{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:42:35Z","timestamp":1793040155446,"version":"4.5.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Tampere University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>Nationwide prevalence studies on people avoiding gluten without celiac disease (PWAG) are lacking, and in particular, long-term follow-up studies are unavailable. We aimed to evaluate the prevalence, incidence, and characteristics of PWAG in a population-based cohort in 2000 and 2011.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Health and diet-related data were collected in nationwide Health 2000 and 2011 surveys, which comprised 5,777 and 3,866 individuals, respectively, representing 2,682,733 and 1,967,876 Finnish adults. Serum samples were taken for the measurement of transglutaminase autoantibodies. In total 3,296 individuals participated in both surveys, forming a prospective cohort. PWAG refers to subjects avoiding gluten without celiac disease or positive autoantibodies. Psychological health was assessed with General Health Questionnaire and the Beck Depression Inventory.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The prevalence of PWAG increased significantly from 0.2% (2000) to 0.7% (2011) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), with the highest prevalence (1.3%) detected in individuals\u2009&gt;\u200970 years old. An annual incidence rate of 42 (95% confidence interval 25\u201371) per 100,000 persons was noted. The PWAG group was more likely to maintain additional special diets than those not avoiding gluten, including e.g. lactose-free diet (41.7% vs. 12.0% in 2011, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and food restriction for allergy (12.5% vs. 3.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.007). Beck Depression Inventory indicated more depression (<jats:italic>p<\/jats:italic>\u2009=\u20090.023) among PWAG in 2000, while no difference was seen in 2011 or in General Health Questionnaire. Celiac disease-related risk factors, including female gender, anemia, autoimmune diseases or antibody levels near the upper limit of normal in 2000, did not predict later gluten avoidance.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The prevalence of PWAG multiplied over a decade, reaching 0.7% in 2011 in Finland. The PWAG group maintained more likely additional dietary restrictions than those not avoiding gluten and had signs of psychosocial burden. No predicting factors for the condition were identified.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12876-025-03799-x","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T01:40:16Z","timestamp":1742953216000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prevalence and characteristics of adults avoiding gluten without celiac disease: a long-term population-based follow-up study"],"prefix":"10.1186","volume":"25","author":[{"given":"Miska","family":"Tiainen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalle","family":"Kurppa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuija","family":"J\u00e4\u00e4skel\u00e4inen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niina","family":"Kaartinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heini","family":"Huhtala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katri","family":"Kaukinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juha","family":"Taavela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"key":"3799_CR1","doi-asserted-by":"crossref","first-page":"4966","DOI":"10.3390\/nu7064966","volume":"7","author":"C Catassi","year":"2015","unstructured":"Catassi C, Elli L, Bonaz B, et al. 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The Health 2000 survey was approved by the Ethics Committee for Research in Epidemiology and Public Health in May 2000, while the Health 2011 survey received approval from the Coordinating Ethics Committee in March 2011, which were part of the Hospital District of Helsinki and Uusimaa at that time. Written informed consent was obtained from all participants. All study data were analyzed anonymized without personal information by which the participants could be identified.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"199"}}