-free, varied, and in sufficient quantity there is no reason to worry more about the nutritional intake of adolescents diagnosed with celiac disease than there is for their non-celiac peers. The findings in this thesis also show that society’s gender order has a great impact on how young women and young men experience their everyday lives, with celiac disease, and with the gluten-free diet.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2014. 76 p.
celiac disease, gluten-free diet, gender, dietary assessment, adolescents, qualitative interviews
National Category
Other Social Sciences not elsewhere specified Nutrition and Dietetics
Research subject
Food and Nutrition
urn:nbn:se:umu:diva-85866 (URN)978-91-7601-014-3 (ISBN)
Public defence
2014-03-21, Hörsal D, Samhällsvetarhuset, Umeå universitet, Umeå, 13:00 (Swedish)
Available from: 2014-02-28 Created: 2014-02-12 Last updated: 2015-11-04Bibliographically approved

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Kautto, EthelRydén, PetraIvarsson, AnneliOlsson, CeciliaNorström, FredrikHagfors, LindaHörnell, Agneta
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