Living with coeliac disease and a gluten-free diet: a Canadian perspective

J Hum Nutr Diet. 2013 Feb;26(1):10-23. doi: 10.1111/j.1365-277X.2012.01288.x. Epub 2012 Nov 15.


Objective: Strict adherence to a gluten-free diet is the only treatment for coeliac disease. The gluten-free diet is complex, costly and impacts on all activities involving food, making it difficult to maintain for a lifetime. The purpose of this cross-sectional study was to evaluate the difficulties experienced, the strategies used and the emotional impact of following a gluten-free diet among Canadians with coeliac disease.

Methods: A questionnaire was mailed to all members (n = 10 693) of both the Canadian Celiac Association and the Fondation québécoise de la maladie cœliaque in 2008.

Results: The overall response rate was 72%. Results are presented for the 5912 respondents (≥18 years) reporting biopsy-confirmed coeliac disease and/or dermatitis herpetiformis. Two-thirds never intentionally consumed gluten. Women reported significantly greater emotional responses to a gluten-free diet but, with time, were more accepting of it than men. Difficulties and negative emotions were experienced less frequently by those on the diet for >5 years, although food labelling and eating away from home remained very problematic. Frustration and isolation because of the diet were the most common negative emotions experienced.

Conclusions: The present study quantifies the difficulties experienced, the strategies used and the emotional impact of following a gluten-free diet. It highlights the need to improve the training and education of dietitians, other health providers and the food service industry workers about coeliac disease and a gluten-free diet, with the aim of better helping individuals improve their adherence to a gluten-free diet and their quality of life.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Canada
  • Celiac Disease / diet therapy*
  • Celiac Disease / psychology
  • Cross-Sectional Studies
  • Dermatitis Herpetiformis / diet therapy
  • Diet, Gluten-Free / psychology*
  • Feeding Behavior*
  • Female
  • Food Labeling
  • Frustration*
  • Glutens* / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / psychology*
  • Sex Factors
  • Social Isolation*
  • Surveys and Questionnaires


  • Glutens