{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T10:32:13Z","timestamp":1761129133790},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,12,30]],"date-time":"2013-12-30T00:00:00Z","timestamp":1388361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Humanities and Social Science Seed Grant from the University of British Columbia"},{"name":"Canadian Institutes of Health Research awarded to AJD"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Human Nutrition Diet"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Currently, the only treatment for coeliac disease is lifelong adherence to a strict gluten\u2010free diet. Strict adherence to a gluten\u2010free diet is challenging, with recent reports suggesting that adherence rates range from 42% to 91%. The present study aimed to: (i) identify motives for adhering to a gluten\u2010free diet and (ii) explore factors implicated in adherence and non\u2010adherence behaviour in terms of accidental and purposeful gluten consumption among adults with coeliac disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two hundred and three adults with coeliac disease completed an online questionnaire. Using a qualitative design, relationships were examined between reported adherence and motivation to follow a gluten\u2010free diet, as well as the onset, duration and severity of symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Feelings of desperation (\u2018hitting rock bottom\u2019) and needing to gain or lose weight were associated with the strictest adherence to a gluten\u2010free diet. Participants who accidentally consumed gluten over the past week developed symptoms the most quickly and reported the most pain over the past 6\u00a0months. Participants who consumed gluten on purpose over the past week reported a shorter duration of symptoms and less pain over the past 6\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hitting rock bottom and needing to gain or lose weight were factors associated with the strictest adherence, when considered in the context of both accidental and purposeful gluten consumption. Future research is warranted to develop resources to help people with coeliac disease follow a strict gluten\u2010free diet.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jhn.12203","type":"journal-article","created":{"date-parts":[[2013,12,31]],"date-time":"2013-12-31T05:05:12Z","timestamp":1388466312000},"page":"542-549","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Motives for adherence to a gluten\u2010free diet: a qualitative investigation involving adults with coeliac disease"],"prefix":"10.1111","volume":"27","author":[{"given":"A. J.","family":"Dowd","sequence":"first","affiliation":[{"name":"School of Kinesiology The University of British Columbia Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. A.","family":"Tamminen","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology and Physical Education The University of Toronto Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. E.","family":"Jung","sequence":"additional","affiliation":[{"name":"School of Health and Exercise Sciences The University of British Columbia at Okanagan Kelowna BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Case","sequence":"additional","affiliation":[{"name":"Registered Dietitian Professional Advisory Board Member Canadian Celiac Association Regina SK Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"McEwan","sequence":"additional","affiliation":[{"name":"School of Kinesiology The University of British Columbia Vancouver BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. 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