Parental influence on eating behavior in children with celiac disease: a multicenter cross-sectional study

Background. This study examined parental feeding practices and parental perceptions of children’s consumption of “unhealthy” foods under a gluten-free diet (GFD) in celiac disease, as well as approaches to parent–child interaction in the context of reduced quality of life. Materials and Methods. The study was based on a questionnaire survey of parents of children and adolescents with confirmed celiac disease. To ensure reproducibility, the full set of questionnaire items was provided and subscales were constructed to assess parental feeding practices and child behavior, including unhealthy food consumption, emotional feeding, perceived necessity of dietary control, weight-related dietary restriction, encouragement of dietary variety, pressure to eat, child involvement in family meals, and home availability of sweets and snacks. Results. Parental feeding practices demonstrated a multidimensional structure represented by several independent domains. Unhealthy food consumption was common: 78% of parents reported at least partial overconsumption of sweets. Despite strict dietary restrictions, unhealthy snacking remained prevalent. Four distinct parental practice profiles were identified: emotionally controlling, moderately supportive, passive, and weight-restrictive. The perceived necessity of dietary control showed a robust inverse association with unhealthy food consumption, reducing its likelihood by approximately threefold. Conclusion. In children with celiac disease, dietary control represents an adaptive and protective strategy when embedded in everyday family life and implemented through involvement and respect for the child’s autonomy rather than through pressure or punitive measures.