Thesis (MA&D) -- AUT University, 2008. / Includes bibliographical references. Also held in print (405 leaves : ill. ; 30 cm.) in the Archive at the City Campus (T 616.399 WAL)

Thesis PlanA (M.S.)--University of Wisconsin--Stout, 2008. / Includes bibliographical references.

The only treatment for celiac disease (CeD), an autoimmune disorder triggered by the ingestion of gluten, is lifelong adherence to a gluten-free diet (GFD). CeD and the GFD have been shown to be associated with low quality of life (QoL). In some individuals, such a strict diet can lead to disordered eating attitudes and behaviors. The purpose of this study was to better understand the extent to which disordered eating attitudes and behaviors may be common in a sample of adults diagnosed with CeD, as well as the relationship with various factors and QoL measures, including anxiety and depression. The study is a cross sectional pilot study of 50 individuals with CeD. Patients between the ages of 18 to 45 years old (mean=29.56, SD=7.40) with a biopsy-proven CeD diagnosis, following a GFD for at least a year (mean=7.20, SD=5.31) with no previous or current eating disorder diagnosis were recruited. In this study, suggestive ED (based on EDDS) and DE (based on EPSI) were present, but low (2% suggestive diagnosis of BED, 12% suggestive diagnosis of OSFED as per DSM-V). The distribution of the self-reported food attitudes and behaviors measures (CD-FAB scores) were spread out around the mean 36.96 (15.30) with a maximum score of 66 out of a possible 77. The CD-FAB may have utility in identifying adults with CeD that may be at risk for disordered eating attitudes and behaviors, particularly those in the first few years after diagnosis. It likely has limited utility in identifying suggestive EDs (as per EDDS) and DE (as per EPSI). The main factors that were associated with higher CD-FAB scores were BMI, number of symptoms, years since diagnosis, diet adherence and personality characteristics. Seven years after diagnosis seems to be an important cut-point in how participants rated food attitudes, fear responses and adaptive responses on the CDFAB scales. Higher CD-FAB scores had a significant and meaningful association with QoL scores. Participants recruited during the COVID-19 pandemic had significantly lower CD-FAB scores and higher QoL scores compared to those recruited pre-pandemic; despite not having significant differences in any other demographic characteristics.

Celiac disease is an autoimmune disorder triggered by the ingestion of gluten, which is found in wheat, barley, and rye. The only treatment for celiac disease is a strict gluten-free diet (GFD), which eliminates common gluten-containing foods found in many cultures and cuisines. This research examined how families experienced celiac disease and the GFD in their households, focusing on the ripple effect of celiac disease for all members of the family and how families promoted adherence and quality of life (QOL). A mixed-methods approach used questionnaires, photographs, and semi-structured interviews with families recruited from the Celiac Disease Center at Columbia University Medical Center. Participants were 16 families with children ages 8-18 living at home who had physician-confirmed diagnoses of celiac disease. A total of 71 in-depth semi-structured interviews were conducted (n =16 reference children with celiac disease, 16 mothers, 15 fathers, 24 siblings). Results showed that the reference children with celiac disease had high GFD adherence (mean CDAT = 9) and QOL (mean CDPQOL 81 of 100). Mothers’ and fathers’ ratings of how their child’s celiac disease diagnosis affected their lifestyle, social life, and level of burden in caring for child’s dietary needs differed significantly (all p-values < 0.05), with mothers reporting more change and burden. Emerging themes related to a negative ripple effect included the burden of assuming the majority of food tasks related to GFD (mothers), the limited restaurant choices for the family (fathers), and feeling annoyed by having to limit certain foods at home (siblings). Emerging themes related to a positive ripple effect, included becoming more creative cooks (mothers), incorporating new family traditions (fathers), and developing empathy for others (siblings). Overall, there was substantial evidence of a ripple-effect of a child’s celiac disease diagnosis on other family members, including how mothers and fathers may experience the change in lifestyle and added responsibilities of maintaining the GFD differently. Including parents and siblings in research provides insight into the entire family experience and can help inform family-centered interventions on how to maximize QOL for everyone impacted by a child’s celiac disease diagnosis.

Thesis (M.S.)--West Virginia University, 2005. / Title from document title page. Document formatted into pages; contains v, 49 p. Vita. Includes abstract. Includes bibliographical references (p. 38-42).

Thesis (Ph.D.)--Duquesne University, 2009. / Title from document title page. Abstract included in electronic submission form. Includes bibliographical references (p. 129-140) and index.

Celiac disease is attributable to autoimmune diseases, where treatment is based on absolute respect for gluten-free diet. As the gluten used widely in all areas of food production, strict adherence to a gluten-free diet really can be difficult for people with celiac disease. Products suitable also for those suffering from the disease are usually expensive. Finally, patients that undergo exclusively on a gluten-free diet are robbing the important nutritional components. Therefore, interest in this type of products innovation enhance as to the nutritional, technological, as well as organoleptic properties. The aim of this final thesis was to draw up literature review of the celiac disease and gluten allergen, or his particular part of gliadin. In the experimental part, attention was focused on the first hydrolytic cleavage of starch, the substrate was sterilized wheat flour and water, where is incorporated spiral just gluten. The best ability of degrading the starch grains, the combination of enzymes and MT3K and GLUAMK concentration of 0, 1% over 4 hours of action, as indicated by a reduction in the starch content of the original amount of 72,65 % at a concentration of 29,00 %. The next item of work distribution used different proteases, to reduce the amount of gliadin to below 20 ppm per kilogram of final product. Low levels investigated allergen (10,79 ppm/kg) recorded by the enzyme combination exoprotease Flavourzyme (0,1 %) and endoprotease Neutral Protease (0,1 %) at 7 hours hydrolytic action. The conclusion of the thesis was prepared several alternatives gluten-free breads and through sensory evaluation assessed the characteristics of color, aroma and taste to predict the location of the products on the commercial market.

This diploma thesis deals with the issue of celiac disease with a focus on the importance of micronutrients in treatment and clinical monitoring of patients with celiac disease. The thesis is divided into two parts, theoretical and practical. The theoretical part is divided into two chapters. The first chapter deals with celiac disease in general - history, epidemiology, pathogenesis, clinical classification, clinical manifestations, diagnostics and complications of celiac disease. Procedures for clinical monitoring of patients with celiac disease are also discussed. Last but not least, cereal proteins are analysed with a focus on gluten and its importance in the pathogenesis of celiac disease. The second chapter describes gluten-free diet as the only available possibility how to treat celiac disease. Furthermore, the pitfalls of the gluten-free diet and its possible nutritional imbalances associated with a gluten-free diet. The issue of gluten-free products is discussed, both in terms of legislation and in terms of selecting suitable foods. The possibilities of supplementation of micronutrients in celiac and other investigated possibilities of treatment of celiac disease outside the gluten-free diet are also mentioned. The practical part of this diploma thesis has two main goals. The first goal is...

Gluten-related disorders (GRDs) refer to a group of conditions that are caused by the ingestion of the gluten proteins present in wheat, barley, and rye. The global prevalence of GRDs is estimated to range from 0.6% to 10.6% of the general population, making it a significant global health issue. Treatment of GRDs requires dietary gluten avoidance. In China, there is believed to be a growing number of people with GRDs associated with changing eating patterns, increasing awareness, and better detection methods of these conditions in China. However, there is a lack of research about how to help this population maintain a restrictive diet and navigate food and social environment. The main purpose of this study was to explore the feasibility and acceptability of a culturally adapted low-gluten diet intervention among young adults in southeastern China. This study was a pre-post study design to investigate whether the intervention is effective in helping participants maintain a low-gluten diet for eight weeks. Participants were 62 young adults living on campus in southeastern China. Image-based food records and questionnaires were used to assess their dietary adherence, dietary quality, satisfaction, knowledge, self-efficacy, and other related determinants of following a low-gluten diet. Results suggested good feasibility of this dietary intervention. Only 1.9% of the total items consumed during the intervention was high-gluten or likely-high-gluten items, such as processed meat, mixed dishes, and fried food, and traditional noodles, suggesting an overall good compliance to the low-gluten diet. Specifically, over 95% of participants were found to be compliant with the diet based on all adherence measures. Females had better compliance than males (p=0.005 based on frequency, p=0.039 based on grams of gluten intake). Results also suggested good acceptability of this dietary intervention. All participants found the dietary intervention to be satisfactory with group communication and reminders rated to be the most helpful components. The perceived difficulty level of maintaining the low-gluten diet was 6.34 out of 10 (10 being the most difficult). The most rated barriers were fewer food choices and change of eating habits. Participants reported having more perceived barriers at the end of study compared to the beginning of the study, mean (SD) 17.19 (5.82) vs. 16.13 (4.19) out of 32, p = 0.285. Motivation scores were significantly lower at the end of study compared to the beginning of the study, mean (SD) 11.66 (2.21) vs. 13.40 (2.37) out of 16, p < 0.001. Increased perceived barriers and decreased motivation may suggest that they experienced more challenges in maintaining the low-gluten diet at the end of this two-month intervention. During the intervention, participants had significantly lower calories, carbohydrates, and vitamin B1 (thiamin) intake compared to baseline (p <0.05). Participants’ average dietary diversity score had no significant difference compared to baseline, 7.68 (1.10) vs. 7.69 (1.35), p=0.96. Participants had increased objective knowledge (p<0.0001), subjective knowledge (p< 0.0001), and behavioral capability (p<0.0001) compared to baseline. However, univariate and multivariate regression analyses did not find significant predicting effects of any determinants on dietary adherence. Our dietary assessment method, the image-based food records, was shown to be a reasonably valid and reliable tool to estimate the dietary intake among Chinese young adults based on comparison to weighted food records with the Bland–Altman plot and inter-rater reliability test (Cohen’s kappa=0.875). These findings suggested that a culturally adapted low-gluten dietary intervention was feasible and acceptable among Chinese young adults. Improvement on long-term dietary adherence and more research on determinants is needed. This study may inform health practitioners and policy makers to provide better culturally tailored support to patients who need to follow a low-gluten diet in China.

Prior research on eating behaviors has shown that romantic partners actively merge their dietary preferences throughout the course of a relationship and find significant value in cooking and eating the same foods together at the same times. Yet, little is known regarding the impacts of specific dietary support processes involved in maintaining said communal diet when one partner drastically alters his or her eating patterns. The current study defined dietary sacrifice as a phenomenon within the context of Celiac Disease (CD): a chronic illness that requires strict adherence to the gluten-free diet (GFD). Drawing from existing research on sacrifice within romantic relationships (e.g., Impett & Gordon, 2008), this project examined whether non-Celiac partners' adherence to the GFD during shared mealtimes impacted relationship satisfaction for both couple members. Female Celiacs and their non-Celiac cohabitating partners (N=152 couples) were recruited for an online survey through various support organizations. Given the dyadic design of this study, the Actor-Partner Interdependence Mediation Model (APIMeM; Ledermann, Macho, & Kenny, 2011) was used to examine the mediating influence of Dietary Approach and Avoidance Motives. Results indicated that partner support in the form of shared GFD adherence bolstered couple happiness to the extent that it was performed for positive gains (e.g., promoting health and well-being) by the non-Celiac. While dietary sacrifice was positively associated with Celiacs' relationship satisfaction above and beyond non-Celiacs' endorsement of Dietary Avoidance Motives, both dyad members experienced significantly lower relationship satisfaction when non-Celiac partners adhered to the diet to deflect negative outcomes (e.g., rejection, fighting). This study serves as the first application of relationship sacrifice research to a specific health issue, and the first psychological exploration into intimate partners' dietary support processes within the Celiac population.