With a growing rise in food costs, research drawing connections between food insecurity and medical diets, such as the gluten-free diet, seem as important as ever. In this article, researchers turn to Canada and reveal some alarming insights.
Food insecurity impacts diet quality and adherence to the gluten‐free diet in youth with celiac disease
Peer-reviewed research by: Xinyi Wang, Sven Anders, Zhiqian Jiang, Marcia Bruce, Dominica Gidrewicz, Margaret Macron, Justine M. Turner, and Diana R. Mager
Abstract
Objectives
Celiac disease (CD) is an autoimmune gastrointestinal disorder that requires a strict lifelong gluten-free diet (GFD). Gluten-free (GF) foods are more expensive and less readily accessible than gluten-containing foods, contributing to an increased risk for food insecurity (FI). The study aimed to determine associations between GF-FI, sociodemographic risk factors and child dietary adherence and diet quality (DQ).
Methods
A 26-item, cross-country online survey was administered through social media to parents of children with CD on the GFD. The survey elicited household and CD child sociodemographic and clinical characteristics (e.g., duration of CD), measures of household FI, child DQ and GFD adherence, and parents’ concerns related to GF food. Household GF-FI was evaluated using the validated Hunger Vital Sign™ and the US Department of Agriculture Six-Item Short Form Household Food Security Survey Module.
Results
GF-FI occurred in 47% of households with children with CD with >30% reporting low to very low food security. Sociodemographic risk factors identified included lower income, renters, rural residency, single-parental households, and having children with additional dietary restrictions (p < 0.001). Regardless of FI status, a majority of households reported experiencing significantly higher GF food expenditure. GF-FI was associated with reduced adherence to the GFD, increased consumption of processed GF food, and lower intakes of fresh fruits and vegetables and GF grains among children with CD (p < 0.05).
Conclusions
GF-FI is prevalent in this multiethnic cohort of households with CD children and is associated with worsening DQ and GFD adherence. Policy interventions are urgently needed to address GF-FI.
Highlights
What is Known
- Household food insecurity (FI) is an important social determinant of health in Canada, contributing to adverse health outcomes and high healthcare expenditure.
- Children with celiac disease (CD) have to adopt a strict life-long gluten-free diet (GFD).
- Many gluten-free (GF) food products are more expensive than their gluten-containing counterparts.
What is New
- The prevalence of GF-FI in a multiethnic cohort of Canadian households with children with CD is approximately two to three times higher than the national average.
- GF-FI is associated with adverse dietary quality and reduced adherence to GFDs in children and youth with CD.
- Parents of children with celiac disease adopt compensatory strategies to address GF-FI.
Click here to check out the full article.
Full Reference //
Wang X, Anders S, Jiang Z, Bruce M, Gidrewicz D, Marcon M, Turner JM, Mager DR. (2024) Food insecurity impacts diet quality and adherence to the gluten-free diet in youth with celiac disease. J Pediatr Gastroenterol Nutr. 79(6):1180-1191.
This article is licensed through the Creative Commons.
Knowledge Stitch amplifies academic research. If you have research you would like readers to check out, click here to suggest your work.
Photo by Devin Avery on Unsplash