{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T16:30:19Z","timestamp":1775665819968,"version":"3.50.1"},"reference-count":68,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T00:00:00Z","timestamp":1724630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Brazilian National Council for Scientific and Technological Development","award":["302602\/2021-6"],"award-info":[{"award-number":["302602\/2021-6"]}]},{"name":"Brazilian National Council for Scientific and Technological Development","award":["539\/2022"],"award-info":[{"award-number":["539\/2022"]}]},{"DOI":"10.13039\/501100005668","name":"FAPDF","doi-asserted-by":"publisher","award":["302602\/2021-6"],"award-info":[{"award-number":["302602\/2021-6"]}],"id":[{"id":"10.13039\/501100005668","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005668","name":"FAPDF","doi-asserted-by":"publisher","award":["539\/2022"],"award-info":[{"award-number":["539\/2022"]}],"id":[{"id":"10.13039\/501100005668","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>This multicenter study aims to assess the impact of public policies (PPs) on the health-related quality of life (HRQoL) of individuals with celiac disease (CD) using the Celiac Disease Questionnaire (CDQ) and PPs for Celiac Disease Score (PPCDS). This cross-sectional exploratory study was conducted in four stages: first, standardizing data from countries using the CDQ; second, analyzing PPs aimed at CD patients; third, statistically examining these data; and fourth, associating HRQoL indicators with corresponding PPs. This study analyzed 15 CDQ assessments from 12 countries from 2007 to 2023. It found that comprehensive PPs positively correlated with HRQoL outcomes (Spearman correlation of 0.358). However, policies specifically targeting gluten-free meals and certification did not significantly improve HRQoL individually, suggesting they may be more effective when implemented together. Additionally, specialized health services did not notably reduce gastrointestinal symptoms, underscoring the necessity for improved patient education to enhance the effectiveness of these services. This study concludes that implementing and rigorously monitoring regulations to support CD patients is crucial for enhancing their HRQoL.<\/jats:p>","DOI":"10.3390\/nu16172855","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T07:53:37Z","timestamp":1724658817000},"page":"2855","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["From Struggle to Strength: A Multicentric Study on How Public Policies for Celiac Disease Transform Lives"],"prefix":"10.3390","volume":"16","author":[{"given":"Ana Lu\u00edsa","family":"Falcomer","sequence":"first","affiliation":[{"name":"Department of Nutrition, School of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2752-4296","authenticated-orcid":false,"given":"Claudia B.","family":"Pratesi","sequence":"additional","affiliation":[{"name":"College of Population Health, University of New Mexico, Albuquerque, NM 87131, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9071-8512","authenticated-orcid":false,"given":"Eduardo Yoshio","family":"Nakano","sequence":"additional","affiliation":[{"name":"Department of Statistics, University of Brasilia, Brasilia 70910-900, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8103-7221","authenticated-orcid":false,"given":"Cl\u00e1udia","family":"Chaves","sequence":"additional","affiliation":[{"name":"ESSV, Centre for Studies in Education and Innovation (CI&DEI), Polytechnic University of Viseu, 3504-510 Viseu, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2495-1831","authenticated-orcid":false,"given":"Mohammad","family":"Rostami-Nejad","sequence":"additional","affiliation":[{"name":"Celiac Disease and Gluten Related Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran 1416634793, Iran"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3963-1366","authenticated-orcid":false,"given":"Morad","family":"Guennouni","sequence":"additional","affiliation":[{"name":"Science and Technology Team, Higher School of Education and Training, Chouaib Doukkali University of El Jadida, El Jadida 24000, Morocco"},{"name":"Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences of Settat, Hassan First University of Settat, Settat 26000, Morocco"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2819-3484","authenticated-orcid":false,"given":"Ay\u015feg\u00fcl","family":"Aksan","sequence":"additional","affiliation":[{"name":"Institute of Nutritional Science, Justus-Liebig University, 35392 Giessen, Germany"}]},{"given":"Jacques","family":"Pouchot","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne, H\u00f4pital Europ\u00e9en Georges Pompidou, Assistance Publique\u2013H\u00f4pitaux de Paris, Universit\u00e9 Paris Cit\u00e9, 75015 Paris, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3742-729X","authenticated-orcid":false,"given":"Winfried","family":"H\u00e4user","sequence":"additional","affiliation":[{"name":"Medizinisches Versorgungszentrum f\u00fcr Schmerzmedizin und Seelische Gesundheit Saarbr\u00fccken\u2014St. Johann Health Care Center Pain Medicine and Mental Health Saarbr\u00fccken, St. Johann Gro\u00dfherzog-Friedrich-Stra\u00dfe 44, 66111 Saarbr\u00fccken, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0370-3089","authenticated-orcid":false,"given":"Renata Puppin","family":"Zandonadi","sequence":"additional","affiliation":[{"name":"Department of Nutrition, School of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,26]]},"reference":[{"key":"ref_1","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_2","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1159\/000347180","article-title":"Gluten-free diet in gluten-related disorders","volume":"31","author":"Mulder","year":"2013","journal-title":"Dig. 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