{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T05:37:58Z","timestamp":1780551478959,"version":"3.54.1"},"reference-count":33,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T00:00:00Z","timestamp":1622073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The COVID-19 pandemic has been present for many months, influencing diets such as the gluten-free diet (GFD), which implies daily challenges even in non-pandemic conditions. Persons following the GFD were invited to answer online ad hoc and validated questionnaires characterizing self-perceptions of the pandemic, current clinical condition, dietary characteristics, adherence to GFD, anxiety, and depression. Of 331 participants, 87% experienced shortage and higher cost of food and 14.8% lost their jobs. Symptoms increased in 29% and 36.6% failed to obtain medical help. Although 52.3% increased food preparation at home and purchased alternative foodstuffs, 53.8% had consumed gluten-containing foods. The Health Eating Index was intermediate\/\u201cneeds improvement\u201d (mean 65.6 \u00b1 13.3 points); in 49.9% (perception) and 44.4% (questionnaire), adherence was \u201cbad\u201d. Anxiety and depression scores were above the cutoff in 28% and 40.4%, respectively. Adherence and mental health were strongly related. The likelihood of poor adherence was 2.3 times higher (p &lt; 0.004) in participants declaring that pandemic altered GFD. Those suffering depressive symptoms were 1.3 times more likely to have poor adherence (p &lt; 0.000). Depression and faulty GFD (mandatory for treatment) appear, affecting a high proportion of participants, suggesting that support measures aimed at these aspects would help improve the health condition of people that maintain GFD. Comparisons of data currently appearing in the literature available should be cautious because not only cultural aspects but conditions and timing of data collection are most variable.<\/jats:p>","DOI":"10.3390\/nu13061822","type":"journal-article","created":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T11:07:02Z","timestamp":1622113622000},"page":"1822","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Pandemic Effects and Gluten-Free Diet: An Adherence and Mental Health Problem"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3759-2121","authenticated-orcid":false,"given":"Karla A.","family":"Bascu\u00f1\u00e1n","sequence":"first","affiliation":[{"name":"Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago 7810000, Chile"},{"name":"Department of Nutrition, Faculty of Medicine, University of Chile, Santiago 8380453, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Manuel","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago 7810000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Osben","sequence":"additional","affiliation":[{"name":"Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago 7810000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago 7810000, Chile"},{"name":"Department of Nutrition, Faculty of Medicine, University of Chile, Santiago 8380453, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7708-9002","authenticated-orcid":false,"given":"Carlos","family":"Sep\u00falveda","sequence":"additional","affiliation":[{"name":"Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago 7810000, Chile"},{"name":"Laboratorio de Ciencias del Ejercicio, Cl\u00ednica Meds, Santiago 7500000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Araya","sequence":"additional","affiliation":[{"name":"Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago 7810000, Chile"},{"name":"Corporaci\u00f3n de Apoyo al Cel\u00edaco (COACEL), Santiago 7810000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,27]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Role of adjunctive treatment strategies in COVID-19 and a review of international and national clinical guidelines","volume":"7","author":"Xu","year":"2020","journal-title":"Mil. 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