Adherence to the Gluten-Free Diet during the Lockdown for COVID-19 Pandemic: A Web-Based Survey of Italian Subjects with Celiac Disease

• Published in: Nutrients Vol. 12; no. 11; p. 3467
• Main Authors: Monzani, Alice, Lionetti, Elena, Felici, Enrico, Fransos, Lucia, Azzolina, Danila, Rabbone, Ivana, Catassi, Carlo
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 12.11.2020; MDPI
• Subjects: Adolescent; Adult; Adults; Age; Betacoronavirus; Caregivers; Celiac disease; Celiac Disease - diet therapy; Celiac Disease - psychology; Child; Compliance; confidence interval; Confidentiality; Coronavirus Infections - prevention & control; Coronaviruses; COVID-19; COVID-19 infection; Diet; Diet, Gluten-Free - psychology; Diet, Gluten-Free - statistics & numerical data; disease control; Disease transmission; Female; Gluten; gluten-free diet; Humans; Internet; Italy; Male; Middle Aged; odds ratio; Pandemics; Pandemics - prevention & control; Parents & parenting; Patient Compliance - statistics & numerical data; Pneumonia, Viral - prevention & control; Population; Quarantine - psychology; Quarantine - statistics & numerical data; Questionnaires; SARS-CoV-2; Social networks; surveys; Surveys and Questionnaires; Teenagers; Telemedicine; Young Adult; Italy; COVID-19; telemedicine; gluten-free diet; diet compliance; web survey; celiac disease; lockdown; coronavirus
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu12113467

We aimed to assess the perceived impact of the lockdown, imposed to control the spreading of COVID-19, on the adherence of Italian celiac disease (CD) subjects to the gluten-free diet by a web-based survey. A total of 1983 responses were analyzed, 1614 (81.4%) by CD adults and 369 (18.6%) by parents/caregivers of CD children/adolescents. The compliance with the GFD was unchanged for 69% of the adults and 70% of the children, and improved for 29% of both. The factors increasing the probability to report stricter compliance were the presence of CD symptoms in the last year before the lockdown (odds ratio (OR) 1.98, 95% confidence interval (CI) 1.46–2.26), a partial usual adherence to gluten-free diet (GFD) (OR 1.91, 95% CI 1.2–3.06), and having tried recipes with naturally gluten-free ingredients more than usual (OR 1.58, 95% CI 1.28–1.96) for adults; the presence of CD symptoms in the last year (OR 2.05, 95% CI 1.21–3.47), still positive CD antibodies (OR 1.89, 95% CI 1.14–3.13), and other family members with CD (OR 2.24, 95% CI 1.3–3.85) for children/adolescents. Therefore, the lockdown led to a reported improved adherence to the GFD in one-third of the respondents, in particular in those with previous worse disease control, offering the opportunity to avoid sources of contamination/transgression and increase the use of naturally gluten-free products.