Jump to content
This site uses cookies. Continued use is acceptance of our Terms of Use and Privacy Policy. More Info... ×
  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.




  • Celiac.com Sponsor (A1):



    Celiac.com Sponsor (A1-M):


  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate
  • Jefferson Adams
    Jefferson Adams

    Being Too Vigilant About Gluten-Free Diet Causes Stress in Teens and Adults with Celiac Disease

    Reviewed and edited by a celiac disease expert.

    Is being too vigilant about gluten-free diet causing stress in teens and adults with celiac disease?

    Being Too Vigilant About Gluten-Free Diet Causes Stress in Teens and Adults with Celiac Disease - Photo: Mike George
    Caption: Photo: Mike George

    Celiac.com 02/19/2018 - It's very important that people with celiac disease maintain a gluten-free diet. Still, there has been some data to suggest that some people with celiac disease may be "hyper vigilant" in their approach to a gluten-free diet, and that such extreme vigilance can cause them stress and reduce their overall quality of life. Can a more relaxed approach improve quality of life for some people with the disease?

    A team of researchers recently set out to determine whether "extreme vigilance" to a strict gluten-free diet may increase symptoms such as anxiety and fatigue, and therefore, lower quality of life (QOL). The research team included Randi L. Wolf, Benjamin Lebwohl, Anne R. Lee, Patricia Zybert, Norelle R. Reilly, Jennifer Cadenhead, Chelsea Amengual, and Peter H. R. Green. They are variously affiliated with the Department of Health and Behavior Studies, Program in Nutrition, Teachers College Columbia University New York USA, the Department of Medicine, Celiac Disease Center Columbia University Medical Center, Harkness Pavilion New York, USA.

    Celiac.com Sponsor (A12):
    The team assessed the influence of QOL with energy levels and adherence to, and knowledge about, a gluten-free diet. For their cross-sectional prospective study, the team looked at 80 teenagers and adults, all with biopsy-confirmed celiac disease, living in a major metropolitan area. They assessed QOL using celiac disease-specific metrics. The team based dietary vigilance on 24-hour recalls and an interview. They based knowledge on a food label quiz. They used open-ended questions to describe facilitators and barriers to following a gluten-free diet.

    Overall, extremely vigilant adults had greater knowledge, but significantly lower QOL scores than their more relaxed counterparts. Both teens and adults who reported lower energy levels had much lower overall QOL scores than those with higher energy levels.

    To maintain a strict gluten-free diet, hyper-vigilant celiacs were more likely to avoid eating out, to cook at home, and to use internet sites and apps. For hyper vigilant eaters, eating out was especially challenging. Being hyper-vigilant about maintaining a strict gluten-free diet can cause stress and adverse effects in both teens and adults with celiac disease.

    Doctors may want to look toward balancing advocacy of a gluten-free diet with promoting social and emotional well-being for celiac patients. In some cases, allowing a more relaxed approach may increase well-being and, thus, make dietary adherence easier. Obviously, people would need to tailor any relaxation in their gluten-free vigilance to make sure they weren't suffering preventable symptoms or doing themselves any harm.

    Source:



    User Feedback

    Recommended Comments



    Guest Kay

    I don't care how many letters these "researchers" have by their names. This is idiocy! As one with celiac disease who chooses to be vigilant to keep gluten out of my diet, I do suffer from stress about it. Who wouldn't? I do cook at home most of the time, because it's just easier on me to know what I'm eating and how and where it was cooked. I do rely on internet and apps when going out, in addition to talking to the staff at restaurants. What's the alternative? Less stress is a lie. Eat the gluten, even in small quantities, and I'm stressed with brain fog, sleepiness, and discomfort in my gut - not to mention the gastritis it triggers, which then adds a couple more weeks of stress. A friend (celiac disease, as well) isn't vigilant and suffers the stress of the symptoms and the stress of guilt for not being vigilant and disciplined. This study is a total waste of time and money.

    Link to comment
    Share on other sites
    Guest Diane

    Some anxious celiacs have no choice but to be hyper-vigilant for their disease, lest they wind up in the emergency room. Others may be prone to clinical anxiety already. Either way, there are ways to mitigate the anxiety - ask your doctor for help. Mindfulness has worked for me.

    Link to comment
    Share on other sites
    Guest Benjamin

    Posted

    Couldn't it also that those that are "hyper vigilant" are more sensitive? I started out really lax, but my health only marginally improved. The stricter I got, the more my health improved (still not even close to before I became symptomatic and diagnosed celiac). Yes, it is stressful eating out when I get sick from simple cross contamination. I'm jealous of those who can just check ingredients without worrying about cross contamination and I have no doubt they have a better QOL. However, whenever I try being more lax about cross contamination I get sick and I have an even worse QOL. I disagree with the conclusion reached by this article. A better conclusion would be "those that are more sensitive to gluten have a lower QOL."

    Link to comment
    Share on other sites
    Guest Fred

    Of course being vigilant causes stress to everyone around. The alternative of being sick for months after getting glutened is far worse. Anyone who doesn't get that should not be writing an article to just be chill about it and deal with the consequences. Vigilance is not optional!

    Link to comment
    Share on other sites
    Guest Concerned

    Posted

    This kind of study will not help people with celiac disease to be taken seriously. How can people NOT be hyper-vigilant when someone's carelessness can poison you with a crumb of gluten and render you deathly ill for a week or weeks? Even people who do not experience painful symptoms would endanger their health by being more "relaxed."

    Link to comment
    Share on other sites
    Guest Jeanne

    I saw this research written about somewhere else recently, too. It bugged me then and it bugs me now. What's "hyper" vigilant? I'm going to be careful about my diet, and that means no gluten ever. I'll be stressed if I have gluten, too, because then I'll be sick for about a week, with that followed by another week of deep fatigue. I'm very careful about what I eat because it's THE ONLY CURE for my disease. I hope I don't see this research on yet another celiac blog site.

    Link to comment
    Share on other sites
    Guest Scott Adams

    Posted

    Of course being vigilant causes stress to everyone around. The alternative of being sick for months after getting glutened is far worse. Anyone who doesn't get that should not be writing an article to just be chill about it and deal with the consequences. Vigilance is not optional!

    We are simply reporting on the study that was published.

    Link to comment
    Share on other sites
    Guest Jamie E Pomana

    Posted

    I don't care how many letters these "researchers" have by their names. This is idiocy! As one with celiac disease who chooses to be vigilant to keep gluten out of my diet, I do suffer from stress about it. Who wouldn't? I do cook at home most of the time, because it's just easier on me to know what I'm eating and how and where it was cooked. I do rely on internet and apps when going out, in addition to talking to the staff at restaurants. What's the alternative? Less stress is a lie. Eat the gluten, even in small quantities, and I'm stressed with brain fog, sleepiness, and discomfort in my gut - not to mention the gastritis it triggers, which then adds a couple more weeks of stress. A friend (celiac disease, as well) isn't vigilant and suffers the stress of the symptoms and the stress of guilt for not being vigilant and disciplined. This study is a total waste of time and money.

    I couldn't agree more. Options are be hyper vigilant or be seriously ill. I wold think that is a no brainer. Celiac is stressful, it just is. This study is absolutely useless.

    Link to comment
    Share on other sites
    Guest Ann
    I don't care how many letters these "researchers" have by their names. This is idiocy! As one with celiac disease who chooses to be vigilant to keep gluten out of my diet, I do suffer from stress about it. Who wouldn't? I do cook at home most of the time, because it's just easier on me to know what I'm eating and how and where it was cooked. I do rely on internet and apps when going out, in addition to talking to the staff at restaurants. What's the alternative? Less stress is a lie. Eat the gluten, even in small quantities, and I'm stressed with brain fog, sleepiness, and discomfort in my gut - not to mention the gastritis it triggers, which then adds a couple more weeks of stress. A friend (celiac disease, as well) isn't vigilant and suffers the stress of the symptoms and the stress of guilt for not being vigilant and disciplined. This study is a total waste of time and money.

    I am with you, as a hypersensitive celiac, there are no days without worry or stress from cross-contamination...the illness far outweighs the stress. This is our life...we do what we must do to stay well and functioning. If those individuals walked a mile in our bowels...good luck coming up with criticism of vigilance! PS Be well, cheering for you!

    Link to comment
    Share on other sites
    Guest Ann
    Couldn't it also that those that are "hyper vigilant" are more sensitive? I started out really lax, but my health only marginally improved. The stricter I got, the more my health improved (still not even close to before I became symptomatic and diagnosed celiac). Yes, it is stressful eating out when I get sick from simple cross contamination. I'm jealous of those who can just check ingredients without worrying about cross contamination and I have no doubt they have a better QOL. However, whenever I try being more lax about cross contamination I get sick and I have an even worse QOL. I disagree with the conclusion reached by this article. A better conclusion would be "those that are more sensitive to gluten have a lower QOL."

    Well said!

    Link to comment
    Share on other sites
    Guest Ruza

    I agree with everything the previous commenters have said. This article makes me almost as furious as the gluten hulk that comes out when I've been glutened. People with celiac have to avoid gluten. Period. To suggest that there is “hyper- vigilance†when discussing a disease that compromises our immune systems with a crumbs worth of gluten is dangerous and irresponsible. I saw that the author commented saying that they were just sharing the study's findings. But sharing these type of findings only furthers the ignorance that has celiacs treated like we're hypochondriacs and fabricators. This is the stuff that tells wait staff that their eye rolling is appropriate and they don't have to be careful with our food. This is the stuff that tells ignorant family members, friends, coworkers, etc., that we really should just take the croutons off or take the burger off the bun. Yes, of course, we have more stress than people who can eat whatever they want whenever they want. That doesn't mean we should compromise our health and be less careful. It means we need to take extra care to find ways of taking care of our bodies and our minds. Meditation is a great way. How about you suggest some ways to be more mindful and present in response to the acknowledgment of the increase in stress that being a celiac and actually following protocol for this disease means?

    Link to comment
    Share on other sites
    Guest Dina

    If anyone has been in some of these Facebook groups for celiacs one would see that many many peoples quality of life is in fact very negatively impacted, in many cases by fear and frustration. Do we need to be "vigilant"? Yes. Am I going to lock myself up and never enjoy anything anywhere ever again? No. I joined the groups for support and for some additional education and left because it was all fear and panic and hyper vigilance to the point of misery. So when this article alludes to maybe not being as vigilant as we are it doesn't mean "Sure! Eat that bread! A little won't hurt!" .... what I take it to mean is if everyone else is having bread,cake, etc I need to enjoy myself with them anyway. If my family wants to meet in a bakery, I eat first and enjoy the COMPANY and not the fact that I "can't".... and believe me I KNOW the fatigue and the brain fog all too well. But is loneliness and longing and fear really any better?

    Link to comment
    Share on other sites



    Create an account or sign in to comment

    You need to be a member in order to leave a comment

    Create an account

    Sign up for a new account in our community. It's easy!

    Register a new account

    Sign in

    Already have an account? Sign in here.

    Sign In Now

  • Get Celiac.com Updates:
    Support Celiac.com:
    Donate
  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University. His articles, essays, poems, stories and book reviews have appeared in numerous magazines, journals, and websites, including North American Project, Antioch Review, Caliban, Mississippi Review, Slate, and more. He is the author of more than 2,500 articles on celiac disease. His university coursework includes studies in science, scientific methodology, biology, anatomy, physiology, medicine, logic, and advanced research. He previously devised health and medical content for Colgate, Dove, Pfizer, Sharecare, Walgreens, and more. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of numerous books, including "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

    >VIEW ALL ARTICLES BY JEFFERSON ADAMS

     


  • Celiac.com Sponsor (A17):
    Celiac.com Sponsor (A17):





    Celiac.com Sponsors (A17-M):




  • Related Articles

    Joanne Bradley
    Celiac.com 06/13/2008 - Students embarking on the college path often ride a roller coaster between sheer unadulterated excitement and deep-in-the-stomach dread of meeting new people and challenges. For the gluten free college student, a whole world of eating choices will await them in all sorts of different social situations. It is a new cornucopia of responsible choice.
    Perhaps the first challenge will be establishing a relationship with the people who manage the food services on campus. Although public understanding of Celiac disease and gluten intolerance are on the fast track, the level of training for gluten free food service is still on the slow track. A thorough understanding on the part of food management usually comes through one or more managers having a relative with the condition...


    Kim Hopkins
    Celiac.com 06/24/2009 - If you are like the majority of people diagnosed with celiac disease, it probably took you many years of experiencing debilitating symptoms, talking to multiple doctors who gave you varied theories and diagnoses, thinking that you would never feel better…before you finally got it figured out.  Whether you had a positive experience with your health care professionals or not, hearing the diagnosis can lead to feeling lost and unsure of what to do next.  It can be quite overwhelming.  After all, food plays an important part in our culture – it’s how we share special moments together, celebrate, and nurture one another.  A big sense of loss can overcome someone when they hear that they can no longer eat wheat, barley, rye, and contaminated oats.  Some people say they g...


    Jefferson Adams
    Adult Celiac Disease: Psychosocial Factors Affect Patient Symptoms and Health More Than Disease Itself
    Celiac.com 09/15/2010 - Until the present study, no clinical research had been published regarding the relative effects of clinical and psychosocial variables on outcome in celiac disease.
    A team of researchers examined psychosocial factors that may influence disease activity in celiac patients, such as relationships among demographics, psychosocial factors, and disease activity with health-related quality of life (HRQOL), health care utilization, and symptoms.
    The research team included Spencer D. Dorn, Lincoln Hernandez, Maria T. Minaya, Carolyn B. Morris, Yuming Hu, Suzanne Lewis, Jane Leserman, Shrikant I. Bangdiwala, Peter H. R. Green and Douglas A. Drossman of the Center for Functional GI and Motility Disorders at the University of North Carolina, Chapel Hill, USA.
    The...


    Jefferson Adams
    Can Researchers Measure the Factors the Make for a Successful Gluten-free Diet?
    Celiac.com 12/02/2015 - A strict gluten-free diet remains the only effective treatment for celiac disease, but studies of gluten-free diet adherence have rarely used precise means of measuring data, which means that there really hasn't been much good data on long-term adherence to the gluten-free diet in the adult population.
    So, what are the factors that keep people on a gluten-free diet? This question has been on the minds of numerous celiac disease researchers.
    To determine the long-term adherence to the gluten-free diet and potential associated factors, a research team recently conducted a survey of adult celiac patients in a large celiac disease referral center population. The research team included J. Villafuerte-Galvez; R. R. Vanga; M. Dennis; J. Hansen; D. A. Leffler; C. P...


  • Recent Activity

    1. - PixieSticks replied to PixieSticks's topic in Super Sensitive People
      2

      Working in a kitchen with gluten?

    2. - BoiseNic replied to BoiseNic's topic in Dermatitis Herpetiformis
      11

      Skinesa

    3. - knitty kitty replied to Whyz's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      6

      Feeling ill

    4. - Scott Adams replied to Brianne03's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      5

      Advantages vs. Disadvantages of having an official Celiac diagnosis

    5. - Scott Adams replied to Whyz's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      6

      Feeling ill


  • Celiac.com Sponsor (A19):



  • Member Statistics

    • Total Members
      126,526
    • Most Online (within 30 mins)
      7,748

    Cher12
    Newest Member
    Cher12
    Joined

  • Celiac.com Sponsor (A20):


  • Forum Statistics

    • Total Topics
      120.9k
    • Total Posts
      69.5k

  • Celiac.com Sponsor (A22):




  • Who's Online (See full list)


  • Celiac.com Sponsor (A21):



  • Popular Now

    • Whyz
      6
    • Art Maltman
      6
    • JA917
      13
    • Dana Gilcrease
      5
    • marion wheaton
      6
  • Popular Articles

    • Scott Adams
    • Scott Adams
    • Scott Adams
    • Scott Adams
    • Scott Adams
  • Upcoming Events

×
×
  • Create New...