The Relation of Gluten-Free Diet and Quality of Life in Children with Celiac Disease: A Cross-sectional Study

Abstract

Background: The present study aimed to determine the relationship between a gluten-free diet (GFD) and quality of life (QoL) in children with celiac disease (CD) and to evaluate the impact of additional factors that may affect both. Methods: This cross-sectional study was conducted in 2021 using a census sampling method. A total of 409 children aged ≤ 10 years with CD were recruited from referral clinics in Zahedan. Data were collected through a structured questionnaire. Statistical analyses were performed using independent t-tests, analysis of variance (ANOVA), chi-square tests, and Pearson’s correlation coefficient in SPSS version 23.0. Results: The gender distribution revealed a predominance of females (61.4%). The children had a mean age of 6.81 ± 2.46 years and a median disease duration of 3 years. The most common symptoms included abdominal pain (75.6%), weight loss (64.1%), and diarrhea (44.7%), while aggression (17.1%) and depression (11.5%) were the most frequently reported comorbidities. Poorer QoL was significantly associated with older age, longer disease duration, more comorbidities, and lower adherence to a GFD (all P < 0.01). Financial difficulties were also linked to reduced dietary adherence and worse QoL (P < 0.01). Conclusions: This study highlights that, while many children with CD maintain a relatively good QoL, several factors — particularly older age, longer disease duration, comorbid conditions, and financial hardship — negatively impact both dietary adherence and QoL.