Emily D Gutowski1, Dayna Weiten2, Kathy H Green3, Lisa N Rigaux4, Charles N Bernstein5, Lesley A Graff6, John R Walker7, Donald R Duerksen8, Jocelyn A Silvester9. 1. Celiac Research Program, Harvard Medical School, Boston, MA, United States. Electronic address: emily_gutowski@hms.harvard.edu. 2. Winnipeg Regional Health Authority, Winnipeg, Canada. Electronic address: dweiten@ggh.mb.ca. 3. Winnipeg Regional Health Authority, Winnipeg, Canada; St. Boniface Hospital Research Center, Winnipeg, Canada. Electronic address: kgreen@sbgh.mb.ca. 4. St. Boniface Hospital Research Center, Winnipeg, Canada. Electronic address: lrigaux2@sbgh.mb.ca. 5. Winnipeg Regional Health Authority, Winnipeg, Canada; Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: Charles.bernstein@umanitoba.ca. 6. Celiac Research Program, Harvard Medical School, Boston, MA, United States; Winnipeg Regional Health Authority, Winnipeg, Canada; Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: lgraff@exchange.hsc.mb.ca. 7. Winnipeg Regional Health Authority, Winnipeg, Canada; St. Boniface Hospital Research Center, Winnipeg, Canada; Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: john.walker@umanitoba.ca. 8. Winnipeg Regional Health Authority, Winnipeg, Canada; St. Boniface Hospital Research Center, Winnipeg, Canada; Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: dduerkse@sbgh.mb.ca. 9. Celiac Research Program, Harvard Medical School, Boston, MA, United States; Winnipeg Regional Health Authority, Winnipeg, Canada; St. Boniface Hospital Research Center, Winnipeg, Canada; Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Boston Children's Hospital, Boston, MA, United States. Electronic address: jocelyn.silvester@childrens.harvard.edu.
Abstract
BACKGROUND & AIMS: Patients with celiac disease (CD) often report inadvertent gluten exposures and challenges reading labels. The most common cause of non-responsive CD is gluten exposure. We aimed to assess whether recently diagnosed CD patients can determine whether a food is gluten-free based on labeling, and to assess skills over time. A secondary aim was to identify factors associated with label reading proficiency. METHODS: Inception cohort with follow-up at 6, 12, and 24 months after diagnosis. Participants were asked to determine whether 25 food items were gluten-free based on labeling information. Diet adherence was assessed using the Celiac Diet Assessment Tool (CDAT) and the Gluten-Free Eating Assessment Tool (GF-EAT). 144 adults with newly diagnosed celiac disease were enrolled. The initial quiz at 6 months was completed by 83%. Quizzes were completed by 72% at 12 months and 70% at 24 months. RESULTS: Median overall accuracy scores were: 23/25, 24/25 and 21/25 at 6, 12 and 24 months respectively. Gluten-free products with explicit "gluten-free" claims had the fewest errors. Quiz scores were not correlated with tTG IgA levels, or CDAT or GF-EAT scores. Diet adherence was generally good (>85% with CDAT <13 suggesting adequate GFD adherence); however, at 24 months, only 11% reported no gluten exposure. CONCLUSIONS: CD patients may be unable to consistently choose gluten-free foods based on product labeling. Explicit identification of gluten-free products may be helpful. Label reading ability appears stable over time. Further studies are needed to evaluate whether erroneous label reading or misleading labels are associated with persistent villous atrophy.
BACKGROUND & AIMS:Patients with celiac disease (CD) often report inadvertent gluten exposures and challenges reading labels. The most common cause of non-responsive CD is gluten exposure. We aimed to assess whether recently diagnosed CDpatients can determine whether a food is gluten-free based on labeling, and to assess skills over time. A secondary aim was to identify factors associated with label reading proficiency. METHODS: Inception cohort with follow-up at 6, 12, and 24 months after diagnosis. Participants were asked to determine whether 25 food items were gluten-free based on labeling information. Diet adherence was assessed using the Celiac Diet Assessment Tool (CDAT) and the Gluten-Free Eating Assessment Tool (GF-EAT). 144 adults with newly diagnosed celiac disease were enrolled. The initial quiz at 6 months was completed by 83%. Quizzes were completed by 72% at 12 months and 70% at 24 months. RESULTS: Median overall accuracy scores were: 23/25, 24/25 and 21/25 at 6, 12 and 24 months respectively. Gluten-free products with explicit "gluten-free" claims had the fewest errors. Quiz scores were not correlated with tTGIgA levels, or CDAT or GF-EAT scores. Diet adherence was generally good (>85% with CDAT <13 suggesting adequate GFD adherence); however, at 24 months, only 11% reported no gluten exposure. CONCLUSIONS:CDpatients may be unable to consistently choose gluten-free foods based on product labeling. Explicit identification of gluten-free products may be helpful. Label reading ability appears stable over time. Further studies are needed to evaluate whether erroneous label reading or misleading labels are associated with persistent villous atrophy.
Authors: Daniel A Leffler; Melinda Dennis; Brian Hyett; Eoin Kelly; Detlef Schuppan; Ciaran P Kelly Journal: Clin Gastroenterol Hepatol Date: 2007-03-26 Impact factor: 11.382
Authors: Jocelyn A Silvester; Satya Kurada; Andrea Szwajcer; Ciarán P Kelly; Daniel A Leffler; Donald R Duerksen Journal: Gastroenterology Date: 2017-05-22 Impact factor: 22.682