Other special diets in addition to gluten-free diet are common among youth with celiac disease, but are not associated with overall well-being or treatment success

BackgroundVarious special diets have become increasingly common. However, their prevalence and significance in patients with celiac disease (CeD) who already adhere to a gluten-free diet (GFD) are unclear.AimWe studied the abovementioned aspects in youth with CeD and controls.Methods210 patients and 212 controls, all adolescents and young adults with comparable age 16-30 years, completed an anonymous survey. Variables were compared between CeD patients with and without additional dietary restriction.ResultsOverall, 53% of CeD patients and 81% of controls were students and 41% vs. 18% working. One-third of patients and controls reported adhering to special diets, particularly a vegetarian/vegan diet (9%/14%), an allergy diet (8%/7%), and a diet for irritable bowel syndrome (7%/8%). Patients with and without an additional diet besides a GFD were comparable in terms of sex, current age, age at diagnosis, body mass index, student/employment status, physical activity, and consumption of alcohol and tobacco. However, those following only a GFD reported fewer gastrointestinal symptoms at diagnosis (58% vs. 75%, p = 0.021) and fewer challenges with school and workplace meals (27% vs. 39%, p = 0.020) than those with another restrictive diet. Altogether 11% reported difficulties combining GFD and other diet, but there were no differences in adherence (91% vs. 93%, p = 0.705), persistent symptoms, health concerns, or well-being.ConclusionOne-third of CeD patients followed additional special diets, similar to the controls. While additional restrictions may not necessarily compromise well-being or treatment success, including GFD adherence and symptom resolution, they posed challenges that underline the need to consider them in CeD management.