Gluten-free diet compliance

  1. Dr.Schär Institute
  2. Dr. Schär Institute
  3. Gluten-free diet compliance

The strict nature of the gluten-free diet can make it difficult for patients to comply. However, for long term health and avoidance of complications strict dietary compliance is a necessity.

In medical terminology, compliance describes the cooperative behaviour of patients with regard to their therapy. This is particularly important not only when taking medication, but also for adhering to certain diets, e.g. a gluten-free diet for coeliac disease. The ubiquitous use of wheat and gluten containing ingredients and the nature of current labelling laws can make it difficult for newly diagnosed patients to comply with a strict gluten free diet, especially since the symptoms are not always immediately associated with gluten intake [1]. There are also patients who have no symptoms despite eating foods containing gluten (although damage to the intestinal mucosa may still be caused). This can lead to either inadvertent or intentional gluten ingestion.  In those individuals who are symptomatic approximately 30% - 50% do not strictly comply with a gluten-free diet [2]. To avoid future health complications, it is imperative that patient education stresses the importance of a strict lifelong gluten-free diet. Providing practical information on successfully navigating routine food shopping, dining out and travel will support compliance. Additionally, connection to a local support group and inclusion of family members in educational sessions will increase compliance and reduce dietary mistakes, which can lead to secondary diseases [3].



  1. Leffler D.A, Edwards-George J, Dennis M, Schuppan D, Cook, F., Franko, D.L., Blom Hoffman, J., Kelly, C.P. Factors that influence adherence to a gluten free diet in adults with celiac disease. Dig Dis Sci. 2008; Jun;53(6):1573-81.
  2. Barratt, S.M., Leeds, J.S., Sanders, D.S. Quality of life in coeliac disease is determined    by perceived degree of difficulty adhering to a gluten free diet, not the level of dietary adherence ultimately achieved. J Gastrointestin Liver Dis. 2011; 20;(3): 241-245.
  3. Lee A.R, Diamond B, Ng D, Ciaccio E, Green PHR. Quality of life of individuals with celiac disease; Survey results from the United States. Journal of Human Nutrition and Dietetics 2012; 25, 233-238.