Availability Of Gluten-free Food Research Articles

Investigation of cost and availability of gluten-free food in Jeddah, KSA

ObjectiveThe prevalence of celiac disease (CD) in KSA is progressively increasing. Consistent adherence to a gluten-free (GF) diet is the only effective CD treatment. The availability and cost of GF food are important factors in adherence to a GFD. The objective of this study was to investigate the cost and availability of GF food in a sample of local stores and supermarkets across Jeddah province in KSA. MethodEleven supermarkets in Jeddah, KSA, ranging from high budget/quality supermarkets to low-budget stores, were visited. Eight food categories were evaluated, including flour, breakfast cereals, breads, pastas, and snacks (e.g., biscuits, cookies, snack bars, and chips). The availability and cost of GF and gluten containing (GC) items within these food categories were recorded. Each item included in these food categories was counted, and the overall average price was calculated. ResultsA total of 233 GF and 24 GC products were found. Supermarket 1 had the highest availability of GF foods (n = 90), followed by supermarket 2 (n = 34), supermarket 3 (n = 30), supermarket 4 (n = 23), supermarket 5 (n = 21), supermarket 6 (n = 18), supermarket 7 (n = 9), and supermarket 8 (n = 8). The median price per 100 g was significantly greater for GF than GC products (p < 0.05). The cost of GF products was significantly higher than that of GC products (p < 0.05); consequently, GF foods were twice as expensive as their GC counterparts. ConclusionThe availability of GF products was limited, and GF products were more expensive than standard GC products. High cost and limited availability are major roadblocks to GFD adherence among people with CD. Governmental organizations must cooperate with healthcare providers and food industries to ensure that GF foods are widely available and affordable for people with CD, to minimize financial pressure and improve health quality.

Celiac Disease: Disease Models in Understanding Pathogenesis and Search for Therapy

Celiac disease is a complex polygenic systemic disorder caused by dietary gluten exposure that selectively occurs in genetically susceptible people. The potential celiac disease is defined by the presence of celiac disease-specific antibodies and compatible human leukocyte antigen but without histological abnormalities in duodenal biopsies. At present, the only treatment is lifelong adherence to a gluten-free diet. Despite its effectiveness, the diet is difficult to maintain due to its cost, availability of gluten-free foods, and hidden gluten. The need to develop non-dietary treatment methods is widely recognized, but this is prevented by the absence of a pathophysiologically relevant preclinical model. Nonetheless, in vitro and in vivo models have made it possible to investigate the mechanisms of the disease and develop new treatment approaches: The use of foods with neutralized gluten, microbiota correction, cocktails of specific endoproteinase, polymer gluten binders, specific inhibitors of transglutaminases and inflammatory cytokines, and a vaccine based on allergen-specific therapy.

A193 PERCEIVED BARRIERS TO GLUTEN-FREE FOOD ACCESS ON-CAMPUS EXPERIENCED BY STUDENTS FROM DIFFERENT CANADIAN UNIVERSITIES AND COLLEGES

BackgroundStudents with gluten-related disorders (GRD), a spectrum of conditions including celiac disease (CeD) and non-celiac wheat sensitivity (NCWS), often experience challenges when accessing gluten-free (GF) foods.AimsTo identify barriers perceived by students with GRD to access GF products on-campus of universities and colleges across Canada.MethodsWe conducted a cross sectional survey using the RedCap platform and distributed it to the Canadian Celiac Association community. We included students who reported adopting a GFD for various reasons including CeD and other GRD. We collected data on adherence to the GFD using a validated questionnaire (CDAT), presence of perceived barriers to follow a GFD while dining on campus, persistent symptoms, and altered quality of life. Continuous data are expressed as median (IQR), and categorical data as proportions of patients. Mann-Whitney U and Chi2 with Fisher correction were used to assess differences between groups.ResultsSeventy nine students responded to the survey (5% male and median age = 25 yrs) and 78 had complete data for analysis. Of the 78 students, 52 (66.6%) reported a diagnosis of CeD, while 26 were adopting a GFD for other reasons (non-CeD). The majority were enrolled in university programs (72/78) and 18% were living on-campus. Almost 90% reported difficulties maintaining a GFD while dining on-campus. Similar proportion of CeD and non-CeD reported eating gluten accidentally (75% vs 80%), while 15% reported eating gluten intentionally on-campus at least a few times per week. This was observed more frequently in non-CeD compared with students with CeD (61% vs 17%; p=0.04). Barriers identified in CeD versus non-CeD groups were related to a reduced GF-food variety (48% vs 69%), lack of availability of GF food (21% vs 46%) and increased cost (46% vs 81%) compared with gluten-containing counterparts. The majority of participants were concerned whether the food available on-campus was truly GF (80% vs 54%) as they reported foods not properly labelled. The majority of participants considered their overall health (79%) and quality of life (65%) was fair to terrible while dining on campus. During the pandemic, 76% of them perceived that it was easier to stick to a GF diet.ConclusionsStudents from various universities and colleges across Canada experience barriers to access GF food on-campus. This has a significant impact on their overall health and quality of life. Proper food labeling, GF certification and improving the variety of GF food on-campus are options for improvement.Funding AgenciesNone

Nutritional quality, cost and availability of gluten-free food in England

Purpose Coeliac disease (CD) is a life-long condition requiring strict adherence to a gluten-free (GF) diet. Due to wide claims of availability and lower costs of gluten-free food (GFF) and clinical commissioning groups (CCGs) in England needing to save costs, access to prescriptions for patients with CD is being limited in England. The purpose of this paper is to investigate the availability and cost of GFF in an area where patients with CD have restricted access to prescriptions and to assess the nutritional composition of GFFs available in comparison with foods containing gluten (FCG). Design/methodology/approach Eight food categories that were representative of a range of commonly purchased GFFs were selected. Availability and cost of the cheapest and most expensive branded and non-branded GFFs and gluten containing equivalents were surveyed at physical stores (n=19) and online stores (n=8). The nutritional composition of some of the widely available GFFs identified (n=190) and comparable FCGs (n=218) were calculated using MyFitnessPal. Findings None of the budget stores or corner shops surveyed stocked any of the surveyed cereal-based GFFs. Online stores had more availability than physical stores; however, there was no significant difference in cost. GFFs cost, on average, 2.18 times more than FCG. When making nutritional comparisons with gluten-containing food, protein content was lower across 55 per cent of GFF categories. There was significantly less sugar in GF brown bread, crackers, and wholegrain pasta compared with those containing gluten (CG). Another main finding was GF ready-meals contained significantly less salt than ready-meals CG. Originality/value Limited resources and perceived wide availability of GF products resulted in reduced GF prescriptions to patients in England. The findings in this study revealed that there is no availability of cereal-based GFFs in budget stores, high cost and limited access to prescriptions can influence adherence to a GF diet and is most likely to affect patients from deprived groups. This study recommends that the prescription of GFF to patients with CD should be continued.

Assessment of Gluten Exposures in Children with Celiac Disease

Abstract BACKGROUND: Celiac Disease (CD) is one of the most common chronic diseases of childhood. A strict, lifelong gluten-free diet (GFD) remains the sole treatment for CD. Reports of accidental or intentional ingestion of gluten are common, but little is known about the sources or context of such exposures. OBJECTIVES: We sought to ascertain the self-reported causes for gluten exposure for children with Celiac Disease. DESIGN/METHODS: Parents of children with biopsy-proven CD followed at McMaster Children’s Hospital were asked to review a 22-item questionnaire listing sources, situations and causes of gluten exposure for their child. The questionnaire encompassed both intentional and unintentional gluten exposures and was developed through consultation with Registered Dietitians and Faculty in the Division of Pediatric Gastroenterology at McMaster Children’s Hospital. Children independently completed a similar 21-item questionnaire adapted for pediatric use. Participants were invited to describe any additional sources or circumstances leading to gluten consumption not captured in the questionnaire. RESULTS: A total of 123 families participated in the study with a median of 32 months on a GFD. A minimum of one cause of gluten exposure was selected by 65% of parents and 60% of children. Restaurant dining was identified as a source of gluten consumption by 39% of parents, due to a lack of knowledge of the GFD by restaurant staff or poor labeling of menu items. Other commonly selected items on the parent questionnaire included: difficulty while traveling (13%), to avoid exclusion at social events (12%), and a lack of negative symptoms following gluten exposure (9%). Few parents identified cost (2%), or the availability of gluten-free food as a concern (5%). Children most commonly identified restaurant eating (32%), and the lack of any negative symptoms from eating gluten as the main causes of gluten exposure (14%). In this study population, 11% of children acknowledged consuming gluten because they felt left out at either home, school or with friends. CONCLUSION: This study provides information about the common causes of gluten exposure for children with CD in Ontario, Canada. Restaurant dining and travel were the most commonly identified sources of gluten ingestion. Our study highlights the need for improved menu labeling and education of restaurant staff, requiring both policy changes and dialogue with food service industries. While availability of gluten-free products has greatly improved, exclusion from social activities remain a concern for both children and their parents. Further qualitative studies may build on these identified themes to better understand challenges families face with the GFD.

Assessment of nutritional status of celiac disease patients in Ludhiana city of Punjab

A sample of 30 celiac patients including 20 adults and 10 children was enrolled to assess their nutritional status. Mean height of females, males and children was 157.78 cm, 160.48 cm and 95.56 cm, respectively and weight was 44.17 kg, 46.58 kg and 14.13 kg, respectively. Both height and weight were less than the standard height and weight of Indians. The mean intake of cereals was 114.65g, 102.13g, 75.83g and pulse intake was 54.66g, 58.36g, 65.95g by females, males and children, respectively. Pulse intake in case of children was significantly higher whereas intake of all other food groups in all the three groups were significantly lower (P<0.01). Energy intake by all the three groups was less i.e. 1268 kcal by females, 1/3 rd of RDA by males (929 kcal) and ½ of RDA by children (888 kcal). As compare to RDA the protein intake was adequate in case of females (43.26g) and children (32.68g) but less in males (31.50g) as compare to suggested intake. Carbohydrate and fibre intake was significantly lower (P<0.01) in all the three groups as compare to suggested intake. Fat intake was significantly lower (P<0.01) by males and children as compare to calculated value based on 20 per cent and 25 per cent of energy, respectively. It was found that celiac patients were using only maize flour and besan to make chapattis and they were not taking any inbetween meal because of lack of availability of gluten free foods.

Su1168 Cost and Availability of Gluten-Free Foods in Argentina and Its Relation With Adherence to the Gluten Free Diet. Preliminary Data From a Multicenter Study

Su1168 Cost and Availability of Gluten-Free Foods in Argentina and Its Relation With Adherence to the Gluten Free Diet. Preliminary Data From a Multicenter Study

Cost and availability of gluten-free food in the UK: in store and online

ObjectiveCoeliac disease (CD) is a lifelong condition requiring strict adherence to a gluten-free (GF) diet and good availability of GF foods is critical to this. Patients with CD from lower...

PTU-156 Cost and availability of gluten-free foods in the uk: in store and online

Introduction Coeliac Disease (CD) is an autoimmune condition of the small bowel. A gluten-free (GF) diet is the only treatment for CD and with increasing incidence, 1 the demand for GF food has increased. Prior studies show GF food is more expensive and high street availability is limited. 2 However this has not been assessed for online GFD. We aimed to assess the availability and cost of GF foods across a range of supermarkets in a single UK city (Sheffield). We also aimed to assess the impact online retailers had on the GF food market. Method 67 supermarkets were analysed, including a range of categories, sizes and locations. The total number of GF items which were on sale was counted and 10 items were selected to represent a range of commonly bought GF foods for which the price and availability was recorded. Where any were found, the price of their gluten-containing counterpart was also recorded. The same factors were then used to assess online retailers. Results Of the 67 supermarkets visited, 27 (40.3%) stocked no GF items, with the remaining 40 (59.7%) stocking at least one. The mean number of GF items sold per store was 30, but this varied greatly by store category and size. None of the budget or corner supermarkets surveyed stocked any GF items. Regular and luxury supermarkets had a greater range (p In terms of the ten items specifically surveyed, 31 (46.3%) stores stocked none of the items, with the remaining 36 (53.7%) stocking at least one. Stores that stocked GF food had a median of 8 of the 10 specific items available. Overall, GF items cost significantly more than their gluten-containing counterparts, with GF items costing on average 4.1 times more (p All 21 online stores surveyed sold at least one GF item. The average number of GF items sold was 609, compared with 30 for stores (p Conclusion The availability of GF food in budget supermarkets and corner shops is lacking and GF food remains significantly more expensive. The greatest availability is online and in larger regular/luxury supermarkets. The issue remains that this could prevent lower socioeconomic groups from fully adhering to a GF diet. Disclosure of interest M. Burden: None Declared, P. Mooney: None Declared, R. Blanshard: None Declared, W. White: None Declared, D. Cambray-Deakin: None Declared, D. Sanders Consultant for: Has received funding from Dr Schar a gluten free food manufacturer for investigator led studies into coeliac disease. References West J, et al . Incidence and prevalence of celiac disease and dermatitis herpetiformis in the UK over two decades: Population-Based study. Am J Gastroenterol. 2014;109:757–768 Singh J, Whelan K. Limited availability and higher cost of gluten-free foods. J Hum Nutr Diet 2011;24:479–486

Mo1056 Cost and Availability of Gluten-Free Foods in the UK: In Store & Online

Mo1056 Cost and Availability of Gluten-Free Foods in the UK: In Store & Online

Factors affecting adherence to a gluten-free diet in children with celiac disease.

The treatment of celiac disease is a strict, life-long gluten-free (GF) diet. This diet is complex and can be challenging. Factors affecting adherence to the GF diet are important to identify for improving adherence. To identify factors that inhibit or improve adherence to a GF diet in children with celiac disease. Patients (<18 years of age) with biopsy-confirmed celiac disease followed by the gastroenterology service at a tertiary care paediatric institution were surveyed using a mailed questionnaire. Factors influencing adherence to a GF diet were scored from 1 to 10 based on how often they were problematic (1 = never, 10 = always). Parents of patients <13 years of age were instructed to complete the survey with their child. Adolescents ≥13 years of age were asked to complete the survey themselves. Of 253 subjects, 126 completed the survey; the median age was 12 years (range two to 18 years). Forty percent were adolescents. Overall, participants reported good adherence at home and school, but lower adherence at social events. Adolescents reported lower adherence compared with parents. Availability of GF foods and cost were the most significant barriers. Other factors identified to help with a GF diet included education for schools/restaurants and improved government support. Availability, cost and product labelling are major barriers to adherence to a GF diet. Better awareness, improved labelling and income support are needed to help patients.