Diet Quality, Ultra-Processed Food Consumption, and Quality of Life in a Cross-Sectional Cohort of Adults and Teens with Celiac Disease

Celiac disease (CeD), a common autoimmune condition, requires strict adherence to a gluten-free diet (GFD). Adherence to the GFD has been associated with quality of life (QOL). However, there may be other diet-related concerns, like overall diet patterns, including diet quality or ultra-processed food (UPF) consumption, that could be associated with QOL among people with CeD following a GFD which has not been examined. Determined diet quality based on 24-h diet recalls of a cross-sectional prospectively recruited sample of 80 participants (50 adults and 30 teens) with biopsy-confirmed CeD (“Study Sample”) using the Healthy Eating Index (HEI) and Alternate Mediterranean Diet (AMED) score. Assessed the amount of UPF consumed using Nova, a food processing classification system. Measured QOL using Celiac Disease-Specific Quality of Life (CDQOL) and Celiac Disease Pediatric-Specific Quality of Life (CDPQOL). Compared the Study Sample’s diet patterns with National Health and Nutrition Examination Survey (NHANES) groups (25 adults reporting prior CeD and GFD; 51 adults with new CeD and no GFD; 15,777 adults & 2,296 teens without CeD). Assessed the relationship of the Study Sample’s diet patterns to CDQOL/CDPQOL using ANCOVA. The Study Sample’s diet patterns were suboptimal but generally favorable compared with all NHANES groups. Compared to Study Adults with the highest tertile of UPF, those with the lowest tertile had significantly higher CDQOL [mean: 67.6 vs 78.3, p<0.001]. Compared to Study Teens with the lowest tertile of AMED, those with the highest tertile had significantly higher CDPQOL [mean: 67.0 vs 79.9, p<0.01]. Maintaining high diet quality and minimizing UPF may be important for CeD-specific QOL among individuals with CeD maintaining a GFD. This article is protected by copyright. All rights reserved.

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