Time Following a Gluten-Free Diet, Ultra-Processed Food Consumption and Quality of Life in Children with Celiac Disease

Abstract

Featured Application: The data from the present study indicate that nutritionists and other healthcare professionals should monitor the quality of life and diet quality of children with celiac disease, especially from the first year of treatment with a gluten-free diet. Maintaining a strict gluten-free diet (GFD) may affect the quality of life of children with celiac disease (CD) and promote a less healthy diet by substituting gluten-containing foods with ultra-processed foods. We aimed to assess the influences of the GFD and ultra-processed food consumption on parents’ perception of the quality of life of children with CD. Fifty-eight children (mean age 8.6 ± 4.1 years) were included. The participants were divided into groups based on the time following a GFD: <6 months (n = 18) versus ≥12 months (n = 37). Their dietary consumption was assessed through a three-day food record. The 20-item Celiac Disease Quality Of Life survey (CD-QOL), which contains four subscales (limitations, dysphoria, health concerns, and inadequate treatment) was used to assess the quality of life. The children who followed a GFD for ≥12 months presented poorer scores in the limitations subscale than those who followed a GFD for <6 months (p = 0.010). The mean % of the energy intake from ultra-processed foods was 47.3 ± 13.5. Children with CD consuming more than 50% of their total energy from ultra-processed foods showed poorer scores for the limitation and inadequate treatment (both, p = 0.019) subscales than their counterparts. According to parents’ perceptions, those children who consumed more than 50% of their energy through ultra-processed foods had more limitations, and their treatment was perceived as less effective.