Factors that influence adherence to a gluten-free diet in adults with celiac disease

Dig Dis Sci. 2008 Jun;53(6):1573-81. doi: 10.1007/s10620-007-0055-3.


Objective: The only treatment for celiac disease is lifelong adherence to a gluten-free diet, yet adherence is limited and factors influencing adherence are poorly understood. The purpose of this study was to determine factors influencing gluten-free diet adherence in adults with celiac disease.

Methods: A questionnaire was developed and administered to 154 adults with celiac disease who then underwent a standardized gluten-free diet evaluation by an experienced nutritionist. Multivariate analysis was conducted to determine factors associated with adherence level.

Results: Thirteen factors hypothesized to contribute to gluten-free diet adherence were found to be significantly associated with improved adherence including: understanding of the gluten-free diet, membership of a celiac disease advocacy group, and perceived ability to maintain adherence despite travel or changes in mood or stress (P < 0.001).

Conclusions: This study identified specific factors correlated with gluten-free diet adherence. These results provide a foundation for the design of educational interventions to improve adherence.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Celiac Disease / diet therapy*
  • Data Interpretation, Statistical
  • Female
  • Glutens*
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance*
  • Risk Factors
  • Surveys and Questionnaires


  • Glutens