Development and Evaluation of a Gluten-Free Food Guide for Children and Youth

• Author / Creator

  Cyrkot, Samantha

• Background: Celiac disease (CD) is an autoimmune disease that results in inflammation and damage to the small intestine when gluten, a protein found in wheat, rye or barley is consumed. The only treatment for CD is lifelong adherence to the gluten-free diet (GFD). However, dietary intake can be high in saturated fat, sugar and lower in micronutrients such as folate. Currently, no comprehensive pediatric guidelines exist that address the nutritional limitations of the GFD. The purpose of this thesis was to describe the development and evaluation of a gluten-free (GF) food guide for children and youth (4-18 years) and to describe potential factors (e.g. home food environment, food literacy) that may influence food guide uptake by children and youth with CD, their parents and health care professionals.Methods: Guide development included a comprehensive evaluation of dietary intake and patterns in children/youth with CD, the development of GFD simulations (n=1260) and pre-and-post guide stakeholder consultations with 656 members of the CD community (children/youth, parents of children/youth with CD) and 231 health care professionals using focus group and survey methodology. Factors that may influence guide uptake were assessed in 16 households of youth with CD (home food environment, parental food literacy, youth dietary intake and food purchasing patterns) using validated surveys, dietary recalls and food receipt methodology.Results: The pediatric GF plate model was developed based on diet simulations that met 100% of macronutrient and micronutrient needs for age-sex with the exception of vitamin D. The GF plate model recommends intake of >50% fruits and vegetables (F&V), 25% protein foods and 35% dietary intake) were consumed taking up >1/3 of the plate.Conclusions: A GF food guide for children and youth was positively perceived by stakeholders and addresses an important gap in literature. Ongoing work will focus on guideline uptake in children/youth with CD on the GFD. Advocacy efforts for public health policies related to healthy and affordable food environments for diverse children and youth with CD and their families are equally warranted.

• Subjects / Keywords

  • Celiac Disease
  • Gluten Free
  • Food Guide
  • Pediatric

• Graduation date

  Fall 2021

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/r3-bpg6-gq92

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.