{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:22:46Z","timestamp":1791872566907,"version":"4.3.4"},"reference-count":60,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T00:00:00Z","timestamp":1720656000000},"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>This cross-sectional study aimed to estimate the relationship between food insecurity (FI) and health-related quality of life (HRQoL) in patients with celiac disease (CD) and assess whether this relationship is mediated or moderated by adherence to the gluten-free diet (GFD). The results of 1162 samples of patients diagnosed with CD showed that 8.3% of individuals who have a combined score of less than 13 exhibited excellent or very good adherence to the GFD. Furthermore, moderate and fair to poor adherence to the GFD was demonstrated, respectively and 71.9% of the patients had poor HRQoL levels. A significant and moderate positive correlation between FI and GFD adherence (r = 0.489) was found, indicating that 24% of the variance in FI is shared with GFD adherence. The patients\u2019 gender, marital status, and monthly income made statistically significant contributions to the prediction (p &lt; 0.05). Females had significantly lower HRQoL scores than males (B = \u22124.619, 95% CL: \u22126.08, \u22123.16) after holding all other variables constant. In conclusion, FI is mediated by GFD adherence to HRQoL. Moreover, a significant total effect relation was found between HRQoL and both FI and GFD adherence, suggesting that lowering symptoms and complications associated with CD may reduce the impact of FI on HRQoL.<\/jats:p>","DOI":"10.3390\/nu16142229","type":"journal-article","created":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T11:30:55Z","timestamp":1720697455000},"page":"2229","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Adherence to the Gluten-Free Diet Role as a Mediating and Moderating of the Relationship between Food Insecurity and Health-Related Quality of Life in Adults with Celiac Disease: Cross-Sectional Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Nour Amin","family":"Elsahoryi","sequence":"first","affiliation":[{"name":"Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman 11196, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7319-2056","authenticated-orcid":false,"given":"Mohammed Omar","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Technology, Faculty of Agriculture, Mutah University, Karak 61710, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0082-3843","authenticated-orcid":false,"given":"Omar Amin","family":"Alhaj","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman 11196, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Scherf, K.A., Catassi, C., Chirdo, F., Ciclitira, P.J., Feighery, C., Gianfrani, C., Koning, F., Lundin, K.E.A., Schuppan, D., and Smulders, M.J.M. 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