SAN DIEGO — A series of cooking courses helped patients with celiac disease improve adherence to a gluten-free diet and their quality of life, according to data from a pilot study presented at Digestive Disease Week.
Randi L. Wolf, PhD, MPH, of Health and Behavior Studies at Columbia University, said that previous studies have linked diminished quality of life to the struggles of maintaining a gluten-free diet, particularly when patients go out to eat.
“In our study of 80 teenagers and adults with celiac disease, more than half mentioned cooking at home as a facilitator to eating a strict gluten-free diet,” she said in her presentation. “Cooking made gluten-free easier, provided a better sense of hidden sources of gluten and reduced worry about the safety of meals at restaurants.”
Researchers developed a cooking-based education intervention designed to promote cooking at home with naturally gluten-free grains, like millet and quinoa. Investigators also wanted to enhance patient motivation and help them act on that motivation.
The course consisted of two 4.5-hour classes that implemented social cognitive theory and social determination theory to increase adherence to a gluten-free diet, reduce symptoms and promote social and emotional well-being.
Researchers used validated measures of celiac disease-specific quality of life (CDQOL), symptoms (CDSD), diet adherence (CDAT), depression (CES-D) and anxiety (STAI) to evaluate the 12 patients included in the study at baseline and at one month of follow-up. They also collected information on patient experiences in the program.
One month after the intervention, Wolf and colleagues observed that patients had significantly improve CDAT scores (mean [standard deviation], 10.7 [2.6] vs. 12.8 [2.9]), total CDQOL (74.9  vs. 64.8 [17.3]) and CESD depression scores (7.2  vs. 11.6 [8.3]).
Patients had positive changes in their perception of risk for a low-quality diet, positive outcome expectation of cooking and self-efficiency, as well as improved perception of social support and knowledge about gluten-free grains.
Participants agreed that the intervention helped them eat healthier and introduced them to foods they otherwise might not have tried. Every patient reported that they would recommend the intervention to others.
Wolf said that while this was an early study, their findings show that a theory-based, behaviorally focused cooking intervention could be useful in patients with celiac disease.
“We believe further studies should continue to consider behavior-change theories to try to better understand modifiable determinants related to adherence and quality of life,” she said. “We should also look at the effects of cooking-based education interventions on long-term diet adherence and quality of life, as well as long-term measures of mucosal healing and the development of other autoimmune diseases.” – by Alex Young
Wolf R, et al. Abstract 597. Presented at: Digestive Disease Week; May 18-21, 2019; San Diego.
Disclosures: Wolf reports no relevant financial disclosures. Please see the meeting disclosure index for all other authors’ relevant financial disclosures.