{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T22:00:58Z","timestamp":1789682458763,"version":"4.0.1"},"reference-count":36,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"GLUTEN3S research group","award":["GIU21\/053"],"award-info":[{"award-number":["GIU21\/053"]}]},{"name":"GLUTEN3S research group","award":["I+D+iPID2021-125695OA-I00"],"award-info":[{"award-number":["I+D+iPID2021-125695OA-I00"]}]},{"name":"GLUTEN3S research group","award":["US22\/22"],"award-info":[{"award-number":["US22\/22"]}]},{"name":"MCIN\/AEI\/10.13039\/501100011033","award":["GIU21\/053"],"award-info":[{"award-number":["GIU21\/053"]}]},{"name":"MCIN\/AEI\/10.13039\/501100011033","award":["I+D+iPID2021-125695OA-I00"],"award-info":[{"award-number":["I+D+iPID2021-125695OA-I00"]}]},{"name":"MCIN\/AEI\/10.13039\/501100011033","award":["US22\/22"],"award-info":[{"award-number":["US22\/22"]}]},{"name":"UPV\/EHU","award":["GIU21\/053"],"award-info":[{"award-number":["GIU21\/053"]}]},{"name":"UPV\/EHU","award":["I+D+iPID2021-125695OA-I00"],"award-info":[{"award-number":["I+D+iPID2021-125695OA-I00"]}]},{"name":"UPV\/EHU","award":["US22\/22"],"award-info":[{"award-number":["US22\/22"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Diet is the only treatment for celiac disease (CeD), and good adherence to a gluten-free diet (GFD) is the only way to ensure complete remission and to prevent complications. Limited education about the disease and a GFD is an attributing factor to inadequate adherence. Thus, our aim was to assess the current knowledge about a GFD and the clinical monitoring of adherence to the diet among CeD people and HCPs. Specific questionnaires were designed and distributed to assess the knowledge of CeD people (Q1 questionnaire) (n = 2437) and to analyze the follow-up of the disease from the perspective of patients (Q2 questionnaire) (n = 1294) and HCPs (Q3 questionnaire) (n = 346). Two-thirds of HCPs specialized in pediatric care, while one-third did so in adult care. In CeD people, general questions regarding food classification and cross-contamination are well understood. When patients have doubts, 51.4% reported using the Internet and social networks. Thus, it is crucial that resources like social media are reliable and provide valuable information. Q3 revealed the lack of time to follow up the diet after diagnosis (48% of HCPs allocate &lt; 15 min), the interest in further training, and the need for a professional specialized in diets within the healthcare system. In conclusion, it is essential to enhance nutritional education to increase awareness of a GFD.<\/jats:p>","DOI":"10.3390\/nu16152512","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T11:34:20Z","timestamp":1722512060000},"page":"2512","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Knowledge Gaps in Gluten-Free Diet Awareness among Patients and Healthcare Professionals: A Call for Enhanced Nutritional Education"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3180-9024","authenticated-orcid":false,"given":"Paula","family":"Crespo-Escobar","sequence":"first","affiliation":[{"name":"i+HeALTH Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC), 47012 Valladolid, Spain"},{"name":"Department of Nutrition and Obesity, Hospital Recoletas Campo Grande, 47007 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2410-3832","authenticated-orcid":false,"given":"Maialen","family":"V\u00e1zquez-Polo","sequence":"additional","affiliation":[{"name":"GLUTEN3S Research Group, Department of Nutrition and Food Science, University of the Basque Country, UPV\/EHU, 01006 Vitoria-Gasteiz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2616-2459","authenticated-orcid":false,"given":"Maria","family":"van der Hofstadt","sequence":"additional","affiliation":[{"name":"ALINUA, Food and Nutrition Cabinet Health Science Faculty, University of Alicante, UA, 03690 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9489-1603","authenticated-orcid":false,"given":"Concepci\u00f3n","family":"Nu\u00f1ez","sequence":"additional","affiliation":[{"name":"Laboratorio de Investigaci\u00f3n en Gen\u00e9tica de Enfermedades Complejas, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7676-9842","authenticated-orcid":false,"given":"Miguel A.","family":"Montoro-Huguet","sequence":"additional","affiliation":[{"name":"Gastroenterology, Hepatology and Nutrition Unit, University Hospital San Jorge, 22004 Huesca, Spain"},{"name":"Department of Medicine, Faculty of Health and Sport Sciences, University of Zaragoza, 22002 Huesca, Spain"},{"name":"Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3771-3963","authenticated-orcid":false,"given":"Itziar","family":"Churruca","sequence":"additional","affiliation":[{"name":"GLUTEN3S Research Group, Department of Nutrition and Food Science, University of the Basque Country, UPV\/EHU, 01006 Vitoria-Gasteiz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8248-2506","authenticated-orcid":false,"given":"Edurne","family":"Sim\u00f3n","sequence":"additional","affiliation":[{"name":"GLUTEN3S Research Group, Department of Nutrition and Food Science, University of the Basque Country, UPV\/EHU, 01006 Vitoria-Gasteiz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/S0140-6736(17)31796-8","article-title":"Coeliac Disease","volume":"391","author":"Lebwohl","year":"2018","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/j.cgh.2017.06.037","article-title":"Global Prevalence of Celiac Disease: Systematic Review and Meta-Analysis","volume":"16","author":"Singh","year":"2018","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"59","DOI":"10.14309\/ajg.0000000000002075","article-title":"American College of Gastroenterology Guidelines Update: Diagnosis and Management of Celiac Disease","volume":"118","author":"Hill","year":"2023","journal-title":"Am. J. Gastroenterol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1111\/j.1365-2036.2009.04053.x","article-title":"Systematic Review: Adherence to a Gluten-Free Diet in Adult Patients with Coeliac Disease","volume":"30","author":"Hall","year":"2009","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1016\/j.cgh.2019.05.046","article-title":"Rate, Risk Factors, and Outcomes of Nonadherence in Pediatric Patients With Celiac Disease: A Systematic Review","volume":"18","author":"Reilly","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/011542650602100101","article-title":"Gluten-Free Diet: The Medical and Nutrition Management of Celiac Disease","volume":"21","author":"See","year":"2006","journal-title":"Nutr. Clin. Pract."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1111\/jhn.12754","article-title":"Facilitators and Barriers to Adherence to Gluten-free Diet among Adults with Celiac Disease: A Systematic Review","volume":"33","author":"Jaana","year":"2020","journal-title":"J. Hum. Nutr. Diet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1159\/000341416","article-title":"Factors Associated with Dietary Adherence in Celiac Disease: A Nationwide Study","volume":"86","author":"Kurppa","year":"2012","journal-title":"Digestion"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1007\/s10620-007-0055-3","article-title":"Factors That Influence Adherence to a Gluten-Free Diet in Adults with Celiac Disease","volume":"53","author":"Leffler","year":"2008","journal-title":"Dig. Dis. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"111249","DOI":"10.1016\/j.nut.2021.111249","article-title":"Predictors of Adherence to a Gluten-Free Diet in Celiac Disease: Do Knowledge, Attitudes, Experiences, Symptoms, and Quality of Life Play a Role?","volume":"90","author":"Dimidi","year":"2021","journal-title":"Nutrition"},{"key":"ref_11","first-page":"17","article-title":"Patients\u2019 Experiences and Perceptions of Living with Coeliac Disease - Implications for Optimizing Care","volume":"21","author":"Ukkola","year":"2012","journal-title":"J. Gastrointest. Liver Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1007\/s12664-018-0895-0","article-title":"All That a Physician Should Know about Gluten-Free Diet","volume":"37","author":"Mehtab","year":"2018","journal-title":"Indian J. Gastroenterol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1097\/MPG.0000000000003019","article-title":"The Knowledge About Celiac Disease Among Healthcare Professionals and Patients in Central Europe","volume":"72","author":"Riznik","year":"2021","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1097\/SGA.0000000000000368","article-title":"Is Adherence to a Gluten-Free Diet by Adult Patients With Celiac Disease Influenced by Their Knowledge of the Gluten Content of Foods?","volume":"42","author":"Paganizza","year":"2019","journal-title":"Gastroenterol. Nurs."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1002\/jpn3.12079","article-title":"Gluten-free Diet for Pediatric Patients with Coeliac Disease: A Position Paper from the ESPGHAN Gastroenterology Committee, Special Interest Group in Coeliac Disease","volume":"78","author":"Luque","year":"2024","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Sim\u00f3n, E., Molero-Luis, M., Fueyo-D\u00edaz, R., Costas-Batlle, C., Crespo-Escobar, P., and Montoro-Huguet, M.A. (2023). The Gluten-Free Diet for Celiac Disease: Critical Insights to Better Understand Clinical Outcomes. Nutrients, 15.","DOI":"10.3390\/nu15184013"},{"key":"ref_17","unstructured":"(2024, July 08). AOECS Standard, Version 3. Available online: www.aoecs.org."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1111\/j.1365-277X.2012.01288.x","article-title":"Living with Coeliac Disease and a Gluten-free Diet: A C Anadian Perspective","volume":"26","author":"Zarkadas","year":"2013","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1016\/j.nut.2016.01.021","article-title":"Is It Gluten-Free? Relationship between Self-Reported Gluten-Free Diet Adherence and Knowledge of Gluten Content of Foods","volume":"32","author":"Silvester","year":"2016","journal-title":"Nutrition"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.appet.2011.01.026","article-title":"Measuring Beliefs about Gluten Free Diet Adherence in Adult Coeliac Disease Using the Theory of Planned Behaviour","volume":"56","author":"Sainsbury","year":"2011","journal-title":"Appetite"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"178","DOI":"10.4291\/wjgp.v13.i6.178","article-title":"Knowledge Regarding Celiac Disease among Healthcare Professionals, Patients and Their Caregivers in Turkey","volume":"13","author":"Sahin","year":"2022","journal-title":"World J. Gastrointest. Pathophysiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e330","DOI":"10.1097\/PG9.0000000000000330","article-title":"Gluten-Free Diet Knowledge and Adherence in Adolescents with Celiac Disease: A Cross-Sectional Study","volume":"4","author":"Pohoreski","year":"2023","journal-title":"JPGN Rep."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Muhammad, H., Reeves, S., Ishaq, S., Mayberry, J., and Jeanes, Y. (2017). Adherence to a Gluten Free Diet Is Associated with Receiving Gluten Free Foods on Prescription and Understanding Food Labelling. Nutrients, 9.","DOI":"10.3390\/nu9070705"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"751","DOI":"10.15537\/smj.2015.6.11519","article-title":"Assessment of Knowledge of Celiac Disease among Health Care Professionals","volume":"36","author":"Assiri","year":"2015","journal-title":"SMJ"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/s12664-019-00958-3","article-title":"Celiac Disease: What the Indian Pediatricians Know about the Disease","volume":"38","author":"Malik","year":"2019","journal-title":"Indian J. Gastroenterol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1007\/s11606-005-0111-7","article-title":"Physician Awareness of Celiac Disease: A Need for Further Education","volume":"20","author":"Zipser","year":"2005","journal-title":"J. Gen. Intern. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"99","DOI":"10.4103\/sjg.SJG_495_19","article-title":"Social Media Usage Pattern and Its Influencing Factors among Celiac Patients and Their Families","volume":"26","year":"2020","journal-title":"Saudi J. Gastroenterol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"V\u00e1zquez-Polo, M., Navarro, V., Larretxi, I., Perez-Junkera, G., Lasa, A., Matias, S., Simon, E., and Churruca, I. (2023). Uncovering the Concerns and Needs of Individuals with Celiac Disease: A Cross-Sectional Study. Nutrients, 15.","DOI":"10.3390\/nu15173681"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"240","DOI":"10.3109\/17538157.2014.907806","article-title":"Parental Knowledge of Coeliac Disease","volume":"40","author":"Tomlin","year":"2015","journal-title":"Inform. Health Soc. Care"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"278","DOI":"10.14306\/renhyd.24.3.1059","article-title":"Situaci\u00f3n Del Dietista-Nutricionista En El Sistema Nacional de Salud Espa\u00f1ol: Documento de Posicionamiento Del Grupo de Especializaci\u00f3n En Nutrici\u00f3n Cl\u00ednica y Diet\u00e9tica de La Academia Espa\u00f1ola de Nutrici\u00f3n y Diet\u00e9tica","volume":"24","year":"2020","journal-title":"Rev. Esp. Nutr. Hum. Diet"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Akbari Namvar, Z., Mahdavi, R., Shirmohammadi, M., and Nikniaz, Z. (2022). The Effect of Group-Based Education on Gastrointestinal Symptoms and Quality of Life in Patients with Celiac Disease: Randomized Controlled Clinical Trial. BMC Gastroenterol., 22.","DOI":"10.1186\/s12876-022-02096-1"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"8850594","DOI":"10.1155\/2020\/8850594","article-title":"Educational Intervention Improved Parental Knowledge, Attitudes, and Practices (KAP) and Adherence of Patients with Celiac Disease to Gluten-Free Diet","volume":"2020","author":"Elsahoryi","year":"2020","journal-title":"Int. J. Food Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.jpeds.2017.02.062","article-title":"Text Message Intervention (TEACH) Improves Quality of Life and Patient Activation in Celiac Disease: A Randomized Clinical Trial","volume":"185","author":"Haas","year":"2017","journal-title":"J. Pediatr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1038\/ajg.2013.47","article-title":"A Randomized Controlled Trial of an Online Intervention to Improve Gluten-Free Diet Adherence in Celiac Disease","volume":"108","author":"Sainsbury","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_35","first-page":"8027532","article-title":"Smartphone Application for Celiac Patients: Assessing Its Effect on Gastrointestinal Symptoms in a Randomized Controlled Clinical Trial","volume":"2022","author":"Nikniaz","year":"2022","journal-title":"Int. J. Telemed. Appl."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1111\/pedi.12815","article-title":"Online Education for Gluten-free Diet Teaching: Development and Usability Testing of an E-learning Module for Children with Concurrent Celiac Disease and Type 1 Diabetes","volume":"20","author":"Connan","year":"2019","journal-title":"Pediatr. Diabetes"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/15\/2512\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:27:59Z","timestamp":1760110079000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/15\/2512"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,1]]},"references-count":36,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["nu16152512"],"URL":"https:\/\/doi.org\/10.3390\/nu16152512","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,1]]}}}