COVID-19 Anxiety and Health-Related Factors Associated with Gluten-Free Diet Adherence in Celiac Disease Patients

Abstract

Objective: Celiac disease (CD) is a chronic autoimmune disorder requiring lifelong adherence to a gluten-free diet (GFD). The COVID-19 pandemic has significantly impacted the lifestyle, psychological well-being, and dietary management of individuals with chronic illnesses, including CD. This study aimed to examine the relationship between COVID-19-related anxiety and adherence to a GFD among adults with CD, and to evaluate changes in dietary behaviors, access to gluten-free products, and professional dietary support during the pandemic. Material and Methods: A cross-sectional study was conducted among adults with physician-diagnosed celiac disease in Türkiye. Participants completed an online questionnaire assessing demographic characteristics, CD-related symptoms, comorbidities, GFD adherence, dietitian consultation, and COVID-19-related anxiety. Results: A significant association was found between COVID-19-related anxiety and greater adherence to a GFD (p=0.020), as well as with specific symptoms such as diarrhea (p=0.032), and comorbidities like thyroid disease (p=0.034) and bone-joint disease (p=0.019). Despite 54% of participants never having received dietitian counseling, and only 15% continuing dietary support during the pandemic, 56.5% reported GFD adherence. Major barriers included product inaccessibility and cost. Although probiotic/supplement use increased slightly, no significant changes in meal frequency, preparation habits, or physical activity were observed. Conclusion: COVID-19-related anxiety appears to have motivated stronger dietary adherence among individuals with celiac disease. However, limited access to professional support and gluten-free foods highlights the need for improved healthcare access and dietary resources during public health crises.

Keywords

• Celiac disease
• covid-19 anxiety
• gluten-free diet

Çölyak Hastalığında Glutensiz Diyete Bağlılıkla İlişkili COVID-19 Anksiyetesi ve Sağlıkla İlgili Faktörler

Abstract

Amaç: Çölyak hastalığı (ÇH), glutensiz diyete (GD) ömür boyu bağlılık gerektiren kronik bir otoimmün hastalıktır. COVID-19 salgını, ÇH dahil kronik hastalıkları olan bireylerin yaşam tarzını, psikolojik refahını ve diyet yönetimini önemli ölçüde etkilemiştir. Bu çalışmanın amacı, ÇH'li yetişkinler arasında COVID-19 ile ilişkili anksiyete ve GD'ye bağlılık arasındaki ilişkiyi incelemek ve pandemi sırasında diyet davranışlarındaki değişiklikleri, glutensiz ürünlere erişimi ve profesyonel diyet desteğini değerlendirmektir. Gereç ve Yöntem: Türkiye'de doktor tanılı çölyak hastalığı olan yetişkinler arasında kesitsel bir çalışma gerçekleştirilmiştir. Katılımcılar demografik özellikleri, ÇH ile ilişkili semptomları, komorbiditeleri, GFD bağlılığını, diyetisyen konsültasyonunu ve COVID-19 ile ilişkili anksiyeteyi değerlendiren çevrimiçi bir anket formu uygulanmıştır. Bulgular: COVID-19 ile ilişkili anksiyete ile GD'ye daha fazla bağlılık (p=0,020) arasında ve ayrıca diyare (p=0,032) gibi spesifik semptomlar ve tiroid hastalığı (p=0,034) ve kemik-eklem hastalığı (p=0,019) gibi komorbiditeler arasında anlamlı bir ilişki bulunmuştur. Katılımcıların %54'ünün hiç diyetisyen danışmanlığı almamış olmasına ve yalnızca %15'inin pandemi sırasında diyet desteğine devam etmesine rağmen, %56,5'i GD'ye uyduğunu bildirmiştir. Başlıca engeller arasında ürünlere erişilememesi ve maliyet yer almaktadır. Probiyotik/takviye kullanımı hafifçe artmış olsa da öğün sıklığı, hazırlama alışkanlıkları veya fiziksel aktivitede önemli bir değişiklik gözlenmemiştir. Sonuç: COVID-19 ile ilgili kaygı, çölyak hastalığı olan bireyler arasında diyete daha güçlü bağlılığı motive etmiş gibi görünmektedir. Bununla birlikte, profesyonel desteğe ve glutensiz besinlere sınırlı erişim, halk sağlığı krizleri sırasında sağlık hizmetlerine erişimin ve diyet kaynaklarının iyileştirilmesi ihtiyacını vurgulamaktadır.

Keywords

• çölyak hastalığı
• Covıd-19 anksiyetesi
• glutensiz diyet

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