Economic burden of a gluten-free diet

Department of Biological Sciences, Columbia University, New York, New York, United States
Journal of Human Nutrition and Dietetics (Impact Factor: 2.07). 11/2007; 20(5):423-30. DOI: 10.1111/j.1365-277X.2007.00763.x
Source: PubMed

ABSTRACT Coeliac disease is a common, autoimmune disorder, for which the only treatment is lifelong adherence to a gluten-free diet. This study evaluates the economic burden of adhering to a gluten-free diet.
A market basket of products identified by name brand, weight or package size for both regular wheat-based products and gluten-free counterparts was developed. The differences in price between purchase venues, both type of store (general grocery store, an upscale grocery store and a health food store and four internet-based grocery sites) and region was also analysed.
Availability of gluten-free products varied between the different venues, regular grocery stores carried 36%, while upscale markets carried 41%, and health food stores 94%, compared with 100% availability on the internet. Overall, every gluten-free product was more expensive than their wheat-based counterpart (P <or= 0.05). Bread and pasta was twice as expensive as their wheat-based counterparts. Cost was affected more by shopping venue than geographic location.
This study demonstrated that gluten-free foods have poor availability and are more expensive than their gluten-containing counterparts. The impact of these findings on dietary compliance and the quality of life needs to be addressed.

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Available from: Peter H R Green, Jun 05, 2014
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    • "One reason noted for the exclusion of this portion of the diet was due to the increased cost of the gluten-free products in the USA. The increased cost of gluten-free foods was confirmed in our recent study that looked at cost and availability across different regions of the USA (Lee et al., 2007). The alternative grains selected provide the specific nutrients that are lower in the standard gluten-free diet menu pattern (Thompson, 2000). "
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    • "The present study suggests that the limited availability of GF products and the elevated prices of these products can have a negative impact on the adherence to a GF diet. These issues negatively affect the quality of life of individuals with CD and can lead to clinical and nutritional complications (Lee et al., 2007; Singh & Whelan, 2011). Low palatability and social pressure are also factors that have been identified as harmful to the adherence to a GF diet (Lerner, 2010). "
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    ABSTRACT: Abstract The present study investigated the perceptions of individuals with celiac disease about gluten-free (GF) products, their consumer behavior and which product is the most desired. A survey was used to collect information. Descriptive analysis, χ(2) tests and Multiple Logistic Regressions were conducted. Ninety-one questionnaires were analyzed. Limited variety and availability, the high price of products and the social restrictions imposed by the diet were the factors that caused the most dissatisfaction and difficulty. A total of 71% of the participants confirmed having moderate to high difficulty finding GF products. The logistic regression identified a significant relationship between dissatisfaction, texture and variety (p < 0.05) and between variety and difficulty of finding GF products (p < 0.05). The sensory characteristics were the most important variables considered for actual purchases. Bread was the most desired product. The participants were dissatisfaction with GF products. The desire for bread with better sensory characteristics reinforces the challenge to develop higher quality baking products.
    International Journal of Food Sciences and Nutrition 06/2014; 65(4):394-8. DOI:10.3109/09637486.2013.879286 · 1.20 Impact Factor
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    • "While there has been an increase in the availability of gluten-free food in markets and restaurants , the availability of gluten-free food in the United States is still limited [Lee et al. 2007]. Gluten-free food is often more than twice the price of similar gluten-containing foods [Lee et al. 2007]. "
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    ABSTRACT: A gluten-free diet is the treatment for celiac disease, but pharmaceutical agents are being developed. The level of interest amongst patients in using a medication to treat celiac disease is unknown. This study examined the level of interest amongst patients in medication to treat celiac disease. A questionnaire was distributed to celiac disease patients and data were collected on demographics, presentation, and interest in medication. Three validated celiac disease-specific instruments were incorporated: Celiac Disease Associated Quality of Life, the Celiac Symptom Index, and the Celiac Dietary Adherence Test. Responses were received from 365 individuals with biopsy-proven celiac disease. Respondents were 78% (n = 276) female, 48% (n = 170) over 50 years of age, and experienced a classical (diarrhea predominant) presentation in 44% (n = 154). Of the 339 individuals answering the question regarding use of a medication to treat celiac disease, 66% were interested. Interest was greatest in older individuals (71% >50 years of age versus 60% <50 years of age, p = 0.0415), men (78% men versus 62% women, p = 0.0083), frequent restaurant customers (76% versus 58%, p = 0.0006), those dissatisfied with their weight (73% versus 51%, p = 0.0003) and those concerned with the cost of a gluten-free diet (77% versus 64%, p = 0.0176). Length of time since diagnosis, education, presentation, and symptoms with gluten exposure did not demonstrate any effect. Interest in medication was associated with a worse quality of life (CD-QOL 69.4 versus 80.1, p < 0.0001). Most individuals with celiac disease are interested in using a medication. Interest was highest among men, older individuals, frequent restaurant customers, individuals dissatisfied with their weight or concerned with the cost of a gluten-free diet, and those with a worse quality of life.
    Therapeutic Advances in Gastroenterology 09/2013; 6(5):358-64. DOI:10.1177/1756283X13492580
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