2016, Number 5
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Rev Invest Clin 2016; 68 (5)
Adherence to a Gluten-Free Diet in Mexican Subjects with Gluten-Related Disorders: A High Prevalence of Inadvertent Gluten Intake
Ramírez-Cervantes KL, Romero-López AV, Núñez-Álvarez CA, Uscanga-Domínguez LF
Language: English
References: 18
Page: 229-234
PDF size: 100.79 Kb.
ABSTRACT
Background: The rate of compliance with a gluten-free diet in patients with gluten-related disorders is unknown in most Latin
American countries.
Objective: To study the adherence to a gluten-free diet of Mexican individuals with celiac disease and nonceliac
gluten sensitivity at the time of their first medical and nutritional consultation at a tertiary referral center.
Methods: A
cross-sectional study was performed. A specific questionnaire was used to gather information on demographics, clinical condition,
and self-reported adherence to a gluten-free diet, and to determine strict compliance and intentional or inadvertent gluten
consumption. All questionnaires were applied by a nutritionist with expertise in gluten-related disorders.
Results: Fifty-six patients
with celiac disease and 24 with non-celiac gluten sensitivity were included. Overall, 46 (57.5%) subjects perceived themselves
as strictly adherent; however, inadvertent gluten intake was frequent in both celiac disease and non-celiac gluten sensitivity
patients (39.2
vs. 33.3%; p = 0.2). Intentional consumption was more prevalent in subjects with celiac disease (48.8
vs.
29.1%; p = 0.048) and individuals with non-celiac gluten sensitivity showed better adherence (37.5
vs. 12.5%; p = 0.035).
Conclusions: The importance of a gluten-free diet is underestimated by Mexican patients with celiac disease. The role of a team
with expertise in gluten-related disorders is essential to identify inadvertent gluten intake.
REFERENCES
Ludvigsson JF, Leffler DA, Bai JC, et al. The Oslo definitions for coeliac disease and related terms. Gut. 2013;62:43-52.
Rubio-Tapia A, Hill ID, Kelly CP, Calderwood AH, Murray JA. ACG clinical guidelines: diagnosis and management of celiac disease. Am J Gastroenterol. 2013;108:656-76.
Fasano A, Sapone A, Zevallos V, Schuppan D. Nonceliac gluten sensitivity. Gastroenterology. 2015;148:1195-204.
N ijeboer P, Bontkes HJ, Mulder CJ, Bouma G. Non-celiac gluten sensitivity. Is it in the gluten or the grain? J Gastrointestin Liver Dis. 2013;22:435-40.
Hall NJ, Rubin G, Charnock A. Systematic review: adherence to a gluten-free diet in adult patients with coeliac disease. Aliment Pharmacol Ther. 2009;30:315-30.
Hollon JR, Cureton PA, Martin ML, Puppa EL, Fasano A. Trace gluten contamination may play a role in mucosal and clinical recovery in a subgroup of diet-adherent non-responsive celiac disease patients. BMC Gastroenterol. 2013;13:40.
Verrill L, Zhang Y, Kane R. Food label usage and reported difficulty with following a gluten-free diet among individuals in the USA with coeliac disease and those with noncoeliac gluten sensitivity. J Hum Nutr Diet. 2013;26:479-87.
Hall NJ, Rubin GP, Charnock A. Intentional and inadvertent nonadherence in adult coeliac disease. A cross-sectional survey. Appetite. 2013;68:56-62.
E lli L, Discepolo V, Bardella MT, Guandalini S. Does gluten intake influence the development of celiac disease-associated complications? J Clin Gastroenterol 2014;48:13-20.
Ramirez-Cervantes KL, Remes-Troche JM, Del Pilar Milke-Garcia M, Romero V, Uscanga LF. Characteristics and factors related to quality of life in Mexican Mestizo patients with celiac disease. BMC Gastroenterol. 2015;15:4.
Simpson S, Thompson T. Nutrition assessment in celiac disease. Gastrointest Endosc Clin N Am. 2012;22:797-809.
Remes-Troche JM, Nunez-Alvares C, Uscanga-Dominguez LF. Celiac disease in Mexican population: an update. Am J Gastroenterol. 2013;108:283-84.
Ontiveros N, Lopez-Gallardo JA, Vergara-Jimenez MJ, Cabrera- Chavez F. Self-reported prevalence of symptomatic adverse reactions to gluten and adherence to gluten-free diet in an adult Mexican population. Nutrients. 2015;7:6000-15.
L effler DA, Dennis M, Edwards George JB, et al. A simple validated gluten-free diet adherence survey for adults with celiac disease. Clin Gastroenterol Hepatol. 2009;7:530-36.
Biagi F, Bianchi PI, Marchese A, et al. A score that verifies adherence to a gluten-free diet: a cross-sectional, multicentre validation in real clinical life. Br J Nutr. 2012;108:1884-8.
A kobeng AK, Thomas AG . Systematic review: tolerable amount of gluten for people with coeliac disease. Aliment Pharmacol Ther. 2008;27:1044-52.
Kurppa K, Paavola A, Collin P, et al. Benefits of a gluten-free diet for asymptomatic patients with serologic markers of celiac disease. Gastroenterology. 2014;147:610-17.
Catassi C, Fabiani E, Iacono G, et al. A prospective, double-blind, placebo-controlled trial to establish a safe gluten threshold for patients with celiac disease. Am J Clin Nutr. 2007;85:160-6.