Psychological resilience and food skills are favorably linked to gluten-free diet adherence in adults with celiac disease: a cross-sectional study.

BACKGROUND

Celiac disease (CD) is a chronic autoimmune condition requiring strict adherence to a gluten-free diet (GFD) to prevent adverse health outcomes; however, strict diet adherence is difficult to maintain. Low psychological resilience has been linked to symptom severity in patients with gastrointestinal disorders including CD; however, resilience-building interventions have a low success rate in general. Psychological resilience has been linked to food skills, suggesting the possibility of improving individual resilience via culinary training. This cross-sectional study was designed to examine the relationships between food skills, psychological resilience, and GFD adherence in adults with CD.

METHODS

An anonymous online survey was used to collect basic demographic and health data as well as the food skills, resilience, and diet adherence characteristics of participants. Participants (n = 327; ≥18 y) were recruited using ads placed on the websites of national CD support groups. Food skills, resilience, and GFD adherence were quantified using validated questionnaires: the Food Skills Questionnaire, the Resilience Scale-14, and the Celiac Dietary Adherence Test.

RESULTS

Correlational analysis identified significant associations between food skills (meal planning, food preparation, and food safety), resilience, and age. The multiple linear regression analyses identified meal planning and resilience as significant explanatory variables for GFD adherence, accounting for 12.3% of the variance in adherence scores.

CONCLUSIONS

The findings suggest that both food skills and psychological resilience significantly influence GFD adherence. These two areas could serve as targets for intervention programs that improve the wellbeing of individuals with CD.