The gluten free diet is currently the only treatment for coeliac disease, but the diet can be difficult to follow. Previous research has identified rates of adherence to the diet range from 42 – 91%. Recently, researchers from the University of Roehampton and the gastroenterology teams in Leicester and Dudley have added to the evidence base. They have published their research exploring factors associated with adherence to the gluten free diet and also looked at how this differs between Caucasians and South Asians.

Questionnaires were completed by a total of 375 adults with coeliac disease, 38 of whom were South Asian and 337 of whom were Caucasian. The researchers used a validated questionnaire (the Coeliac Dietary Adherence Test (CDAT)) to assess adherence to the diet.

A number of factors were identified as having a role in how well people were sticking to the diet:

Receiving gluten free food on prescription

74% of the adults surveyed were receiving gluten free food on prescription. Of those receiving prescriptions, 42% were classified as not adhering to the diet, compared to 62% of those who were not receiving gluten free food on prescription. The researchers therefore recommend retaining access to gluten free food on prescription to support adherence to the gluten free diet.

Understanding food labels

Not understanding food labels was significantly associated with poorer adherence to the diet. Of those who said that they did not understand food labels, 73% were not sticking to the diet. Not understanding food labels was found to be more common in South Asians (53%) compared to Caucasians (4%).

Coeliac UK membership

Membership of Coeliac UK was also found to be related to adherence to the gluten free diet. People who were members of Coeliac UK had significantly lower CDAT scores (indicating better adherence) compared to non members. However, this same difference in adherence was not seen in South Asian respondents, where similar adherence scores were seen in members and non members.

The taste of gluten free foods

Reporting that gluten free foods “have an unpleasant taste” was associated with poorer adherence to the gluten free diet and South Asian respondents were more likely to agree that gluten free foods taste unpleasant.

This research provides further evidence which supports access to gluten free food on prescription. The publication of this research is timely as the Department of Health is currently reviewing gluten free prescribing in England and we will be sharing this research with them.

The full paper is available to read online.