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: 1.99). 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.

Download full-text


Available from: Peter H R Green, Jun 05, 2014
1 Follower
107 Reads
  • Source
    • "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). "
  • Source
    • "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). "
    [Show abstract] [Hide abstract]
    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 · 1.21 Impact Factor
  • Source
    • "With treatment, a strict gluten-free diet, the serological markers normalize, the small intestinal mucosa recovers, and symptoms alleviate [3,9]. However, adhering to a strict gluten-free diet poses difficulties in everyday life including increased costs, social restrictions and stigmatisation, which may impact negatively on the health-related quality of life (HRQoL) [10-14]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Knowledge regarding the health-related quality of life (HRQoL) of children with celiac disease remains limited and inconclusive. We investigated the HRQoL of three groups of 12-year-olds with: i) undetected celiac disease ii) clinically diagnosed celiac disease, and iii) without celiac disease. Methods A school-based cross-sectional multicenter screening study invited 18 325 children, whereof 68% consented to participate. Participants provided a blood sample, which was later analyzed for anti-tissue-tranglutaminase antibodies, and alongside filled in a questionnaire. When anti-tissue-tranglutaminase antibodies were elevated, a small intestinal biopsy verified the screening-detected celiac disease diagnosis. Self-reported HRQoL was measured using Kidscreen, a generic 52 items instrument with proven reliability and validity. Scores were linearly transformed into a 0–100 scale with higher values indicating better HRQoL. Mean values with standard deviations (mean ± SD) were compared, and uni- and multivariate logistic regression models tested the odds of a low HRQoL among children with undetected or diagnosed celiac disease, respectively. Results Children with undetected celiac disease (n = 238) reported similar HRQoL as children without celiac disease (n = 12 037) (83.0 ± 11.0 vs. 82.5 ± 11.3, P = 0.51), and also similar HRQoL (82.2 ± 12.2, P = 0.28) to that of children with diagnosed celiac disease (n = 90), of whom 92% were adherent to treatment. Having undetected celiac disease did not increase the odds of low overall HRQoL, independent of sex, area of residence, study year and occurrence of gastrointestinal symptoms (adjusted odds ratio 0.77, 95% CI 0.54-1.10). Comparable results were seen for diagnosed celiac disease cases (adjusted odds ratio 1.11, 95% CI 0.67-1.85). Conclusion Children with undetected celiac disease reported comparable HRQoL as their peers with diagnosed celiac disease, and those without celiac disease, when reporting prior to receiving the diagnosis through screening. Thus, children with celiac disease, both untreated and diagnosed, perceive their HRQoL as unimpaired by their disease.
    BMC Public Health 05/2014; 14(1):425. DOI:10.1186/1471-2458-14-425 · 2.26 Impact Factor
Show more