{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:15:39Z","timestamp":1792059339031,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Celiac disease (CeD) requires lifelong adherence to a gluten\u2010free (GF) diet (GFD), though GF foods are more expensive. This study aimed to: (1) evaluate concordance between GF and general food insecurity (FI) among households with a child with CeD, (2) assess demographic and social factors associated with GF FI, and (3) investigate the impact of GF FI on tissue transglutaminase immunoglobulin A (TTG IgA) decline and GFD adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single\u2010center cohort study included CeD patients less than 18 years old. A de novo survey assessing GF FI, general FI, GFD adherence, social determinants of health, and sociodemographic information was distributed electronically to all CeD patients seen over a 6\u2010year period. Additional clinical information was obtained from the electronic health record for respondents. Time to normalization of TTG IgA was assessed using Kaplan\u2013Meier curves, log\u2010rank tests, and Cox regression models. Independent associations between GF FI and GFD adherence were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1039 CeD patients from 994 unique households received surveys with a 34.8% response rate. More respondents reported GF FI (26%) than general FI (20%). GF food insecure respondents took significantly longer to achieve TTG IgA normalization (hazard ratio\u2009=\u20090.63, 95% confidence interval 0.44\u20130.9) than their food secure peers. Furthermore, GF FI was significantly associated with worse GFD adherence and gluten consumption due to transportation barriers, cost, and lack of GF food accessibility (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>GF FI should be considered in the routine care of pediatric CeD given its prevalence and impact on TTG IgA normalization and GFD adherence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpn3.70235","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T11:09:57Z","timestamp":1760699397000},"page":"108-117","source":"Crossref","is-referenced-by-count":5,"title":["The prevalence and impact of gluten\u2010free food insecurity in pediatric celiac disease"],"prefix":"10.1002","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3938-6003","authenticated-orcid":false,"given":"Andrew","family":"Krueger","sequence":"first","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashmi D.","family":"Sahay","sequence":"additional","affiliation":[{"name":"Division of Biostatistics &amp; Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emrah","family":"Gecili","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Cincinnati Children's Hospital Medical Center, Division of Biostatistics &amp; Epidemiology, University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne W.","family":"Henize","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Cincinnati Children's Hospital Medical Center, Division of General and Community Pediatrics, University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew F.","family":"Beck","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Cincinnati Children's Hospital Medical Center, Divisions of General and Community Pediatrics and Hospital Medicine, University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Cincinnati Children's Hospital Medical Center, Divisions of General and Community Pediatrics and Hospital Medicine, University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4126-9191","authenticated-orcid":false,"given":"Daniel","family":"Mallon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology and Nutrition, University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","unstructured":"JonesJW ToossiS.The Food and Nutrition Assistance Landscape: Fiscal Year 2023 Annual Report. 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