Memo to patients with celiac disease (CD) and their doctors: Avoiding gluten is important — but so is maintaining quality of life.
So finds a study led by TC’s Randi Wolf, Associate Professor of Human Nutrition, published last spring in Digestive Diseases & Sciences.
“There are potential negative consequences of hypervigilance to a strict gluten-free diet,” write Wolf and co-authors (including Celiac Disease Center at Columbia University faculty and TC students Jennifer Cadenhead and Chelsea Amengual). “Clinicians must consider the importance of concurrently promoting both dietary adherence and social and emotional well-being for individuals with CD.”
An accompanying editorial said the study “highlights the need for finding balance between adherence to a gluten-free diet and maintaining a high quality of life” and called for further studies to determine that balance.
“Clinicians must consider the importance of concurrently promoting both dietary adherence and social and emotional well-being for individuals with CD.”
— Randi Wolf
With celiac disease, a genetically acquired autoimmune disorder, the intestine becomes inflamed after the ingestion of gluten, a protein found in wheat, barley and rye. Some people have no symptoms; others experience abdominal pain, infertility and anemia. Continued gluten ingestion can cause intestinal damage and increase risk for osteoporosis and certain cancers. The condition affects one in 133 people — a five-fold increase since the 1950s.
Randi Wolf, Associate Professor of Human Nutrition
Wolf’s team surveyed adults and teens with biopsy-confirmed celiac disease. Some patients, classified as “hypervigilant,” carefully monitored their diets to avoid intentional and unintentional gluten exposure, dined in gluten-free restaurants, prepared food for non-household consumption and closely attended to food labeling. A second group was less meticulous in monitoring food intake inside and outside the home.
The hypervigilant participants reported lower energy and greater anxiety and stress, including constant worries about cross-contamination and dismissive or uninformed wait staff.