Adherence to a Gluten Free Diet Is Associated with Receiving Gluten Free Foods on Prescription and Understanding Food Labelling

Nutrients. 2017 Jul 6;9(7):705. doi: 10.3390/nu9070705.


Treatment of coeliac disease requires a strict gluten-free (GF) diet, however, a high proportion of patients do not adhere to a GF diet. The study explores the practical challenges of a GF diet and dietary adherence in Caucasian and South Asian adults with coeliac disease. Patients with biopsy- and serology-proven coeliac disease were recruited from a hospital database. Participants completed a postal survey (n = 375), including a validated questionnaire designed to measure GF dietary adherence. Half of Caucasians (53%) and South Asians (53%) were adhering to a GF diet. The quarter of patients (n = 97) not receiving GF foods on prescription had a lower GF dietary adherence score compared with those receiving GF foods on prescription (12.5 versus 16.0; p < 0.001). Not understanding food labelling and non-membership of Coeliac UK were also associated with lower GF dietary adherence scores. A higher proportion of South Asian patients, compared with Caucasians, reported difficulties understanding what they can eat (76% versus 5%; p < 0.001) and understanding of food labels (53% versus 4%; p < 0.001). We recommend retaining GF foods on prescription, membership of a coeliac society, and regular consultations with a dietitian to enable better understanding of food labels. Robust studies are urgently needed to evaluate the impact of reducing the amount of GF foods prescribed on adherence to a GF diet in all population groups.

Keywords: coeliac disease; dietary adherence; gluten free; prescription.

MeSH terms

  • Adult
  • Aged
  • Asian Continental Ancestry Group
  • Celiac Disease / diet therapy*
  • Cross-Sectional Studies
  • Diet, Gluten-Free*
  • European Continental Ancestry Group
  • Female
  • Food Analysis
  • Food Labeling*
  • Glutens / chemistry
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / statistics & numerical data
  • Prescriptions
  • Surveys and Questionnaires


  • Glutens