Evaluation of adherence to gluten-free diets in Moroccan celiac patients and factors of adherence failure

Abstract

The prevalence of celiac disease (CD) is increasing in the world. In Morocco, its incidence is also increasing considerably. The gluten-free diet (GFD) remains the only effective treatment so far. Its effectiveness depends essentially on good adherence to this diet. However, several factors hinder adherence by contributing to diet failure. Within this framework, this study aims to evaluate adherence to this diet in celiac children and adolescents continuing in a tertiary health center. The article also looks to identify the different factors influencing adherence to GFD in Morocco. The results show from serological and/or biopsy tests on 238 celiac patients that half had good adherence and 13% had poor adherence. The questionnaire aimed at 127 parents or proxies of celiac children and adolescents shows that several factors are responsible for the failure to adhere to the diet such as the role of the mass media, cultural and psychological factors. The exorbitant price, nutritional quality, and low availability of gluten-free products play a major role in GFD failure. Low socio-economic factors have a negative influence on the adherence to the GFD.