A score that verifies adherence to a gluten-free diet: a cross-sectional, multicentre validation in real clinical life.

A dietary interview performed by expert personnel is the best method to check whether patients with coeliac disease follow a strict gluten-free diet (GFD). We previously developed a score based on four fast and simple questions that can be administered even by non-expert personnel. The aim of the present study is to verify the reliability of our questionnaire in a new cohort of patients. The questionnaire has a five-level score. From March 2008 to January 2011, the questionnaire was administered to 141 coeliac patients on a GFD, who were undergoing re-evaluation. The score obtained was compared with persistence of both villous atrophy and endomysial antibodies (EMA). The rate of lower scores was higher among the 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). Given that the coeliac patients have been well instructed on what a GFD means and on how to follow it, our questionnaire is a reliable and simple method to verify compliance to a GFD.

[1]  G. Holmes,et al.  Causes of Death in People With Celiac Disease Spanning the Pre- and Post-Serology Era: A Population-Based Cohort Study From Derby, UK , 2011, The American Journal of Gastroenterology.

[2]  D. Balduzzi,et al.  Are we not over-estimating the prevalence of coeliac disease in the general population? , 2010, Annals of medicine.

[3]  Tsung-Teh Wu,et al.  Mucosal Recovery and Mortality in Adults With Celiac Disease After Treatment With a Gluten-Free Diet , 2010, The American Journal of Gastroenterology.

[4]  G. Corazza,et al.  Mortality in celiac disease , 2010, Nature Reviews Gastroenterology &Hepatology.

[5]  G. Corazza,et al.  A gluten-free diet score to evaluate dietary compliance in patients with coeliac disease. , 2009, The British journal of nutrition.

[6]  E. Cook,et al.  A simple validated gluten-free diet adherence survey for adults with celiac disease. , 2009, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[7]  D. Schuppan,et al.  Factors that Influence Adherence to a Gluten-Free Diet in Adults with Celiac Disease , 2008, Digestive Diseases and Sciences.

[8]  G. Corazza,et al.  Clinical response to gluten withdrawal is not an indicator of coeliac disease , 2008, Scandinavian Journal of Gastroenterology.

[9]  S. Cessie,et al.  Food questionnaire for assessment of infant gluten consumption. , 2007, Clinical nutrition.

[10]  J. Murray,et al.  Gluten-free diet: the medical and nutrition management of celiac disease. , 2006, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition.

[11]  M. Pietzak Follow-up of patients with celiac disease: achieving compliance with treatment. , 2005, Gastroenterology.

[12]  S. Case The gluten-free diet: how to provide effective education and resources. , 2005, Gastroenterology.

[13]  G. Corazza,et al.  A milligram of gluten a day keeps the mucosal recovery away: a case report. , 2004, Nutrition reviews.

[14]  G. Corazza,et al.  Endomysial and tissue transglutaminase antibodies in coeliac sera: a comparison not influenced by previous serological testing. , 2001, Scandinavian journal of gastroenterology.

[15]  P. Howdle,et al.  management of patients with non‐responsive coeliac disease , 1996, Alimentary pharmacology & therapeutics.

[16]  L. Greco,et al.  Endomysial Antibodies as Unreliable Markers for Slight Dietary Transgressions in Adolescents with Celiac Disease , 1995, Journal of pediatric gastroenterology and nutrition.

[17]  G. Holmes,et al.  Malignancy in coeliac disease--effect of a gluten free diet. , 1989, Gut.

[18]  L. Fry,et al.  Increased incidence of malignancy in dermatitis herpetiformis. , 1983, British medical journal.