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      Food Neophobia in Celiac Disease and Other Gluten-Free Diet Individuals

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          Abstract

          The only treatment currently available to combat celiac disease (CD) is strict adherence to a gluten-free diet (GFD), but there may be various determinants of its adherence, including food neophobia (FN), that is associated with sensory aversions, or fears of negative consequences of eating specific food products, that may be crucial for CD patients following a GFD. The aim of the present study was to analyze food neophobia levels and its determinants in CD patients in comparison with other individuals who follow a GFD based on their own decision. The study was conducted in two independent groups of individuals following a GFD: those diagnosed with CD ( n = 101) and those following a GFD based on their own decision ( n = 124). Each group was recruited with cooperation from the local CD and GFD societies located in Poland. The FN was assessed using the Food Neophobia Scale (FNS) and compared between groups, as well as the influence of gender, age, body mass index, educational level, place of residence and employment status was assessed. It was stated, that for the individuals following a GFD, CD was the major determinant of FN. The FNS score values were higher (indicating higher food neophobia) for CD individuals (39.4 ± 9.2), than for those following a GFD based on their own decision (33.6 ± 8.7; p < 0.0001) and it was observed both for general group and for sub-groups stratified by assessed variables. Moreover, the indicated variables did not influence the FNS in any of the analyzed groups. The influence of CD with no influence of other variables was confirmed in the regression analysis. It may be concluded that CD is a major contributor to FN, which can be attributed to fear of developing adverse reactions to gluten-contaminated food products, which is more pronounced in CD patients compared to non-CD patients following a GFD based on their own decision.

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          Changing children's eating behaviour - A review of experimental research.

          The interest in children's eating behaviours and how to change them has been growing in recent years. This review examines the following questions: What strategies have been used to change children's eating behaviours? Have their effects been experimentally demonstrated? And, are the effects transient or enduring? Medline and Cab abstract (Ovid) and Web of Science (Thomson Reuters) were used to identify the experimental studies. A total of 120 experimental studies were identified and they are presented grouped within these 11 topics; parental control, reward, social facilitation, cooking programs, school gardens, sensory education, availability and accessibility, choice architecture and nudging, branding and food packaging, preparation and serving style, and offering a choice. In conclusion, controlling strategies for changing children's eating behaviour in a positive direction appear to be counterproductive. Hands-on approaches such as gardening and cooking programs may encourage greater vegetable consumption and may have a larger effect compared to nutrition education. Providing children with free, accessible fruits and vegetables have been experimentally shown to positively affect long-term eating behaviour. The authors recommend future research to examine how taste and palatability can positively affect children's attitudes and eating behaviour.
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            Celiac disease: From pathophysiology to treatment

            Celiac disease, also known as “celiac sprue”, is a chronic inflammatory disorder of the small intestine, produced by the ingestion of dietary gluten products in susceptible people. It is a multifactorial disease, including genetic and environmental factors. Environmental trigger is represented by gluten while the genetic predisposition has been identified in the major histocompatibility complex region. Celiac disease is not a rare disorder like previously thought, with a global prevalence around 1%. The reason of its under-recognition is mainly referable to the fact that about half of affected people do not have the classic gastrointestinal symptoms, but they present nonspecific manifestations of nutritional deficiency or have no symptoms at all. Here we review the most recent data concerning epidemiology, pathogenesis, clinical presentation, available diagnostic tests and therapeutic management of celiac disease.
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              Effect of a gluten-free diet on gastrointestinal symptoms in celiac disease.

              Atypical presentations of celiac disease appear to be at least as common as is the classic presentation of steatorrhea, diarrhea, and weight loss. We examined the effect of a gluten-free diet on gastrointestinal symptoms in a cohort of US patients with celiac disease. A follow-up survey was conducted in 215 patients who were evaluated at the University of Iowa from 1990 through 1997 as having biopsy-confirmed celiac disease. The systematic survey asked detailed questions regarding gastrointestinal symptoms before and after the institution of a gluten-free diet in the patients, all of whom had been given the same dietary advice. The group consisted of 160 female and 55 male patients. Although diarrhea was the most frequent symptom in untreated celiac disease, steatorrhea occurred in only one-fifth of patients. Other complaints were common, and most responded to gluten exclusion. The benefit of gluten exclusion was equally apparent in men and women. Diarrhea responded in most patients, usually within days, and the mean time to resolution was 4 wk. Many patients had alternating diarrhea and constipation, both of which were responsive to the gluten-free diet. Most patients had abdominal pain and bloating, which resolved with the diet. Celiac disease causes a wide range of gastrointestinal symptoms. Clinicians must have a high level of suspicion to detect the atypical forms of celiac disease. With a gluten-free diet, patients have substantial and rapid improvement of symptoms, including symptoms other than the typical ones of diarrhea, steatorrhea, and weight loss.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                31 July 2019
                August 2019
                : 11
                : 8
                : 1762
                Affiliations
                [1 ]Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW–WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland
                [2 ]Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW–WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland
                Author notes
                [* ]Correspondence: dominika_guzek@ 123456sggw.pl ; Tel.: +48-22-593-71-34
                Author information
                https://orcid.org/0000-0001-8588-7357
                https://orcid.org/0000-0002-0784-3604
                Article
                nutrients-11-01762
                10.3390/nu11081762
                6722680
                31370243
                fe3dd76d-70b2-40a4-8c72-9dec802ea7e4
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 26 June 2019
                : 29 July 2019
                Categories
                Article

                Nutrition & Dietetics
                food neophobia scale (fns),celiac disease,gluten-free diet,adults,eating behaviors,consumer behaviors

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