Can a Quick and Easy Quiz Determine Gluten-free Diet Success?

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By Jefferson Adams

March 1, 2012
By Jefferson Adams • March 1, 2012

Can a Quick and Easy Quiz Determine Gluten-free Diet Success?

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Reviewed and edited by a celiac disease expert.
Celiac.com 03/01/2012 - Currently, the best way to assess whether patients with celiac disease are actually maintaining a strict gluten-free diet is to have trained experts conduct a dietary interview. These interviews can vary in complexity, depending on the nature and number of the questions, and on the amount of medical expertise required to score the responses.

A team of researchers has developed a way to score gluten-free dietary adherence based on answers to four quick and easy questions that can be assessed by non-expert personnel. The researchers recently set out to test the reliability of their questionnaire in a new group of patients.

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The research team includes F. Biagi, P.I. Bianchi, A. Marchese, L. Trotta, C. Vattiato, D. Balduzzi, G. Brusco, A. Andrealli, F. Cisarò, M. Astegiano, S. Pellegrino, G. Magazzù, C. Klersy, and G.R. Corazza.

They are affiliated with the Coeliac Centre/First Department of Internal Medicine of the Fondazione IRCCS Policlinico San Matteo at the University of Pavia in Pavia, Italy.

The scoring for the quiz is set up to verify adherence to a gluten-free diet. The questionnaire has a five-level score.

From March 2008 to January 2011, the team surveyed 141 celiac disease patients who were undergoing re-evaluation. Each patient was following on a gluten-free diet.

The team then compared survey scores with levels of both villous atrophy and endomysial antibodies (EMA). Patients with persistence of either villous atrophy (Fisher's exact, P < 0·001; test for trend, P < 0·001) or positive EMA (Fisher's exact, P = 0·001; test for trend, P = 0·018) showed the lowest scores, which indicates poor compliance with a gluten-free diet.

Given that the celiac patients have been well instructed on what a gluten-free diet means and on how to follow it, our questionnaire is a reliable and simple method to verify compliance to a gluten-free diet. The team did not share in the study abstract the exact questions included in the survey, so stay tuned to find out the exact questions the team is testing.

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About Me

Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University. His articles, essays, poems, stories and book reviews have appeared in numerous magazines, journals, and websites, including North American Project, Antioch Review, Caliban, Mississippi Review, Slate, and more. He is the author of more than 2,500 articles on celiac disease. His university coursework includes studies in science, scientific methodology, biology, anatomy, physiology, medicine, logic, and advanced research. He previously devised health and medical content for Colgate, Dove, Pfizer, Sharecare, Walgreens, and more. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of numerous books, including "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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