Barriers to Dietary Adherence in Children with Celiac Disease

Abstract Background: Adherence to a gluten-free diet is the only treatment option available for those with celiac disease. Barriers to dietary compliance have been studied among adults, but limited attempts have been made in exploring barriers of dietary adherence in children, as well as strategies to overcome the barriers. Objectives: The purpose of this integrative literature review was to identify the barriers of adherence to a gluten-free diet among children with celiac disease as well as explore effective strategies that could be used to increase dietary adherence. Method: An integrative literature review was conducted using the databases PubMed, Cumulative Index of Nursing and Allied Health (CINAHL) Complete and Pro-Quest Nursing & Allied Health Source. Search terms included celiac disease, children, barriers, dietary adherence OR compliance, strategies and gluten-free diet. Results: Of the documented barriers to dietary adherence among children with celiac disease to a gluten-free diet, the four most supportive barriers were poor availability, insufficient labeling, lack of knowledge and high cost. The three most common strategies for dietary adherence included better awareness, improved labeling, and societal support. Conclusion: This review found four contributing barriers to dietary adherence among children with celiac disease and three strategies to dietary adherence including increased support through societal associations; however, there is a limited number of programs aimed at children. Therefore, the expansion of societal support programs aimed specifically at children would be beneficial in supporting dietary adherence